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A mysterious cannabis disorder that causes extreme vomiting has received official recognition from global health authorities, marking a crucial development as cases surge across the United States.
The World Health Organization (WHO) formally added cannabis hyperemesis syndrome (CHS) to its diagnostic manual in October, assigning the condition its own specific code. This update, now adopted by the Centers for Disease Control and Prevention, enables physicians nationwide to properly identify, track and study the disorder rather than categorizing it under broader gastrointestinal conditions.
CHS is characterized by severe nausea, repeated vomiting, abdominal pain, dehydration, and weight loss, according to the National Institutes of Health. In rare cases, it can lead to heart rhythm problems, seizures, kidney failure, and even death. Many patients experience a particularly distressing symptom known as “scromiting” — simultaneously screaming and vomiting due to extreme pain.
“A new code for cannabis hyperemesis syndrome will supply important hard evidence on cannabis-adverse events, which physicians tell us is a growing problem,” said Beatriz Carlini, a research associate professor at the University of Washington School of Medicine who studies the adverse health effects of cannabis.
Prior to this designation, doctors struggled to diagnose CHS because its symptoms closely resemble food poisoning or stomach flu. Many patients have endured months or even years without answers, often undergoing unnecessary medical procedures and hospital visits.
A recent study published in JAMA Network Open revealed that emergency room visits for CHS increased approximately 650% from 2016 to their peak during the COVID-19 pandemic, particularly among 18-to-35-year-olds. Researchers suggest that pandemic-related isolation, stress, and increased access to high-potency cannabis products likely contributed to this dramatic rise.
The study also noted a significant increase in THC potency in cannabis products over time. Today’s products frequently contain more than 20% THC, compared to around 5% in the 1990s. This potency shift may be a key factor in the syndrome’s growing prevalence.
“In my opinion, and the research also supports this, the increased rates of CHS are absolutely linked to high-potency cannabis — often products are over 90% THC,” said John Puls, a Florida-based psychotherapist and nationally certified addiction specialist. He added that the most common misconception about CHS is that it is not a real condition, which is why the new diagnosis code represents “a significant step in the right direction.”
Despite increasing recognition, the underlying cause of CHS remains unclear. One theory suggests that heavy, long-term cannabis use overstimulates the body’s cannabinoid system, triggering the opposite of marijuana’s usual anti-nausea effect. “Although cannabis can be used to treat nausea, those products are typically much lower dose THC — usually less than 5%,” Puls explained.
A distinctive feature of CHS is that sufferers often find temporary relief only by taking long, hot showers—a phenomenon that scientists still don’t fully understand. Standard anti-nausea medications rarely help these patients, forcing doctors to consider stronger drugs or alternative treatments like capsaicin cream, which mimics the warming relief many patients get from hot showers.
The condition’s intermittent nature adds to the challenge of diagnosis. Users may experience a bout of illness, assume it was an isolated incident, and continue using cannabis without problems before suddenly becoming violently ill again.
“Some people say they’ve used cannabis without a problem for decades,” said Dr. Chris Buresh, an emergency medicine specialist with UW Medicine. “But even small amounts can make these people start throwing up.”
Complete cessation of cannabis use appears to be the only definitive treatment, according to the Cleveland Clinic and NIH. However, experts note that many people resist the diagnosis, and even those who accept it often struggle to quit due to addiction.
Public health experts anticipate that the new WHO diagnostic code will significantly improve surveillance and help physicians identify trends, particularly as cannabis legalization expands and high-potency products become increasingly available in the marketplace.
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18 Comments
The fact that CHS can lead to such severe outcomes like heart problems, seizures, and even death is quite alarming. Proper diagnosis and medical care for this condition seems absolutely critical.
Definitely. With the potential for life-threatening complications, raising awareness among both patients and healthcare providers is essential.
Cannabis legalization has expanded access, but it’s crucial we also study potential negative health impacts. This syndrome sounds quite serious and I’m glad the WHO is officially recognizing it now.
Yes, a balanced approach is needed – acknowledging both the benefits and risks of cannabis use. Proper medical classification is an important first step.
While the legalization of cannabis has brought benefits, it’s important we don’t ignore the potential downsides. This new CHS classification highlights the need for a nuanced, science-based approach to cannabis policy.
Well said. A balanced, evidence-driven perspective that considers both the upsides and risks of cannabis use is essential as the landscape continues to evolve.
As cannabis use becomes more mainstream, it’s important that we continue to study and monitor any potential negative health impacts. This new WHO classification for CHS is an important step in that direction.
Agreed. Maintaining a balanced, evidence-based perspective on the health effects of cannabis will be crucial as legalization and use continue to expand.
The rising ER cases of CHS is a concerning trend. I hope this new WHO classification will spur more research funding and clinical trials to develop better prevention and treatment strategies.
Yes, increased research and medical attention is critical, especially given the potentially life-threatening nature of CHS. Early intervention could make a big difference.
This is a concerning development. Severe vomiting and other dangerous symptoms linked to cannabis use are certainly worth investigating further. I hope this new classification leads to a better understanding and treatment of this condition.
Agreed. Tracking and studying CHS more closely will be important to raise awareness and improve patient care.
I’m glad to see the WHO formally recognizing CHS as a distinct condition. This should help drive more focused research and better clinical management of this serious cannabis-related disorder.
Agreed. Proper medical classification is an important first step toward developing effective prevention and treatment protocols for CHS.
It’s interesting that the ‘scromiting’ symptom has been identified – the simultaneous screaming and vomiting. That must be an incredibly distressing experience for those affected. I hope further research can shed light on the underlying mechanisms behind this.
Absolutely, the scromiting symptom sounds extremely painful and disturbing. Better understanding the neurobiology behind it could lead to more effective treatments.
I’m curious to learn more about the underlying causes and risk factors for CHS. Does it tend to affect certain populations or user groups more than others? And what treatment options are available?
Good questions. Identifying the root causes and demographics most impacted will be key to developing effective interventions and prevention strategies.