What Emergency Nurses Need to Know About Cannabinoid Hyperemesis Syndrome | Research

The takeaway

This nursing guide describes cannabinoid hyperemesis syndrome, a condition of severe nausea and vomiting in regular cannabis users that responds to hot bathing and cannabis cessation but not to standard antiemetics.

Cannabis users who experience unexplained cyclical vomiting, or anyone interested in lesser-known risks of regular cannabis use.

CHS resolves completely when cannabis use stops

What the researchers found

This article reviewed cannabinoid hyperemesis syndrome (CHS), a condition first described in 2004 that causes severe, recurring nausea and vomiting in people who regularly use cannabis.

Key features of CHS include cyclical episodes of intense nausea and vomiting, temporary relief from hot water bathing (a distinctive hallmark), failure to respond to conventional antiemetic medications, and complete resolution when cannabis use stops.

The article noted that CHS is underrecognized in emergency settings, partly because the association between cannabis use and vomiting seems paradoxical, given that cannabis is often used to treat nausea.

Why it matters

CHS can lead to repeated emergency department visits and unnecessary diagnostic testing when clinicians are unaware of the condition. Recognition by emergency nurses can lead to faster diagnosis, appropriate treatment, and patient education about the need to stop cannabis use.

The numbers in context

No specific prevalence data were presented. The article focused on clinical presentation, diagnostic criteria, and management strategies.

How the study worked

This was a clinical review article published in a nursing journal that examined the existing literature on cannabinoid hyperemesis syndrome and included a case study illustrating patient management.

What this study cannot tell us

This was a brief clinical review, not a systematic review or original research. The pathophysiology of CHS remains poorly understood. The article was written for a nursing audience and provides a clinical overview rather than in-depth mechanistic analysis.

How to read the evidence

This is a clinical review article aimed at nursing professionals. It summarizes existing knowledge but does not present new research data.

When this study was published

Published in 2015. Awareness and diagnosis of cannabinoid hyperemesis syndrome have increased substantially since then.

The bigger picture

As cannabis use has become more widespread, reports of cannabinoid hyperemesis syndrome have increased. The condition highlights that cannabis is not without risks, even in the area of gastrointestinal function where it is often considered helpful.

Questions still open

Why does hot bathing relieve CHS symptoms? What determines which regular cannabis users develop CHS and which do not? Is there a dose or duration threshold for CHS risk?

Common questions

How can cannabis cause vomiting when it is used to treat nausea?

The paradox remains partially unexplained. One theory involves the different effects of cannabinoids on the brain (anti-nausea) versus the gut (potentially pro-nausea at certain receptor thresholds). Chronic heavy use may tip the balance toward gastrointestinal distress in susceptible individuals.

Why does hot water help with cannabinoid hyperemesis?

The exact mechanism is unclear. One hypothesis involves the TRPV1 receptor, which responds to both heat and capsaicin and interacts with the endocannabinoid system. Hot water may activate this receptor pathway in a way that temporarily overrides the nausea signals.

Read the original research

Diagnosing and treating cannabinoid hyperemesis.

Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association, 23(8), 22-5

View on PubMed ↗Publisher’s paper ↗

Citation

Wilson, Olivia; Lutton, Stuart; Doherty, Kelly. (2015). Diagnosing and treating cannabinoid hyperemesis.. Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association, 23(8), 22-5. https://doi.org/10.7748/en.23.8.22.s25