Table of Contents
Prevalence and Correlates of Symptoms of Cannabinoid Hyperemesis Syndrome in the United States.
National survey finds CHS-like symptoms affect nearly 1 in 5 daily cannabis users, representing millions of Americans with potential cannabinoid hyperemesis syndrome.
This survey provides the first national prevalence estimate for CHS-like symptoms outside healthcare settings, suggesting the condition affects approximately 1 in 6 daily cannabis users. The finding that over 40 million Americans use cannabis daily establishes the population at risk for developing CHS.
With cannabis legalization expanding and daily use becoming more common, clinicians need to recognize CHS as a relatively frequent complication of heavy cannabis use. This prevalence data helps calibrate clinical suspicion and counseling conversations about cannabis-related health risks.
| Study Type | Cross-sectional Survey |
| Population | 7,034 US adults over 18 years, nationally representative sample |
| Intervention | Survey assessment of CHS symptoms and cannabis use patterns |
| Comparator | Not applicable |
| Primary Outcome | Prevalence of CHS-like symptoms (severe nausea, vomiting, abdominal pain) among cannabis users |
| Key Finding | 17.8% of daily cannabis users reported CHS-like symptoms; 15.2% of adults reported daily cannabis use in past 5 years |
| Journal | medRxiv |
| Year | 2025 |
CHS-like symptoms appear in nearly 20% of daily cannabis users nationally, making it a clinically relevant consideration for patients with unexplained gastrointestinal symptoms and heavy cannabis use. This prevalence is substantially higher than most clinicians likely encounter in practice, suggesting significant underdiagnosis.
The study cannot establish causation between cannabis use and symptoms, nor validate that reported symptoms actually represent true CHS versus other gastrointestinal conditions. Self-reported symptoms may not meet formal diagnostic criteria for CHS.
Survey-based symptom reporting lacks clinical validation and may overestimate true CHS prevalence. The preprint status means peer review is pending, and the cross-sectional design cannot establish temporal relationships between cannabis use patterns and symptom development.
CHS appears to be a common complication of daily cannabis use, affecting millions of Americans, though survey-reported symptoms require clinical validation. Clinicians should maintain heightened awareness for CHS in patients with heavy cannabis use and gastrointestinal symptoms.
Join the Conversation
Have a question about how this applies to your situation? Ask Dr. Caplan →
Want to discuss this topic with other patients and caregivers? Join the forum discussion →
Have thoughts on this? Share it:
FAQ
FAQ
How common is Cannabinoid Hyperemesis Syndrome among cannabis users?
According to this national survey, 17.8% of daily cannabis users report CHS-like symptoms including severe nausea, vomiting, or abdominal pain. With over 40 million Americans using cannabis daily in the past 5 years (15.2% of US adults), this represents a significant population at risk for CHS.
Who is most at risk for developing CHS symptoms?
CHS symptoms are associated with heavy, daily cannabis use patterns. The study specifically examined those who used cannabis daily over a 5-year period, suggesting that chronic, frequent use is the primary risk factor for developing CHS-like symptoms.
What are the main symptoms of CHS that patients should watch for?
The key symptoms of CHS include persistent and severe nausea, vomiting, and abdominal pain. These symptoms are distinguishing features that differentiate CHS from other cannabis-related effects and typically occur in individuals with heavy cannabis use patterns.
How should clinicians approach suspected CHS in their practice?
Given that nearly 1 in 5 daily cannabis users may experience CHS-like symptoms, clinicians should routinely screen for cannabis use patterns when evaluating patients with unexplained nausea and vomiting. A detailed cannabis use history is essential for identifying potential CHS cases that might otherwise be misdiagnosed.
Is CHS underdiagnosed in clinical practice?
This study suggests CHS may be significantly underdiagnosed, as it represents the first national prevalence data outside of healthcare settings. The high prevalence found in this community-based survey indicates many cases may not be reaching clinical attention or may be misdiagnosed as other gastrointestinal conditions.
