A recent study has revealed a concerning increase in cases of cannabinoid hyperemesis syndrome (CHS) in the United States, particularly among younger adults. Researchers at the University of Illinois Chicago examined emergency department visits from 2016 to 2022 and found a notable rise in instances of this condition, which is characterized by severe and persistent vomiting.
CHS has become a significant health issue, prompting calls for greater awareness among healthcare providers. According to James Swartz, lead author of the study, “Cannabinoid hyperemesis syndrome is real, and it’s becoming a more routine part of emergency medicine in the U.S.”
Understanding Cannabinoid Hyperemesis Syndrome
Individuals suffering from CHS experience cyclical episodes marked by intense abdominal cramps, nausea, and vomiting. These acute episodes can last from one to two days and can be so severe that affected individuals may scream in pain—a phenomenon that has been colloquially dubbed “scromiting.”
Typically, CHS occurs in those who have used cannabis chronically for several years. While the exact cause remains unclear, researchers suggest that it may be linked to the overstimulation of cannabinoid receptors in the gastrointestinal tract. The rise in cases appears to correlate with the increasing legalization of cannabis across various states in the U.S.
The study analyzed data from approximately 100,000 suspected CHS cases documented during the specified timeframe. Prior to the COVID-19 pandemic, the annual rates of CHS remained stable. However, starting in 2020, emergency room visits for suspected CHS surged. Although there was a decline in 2022, the number of cases remained above pre-pandemic levels. Importantly, general cannabis-related health issues also escalated during this period, while cases of cyclical vomiting syndrome without cannabis association did not, further indicating a genuine increase in CHS instances.
Factors Contributing to the Increase
The timing of the surge suggests that the COVID-19 pandemic may have played a significant role in the rise of CHS cases, as increased stress, isolation, and cannabis use during this period likely contributed. Researchers noted, “The COVID-19 pandemic likely catalyzed the rise in CHS through stress, isolation, and increased cannabis use.”
While cases peaked in 2021, they plateaued above pre-pandemic levels, suggesting that structural or clinical factors may be sustaining this trend.
Despite the alarming rise in CHS cases, the authors emphasize that it remains a relatively rare side effect of cannabis use. Effective management and treatment options are available. For instance, hot baths or showers can provide temporary relief during acute episodes. The only definitive method to prevent CHS episodes is to cease cannabis use entirely. It may take weeks for symptoms to resolve, but they will eventually subside.
Earlier this year, CHS was officially included in the latest edition of the International Classification of Diseases (ICD), which standardizes diagnostic codes globally. This inclusion aims to facilitate better diagnosis and tracking of the condition.
The researchers stress the necessity for greater clinical awareness to prevent frequent misdiagnoses and unnecessary medical tests. “Given frequent misdiagnosis and costly, unnecessary testing, greater clinical awareness is needed,” the authors stated.
More research is essential to determine the specific causes of CHS and why only certain long-term cannabis users develop the condition. As cannabis use continues to rise, understanding its potential risks becomes increasingly important for public health.
