Unveiling the Rise of Cannabis Hyperemesis Syndrome: Essential Symptoms and Warning Signs to Know

The legalization of marijuana has been on the rise in numerous states over recent years. In tandem with this trend, the federal government seems to be moving toward changing marijuana’s classification, following an executive order issued by President Trump in December.

At the same time, medical professionals nationwide have observed an increase in a distressing condition associated with prolonged marijuana use, known as cannabinoid hyperemesis syndrome (CHS). This condition can cause severe discomfort and, in some cases, can be debilitating.

Research conducted in 2025 highlighted that in 2016, 4.4 out of every 100,000 emergency department visits were attributed to CHS. By 2020, this figure surged to 33.1 per 100,000 visits, although it decreased to 22.3 per 100,000 by 2022.

Emergency departments in Virginia have noted an almost 29% increase in CHS cases since 2020. Similar trends have been observed in Massachusetts, Northern California, and areas of North Carolina. In June, a representative from Duke Regional Hospital in Durham, North Carolina, mentioned that CHS patients are encountered “every week, if not every day.”

Another study suggests more than 2.75 million Americans may have CHS symptoms.

What is cannabinoid hyperemesis syndrome?

First reported in Australia more than 20 years ago, cannabinoid hyperemesis (or “excessive vomiting“) syndrome is a condition that causes recurring bouts of severe stomach pain, nausea, and vomiting in some long-time chronic cannabis users.

The World Health Organization added CHS to its diagnostic manual in October. The designation makes it easier for health care providers to report the specific diagnosis for patients, rather than an overview of their symptoms.

Patients may be misdiagnosed as having another condition, like cyclic vomiting syndrome, according to a 2025 study. An increase in correct diagnoses of CHS may be linked to the rise in cases in recent years, researchers noted.

While it’s not clear how marijuana use causes CHS, Cedars Sinai said it may be brought on by receptors in the brain no longer responding to marijuana as they had before.

Who has developed cases of cannabinoid hyperemesis syndrome?

A George Washington University study of more than 1,000 people who reported experiencing CHS found that over 40% said they used marijuana more than five times a day. Roughly the same proportion of people said they had regularly used marijuana for more than five years before experiencing CHS.

A study out of Massachusetts found that younger adults, ages 18 to 34, could be at a higher risk of experiencing CHS, as could Hispanic and Black individuals. A similar 2025 study of nationwide data found CHS was most common among those ages 16 to 34 and corresponded with heavier cannabis use. The same study found CHS was “notably more prevalent in the South,” but that those who reported the highest rates of cannabis use were in states that have legalized recreational cannabis, which are primarily in other regions.

What’s more difficult is that health experts haven’t yet determined why the reaction to cannabis changes for some people over time.

“Some people say they’ve used cannabis without a problem for decades. Or they smoke pot because they think it treats their nausea,” Dr. Chris Buresh, an emergency medicine specialist with UW Medicine and Seattle Children’s, said in November. “It seems like there’s a threshold when people can become vulnerable to this condition, and that threshold is different for everyone. Even using in small amounts can make these people start throwing up.”

It’s also possible that a chronic user never develops CHS, health experts say, while other patients reported experiencing the condition after only a few years of marijuana use.

What are ‘scromiting,’ other symptoms of CHS?

Symptoms tend to set in after 10 to 12 years of chronic marijuana use, according to Cedars Sinai and the Cleveland Clinic. CHS can occur in three phases: prodromal, hyperemetic, and recovery.

During the first, which “may last for months or years,” patients can experience belly pain and nausea in the morning. This may lead to increased marijuana use, as it is often used to treat such symptoms.

In the hyperemetic phase, symptoms can become worse and progress to vomiting that is “overwhelming” and “recurrent,” lasting about a day or two. Patients may feel the need to bathe frequently, as hot water has been known to ease their nausea.

Some have referred to a combination of CHS symptoms seen during these bouts – screaming, due to the intense pain, and vomiting – as “scromiting.”

“Every morning, I’d wake up, and I’d have to throw up. I couldn’t eat. I couldn’t sleep. It was a complete nightmare,” Leonna Davis recounted to Nexstar’s WIAT in 2021. “My episodes would last for hours at a time. I would throw up 15 times in one, four-hour episode. I threw up for eight hours once, to the point that my throat was bleeding.”

She added that she was unable to eat solid foods, consuming only popsicles while taking a shower and drinking nutritional shakes. CHS patients may experience dehydration or electrolyte problems, according to Cedars-Sinai, which can lead to muscle spasms or weakness, seizures, kidney problems, and more.

It’s during this second phase that health experts say patients typically seek medical care.

During the final phase, recovery, symptoms fade over time before disappearing as the patient stops using any and all forms of cannabis. Symptoms are known to return if they try marijuana again, however.

What treatment options exist for cannabinoid hyperemesis syndrome?

Treating CHS can include options like an IV of fluids to prevent dehydration, medication to decrease vomiting and pain, a prescription for benzodiazepines “that help calm you down,” or “frequent hot showers,” Cedars Sinai outlines.

Davis said it was “scorching hot, boiling showers” that eased her nausea.

“It’s pretty universal for these patients to say they need a really, really hot shower, or a really hot bath, to improve their symptoms,” Dr. Sam Wang, pediatric emergency medicine specialist and toxicologist at Children’s Hospital Colorado, recently told CNN.

While the symptoms can be treated, stopping cannabis use has been the only known way to stop episodes, Andrew Meltzer, professor of emergency medicine at the George Washington School of Medicine & Health Sciences and lead author of an aforementioned study, explained last year.

If you believe you’re experiencing symptoms of CHS, health experts recommend speaking with your doctor.

Davis offered additional advice: “If you smoke weed, please be informed.”

“If you feel like you are starting to feel sick every day, in the mornings especially, and if hot showers are the only thing that helps you, please seek medical advice and mention CHS to get more information. This could kill you. People that continue to smoke have lost their lives because they were so dehydrated and didn’t seek help. I was lucky. I was able to get to the hospital in time.”

Lee Hedgepeth, formerly of Nexstar’s WIAT, contributed to this report.

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