As cannabis use becomes increasingly common (both recreationally and medically), healthcare providers are observing a rise in a rare but serious condition known as Cannabis Hyperemesis Syndrome (CHS). Reported cases, including deaths, underscore the importance of recognizing this condition, particularly in people who use cannabis daily over extended periods.

What is Cannabis Hyperemesis Syndrome?

CHS was first described in 2004 in a series of case reports involving chronic cannabis users experiencing recurrent nausea, vomiting, and diffuse abdominal pain. A hallmark symptom is a compulsive need to take hot showers or baths to temporarily relieve discomfort. Notably, symptoms disappear completely when cannabis use stops but recur if cannabis consumption resumes.

Because CHS is cyclical and not widely recognized, patients often present repeatedly to emergency departments, undergoing costly and sometimes unnecessary tests. Misdiagnoses, such as psychogenic vomiting, bulimia, or cyclic vomiting syndrome, are not uncommon.

The Three Phases of CHS

CHS is typically divided into three phases:

Prodromal Phase

• Occurs months to years before acute symptoms.
• Symptoms include mild morning sickness, abdominal discomfort, and fear of vomiting.
• Patients maintain normal eating habits and may even increase cannabis use in an attempt to relieve discomfort.
• Hot showers are usually not yet needed.

Hyperemetic (Acute) Phase

• Lasts 24–48 hours, sometimes extending to 7–10 days.
• Severe, relentless vomiting can occur up to 5 times per hour, often resistant to standard antiemetics.
• Mild, diffuse abdominal pain, dehydration, and even acute renal failure can develop.
• Patients exhibit compulsive hot showers, sometimes causing burns due to high temperatures.
• Appetite decreases, and weight loss is common.
• Emergency department visits often result in negative investigations (imaging, endoscopies).

Recovery Phase

• Begins when cannabis use is stopped.
• Symptoms typically resolve within 7–10 days.
• Normal eating patterns return, and the urge for hot showers disappears.
• Symptoms will recur if cannabis use resumes.

Treatment Approaches

The most effective symptomatic relief during the acute phase is hot showers or baths. Other supportive measures include intravenous fluids and electrolyte correction. Conventional antiemetics are usually ineffective.

If you have severe or ongoing vomiting, or signs of dehydration, see a doctor or go to the emergency department. A medical professional can assess you and recommend the right treatment.

Key Patient Advice

• Complete cessation of cannabis is the only effective method to prevent symptom recurrence.
• Symptoms usually resolve spontaneously within 7–10 days after stopping cannabis.
• Supportive therapies such as cognitive behavioural therapy and motivational interviewing can assist with cannabis withdrawal.

Additional Notes

• CHS is most commonly linked to inhaled cannabis, but cases have been reported with vaporized cannabis, oils, waxes, and synthetic cannabinoids.
• Healthcare professionals can find more information in Health Canada’s document summarizing the therapeutic uses and risks of cannabis and cannabinoids.

Stay Connected with Orleans Family Health Clinic!

If you found this article helpful, don’t forget to like, share, and Follow to stay up to date on our latest health tips, updates, and wellness advice.

And follow us on social media

• Facebook
• Instagram

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.