Long-term cannabis use can trigger a condition called cannabinoid hyperemesis syndrome, marked by severe nausea, vomiting, and compulsive hot water bathing.
Read this if you use cannabis regularly and experience unexplained nausea or vomiting, or if you want to understand this underrecognized condition.
CHS is considered underrecognized and underdiagnosed in emergency departments
What the researchers found
This review described cannabinoid hyperemesis syndrome (CHS), a condition associated with long-term cannabis use characterized by cycles of severe nausea and vomiting without another identifiable cause. A distinctive feature of CHS is that patients develop compulsive hot water bathing behavior, which temporarily relieves symptoms.
Patients with CHS frequently visit emergency departments for relief but are often subjected to extensive diagnostic workups before receiving a correct diagnosis. The authors concluded that CHS is likely underrecognized and underdiagnosed, particularly in emergency settings.
Why it matters
As cannabis use has become more common, clinicians have increasingly recognized CHS as a distinct clinical entity. Awareness of this condition can help prevent unnecessary and invasive diagnostic procedures in patients whose symptoms have a straightforward explanation.
The numbers in context
No large-scale prevalence data were reported. The review synthesized findings from published case reports and small case series available through 2013.
How the study worked
The authors conducted a literature review using PubMed to identify published reports and case series describing cannabinoid hyperemesis syndrome, its clinical features, and management approaches.
What this study cannot tell us
This was a narrative review based primarily on case reports and small series, not controlled studies. The exact prevalence of CHS remained unknown at the time of publication. The mechanisms behind compulsive hot bathing behavior were not well understood.
How to read the evidence
Narrative review of case reports and small series, without systematic methodology or controlled data.
When this study was published
Published in 2013. Since then, CHS has become much more widely recognized, with larger case series and proposed diagnostic criteria published.
The bigger picture
CHS challenges the widespread perception that cannabis use carries minimal gastrointestinal risk. The condition appears to be dose and duration dependent, typically emerging after years of regular use, and it resolves only with sustained abstinence from cannabis.
Questions still open
- What is the actual prevalence of CHS among long-term cannabis users? Are certain patterns of use (frequency, potency, route) more likely to trigger the syndrome? Why does hot water bathing provide temporary relief?
Common questions
What is cannabinoid hyperemesis syndrome?
Why do people with CHS take hot baths?
Read the original research
Cannabinoid hyperemesis syndrome.
Hospital pharmacy, 48(8), 650-5
Citation
Sun, Shusen; Zimmermann, Anthony E. (2013). Cannabinoid hyperemesis syndrome.. Hospital pharmacy, 48(8), 650-5. https://doi.org/10.1310/hpj4808-650
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