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Study breakdown

How Emergency Departments Treat Cannabinoid Hyperemesis Syndrome

ReviewModerate evidence
The takeaway

This review summarizes current pharmacological and non-pharmacological treatments for cannabinoid hyperemesis syndrome in the emergency department setting.

Emergency medicine professionals, pharmacists, cannabis users experiencing cyclical vomiting, and anyone wanting to understand CHS treatment options.

What the researchers found

CHS management in the ED includes both pharmacological approaches (antiemetics, capsaicin) and non-pharmacological strategies (hot showers), with emergency pharmacists playing an increasingly important role in treatment decisions.

Why it matters

CHS is becoming more common as cannabis use rises. Patients often cycle through multiple ER visits before diagnosis, and clear treatment protocols can reduce suffering and healthcare costs.

The numbers in context

Review article — synthesizes existing evidence on CHS treatments including pharmacological and non-pharmacological approaches.

How the study worked

Review article summarizing current evidence on pharmacological and non-pharmacological therapies for cannabinoid hyperemesis syndrome (CHS) in the emergency department.

What this study cannot tell us

CHS treatment evidence is largely based on case reports and small studies. No large RCTs exist for most recommended therapies.

How to read the evidence

Review of existing treatment evidence, which is itself largely based on case reports and small studies rather than rigorous trials.

When this study was published

Recent review reflecting current clinical practices for a condition that has become significantly more common in recent years.

The bigger picture

CHS was barely recognized a decade ago and is now a routine ED diagnosis. As cannabis potency and use frequency increase, clinical awareness and standardized treatment protocols become essential.

Questions still open

  • Which pharmacological treatments are most effective for acute CHS episodes? Can we identify cannabis users at highest risk for developing CHS before it occurs?

Common questions

What is cannabinoid hyperemesis syndrome?
CHS causes cyclic vomiting and abdominal pain in people who use cannabis heavily and frequently. Symptoms are often temporarily relieved by hot showers but keep recurring until cannabis use stops.
How is CHS treated in the emergency room?
Treatment includes antiemetic medications, topical capsaicin cream, IV fluids, and sometimes benzodiazepines. Hot showers provide temporary relief. The definitive treatment is stopping cannabis use.

Read the original research

Managing cannabinoid hyperemesis syndrome in adult patients in the emergency department.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 82(24), 1340-1352

Citation

Won, Kimberly J; Celmins, Laura. (2025). Managing cannabinoid hyperemesis syndrome in adult patients in the emergency department.. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 82(24), 1340-1352. https://doi.org/10.1093/ajhp/zxaf125