Medically Reviewed by
Jason Crawford

Article Last Updated on January 18, 2023

The endocannabinoid system (ECS) is a unique nerve signaling system in our body that’s affected by the psychoactive, sedative, and anti-inflammatory cannabinoids, the two most well-known being tetrahydrocannabinol (THC) and cannabidiol (CBD). Because of the unique build of our body, but mainly the ECS, we’re able to enjoy these cannabinoids and experience their effects.

After the legalization of cannabis in a lot of US countries, especially medical marijuana which is now legal in 36 states, weed consumption has greatly increased. Some users smoke weed as a way to relax and wind down, while others consume weed as therapy for medical conditions like epilepsy, chronic pain, and also as an appetite stimulant and nausea suppressant in cancer patients.

Cannabis use can be a relaxing experience after a hard day at work, but on rare occasions, it can also take you to the emergency room with severe vomiting symptoms, and nothing can ruin a good high like throwing up. So, why does that happen and how can you avoid this side effect of smoking weed? Read on to find out.

The 411 on Cannabinoid Hyperemesis Syndrome (CHS)

Cannabinoid hyperemesis syndrome is a condition that occurs among long-term cannabis users who consume marijuana daily and presents itself as severe episodes of vomiting. So, all you newbie and first-time users have nothing to worry about, as CHS isn’t common among occasional users.

While there is no singular reason for the causes of CHS, researchers have a few theories. Because not all chronic marijuana users develop CHS, researchers are starting to believe that genetics may have something to do with it. Others believe that as a person increases their marijuana consumption and consumes marijuana for a longer period, the effects of weed may change. 

As we’ve previously mentioned, cannabis binds to the cannabinoid receptors in the body (CB1 and CB2), which regulate how marijuana affects the body. Therefore, some researchers believe that the cause of CHS in some patients is the CB1 receptor’s gastrointestinal tract. Allegedly, in people with cannabis hyperemesis syndrome, some receptors are more active and others shut down which may lead to the patient developing the symptoms of CHS. 

Since the research on CHS is ongoing and there’s no definitive answer as to why it happens,  we can expect the answer to this question in the near future. (Sorensen et al, 2017)

What Are the Symptoms of CHS?

Cannabinoid hyperemesis syndrome has 3 phases during which patients first experience the initial symptoms from which they recover. The 3 phases are as follows:

  • Prodromal phase;
  • Hyperemetic phase;
  • Recovery phase.

Prodromal Phase

The first phase is characterized by symptoms such as morning nausea and abdominal pain. During the first phase, people consume more weed in an attempt to stop nausea. Since users generally don’t experience a lot of symptoms, they continue using cannabis regularly which means that they may not know they are in this phase for months, and even years, which makes early-stage CHS difficult to diagnose.

Hyperemetic Phase

The second phase is more intense than the first one and the most common symptoms include:

  • Episodes of repeated vomiting;
  • Abdominal pain;
  • Nausea;
  • Weight loss as a result of decreased food intake;
  • Dehydration.

Because the symptoms worsen over time, a lot of people with CHS take a lot of hot showers in an attempt to relieve nausea, which can turn into compulsive bathing. Showering with hot water may help because the increased temperature affects the hypothalamus which regulates the body temperature and vomiting impulses. This phase can last until the user seeks medical care and stops using marijuana altogether, which is when the healing process can start.    

Recovery Phase

This phase is characterized by the reduction of symptoms as a result of quitting marijuana. Remember that some patients who are used to large doses of cannabis may experience cannabis withdrawal symptoms which will pass in a few weeks at most. After quitting weed, the symptoms slowly start to go away, although they do come back if the user consumes marijuana during the recovery phase.

How Is CHS Diagnosed and Treated?

There are a few methods that can help cannabis users find out whether they have CHS. To get the diagnosis, users need to talk about their marijuana use and disclose all their symptoms to their healthcare provider who may order a list of tests to check their health. Those tests may include:

  • Blood test;
  • Pregnancy test;
  • Head and abdominal CT scan;
  • Drug screen;
  • Other common tests.

Because CHD was discovered recently, a lot of doctors confuse it with cyclical vomiting disorder as both conditions have similar symptoms, but a gastroenterologist might diagnose the condition.

Treatment for cannabinoid hyperemesis syndrome may include:

  • An intravenous fluid replacement to rehydrate the body;
  • Medicine to reduce vomiting;
  • Hot showers;
  • Rubbing capsaicin cream on the stomach to reduce nausea and pain.

The symptoms tend to stop after a few days if the user quits weed. This may be harder for some patients than others depending on how much and how often they’ve used marijuana in the past. 

If left untreated, CHS may lead to:

  • Dehydration;
  • Muscle weakness;
  • Electrolyte imbalances;
  • Seizures;
  • Gastrointestinal problems;
  • Kidney failure;
  • Brain swelling (in rare cases).

How to Prevent Cannabinoid Hyperemesis Syndrome?

While weed can help with nausea in people who don’t use marijuana regularly, chronic users who have the above-mentioned symptoms need to stop consuming weed in order for the symptoms to stop. Therefore, cannabinoid hyperemesis syndrome is easily preventable because the main cause of the syndrome is smoking marijuana.

Because users have been smoking cannabis for many years without any serious health problems, they might not realize that they’ve been developing the syndrome which can take a few years to develop.

Final Thoughts on Cannabinoid Hyperemesis Syndrome

Now you know all about the cannabinoid hyperemesis syndrome, so if you’ve been experiencing some of the symptoms mentioned above and you’ve been consuming weed on a regular basis for years, it may be time to get an annual check-up and talk to your healthcare provider.

CHS is a serious condition that can lead to future health problems if left undiagnosed and untreated, but the symptoms can be over in a few days if you talk to your doctor openly, detox, and get the necessary treatment.

Additional Sources                                 

Sorensen, C. J., DeSanto, K., Borgelt, L., Phillips, K. T., & Monte, A. A. (2017). Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 13(1), 71–87. https://doi.org/10.1007/s13181-016-0595-z

A passionate advocate for the benefits of cannabis. Fraser Horton, who has a background in botany and a strong love of nature, has spent years researching how cannabis affects the body and mind. He established Leaf Nation in 2020, where he has devoted himself to educating people about the legalisation of marijuana and its safe and responsible use. Fraser is committed to highlighting cannabis’ potential for improving wellness and working to dispel the stigma associated with its use.


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