# Prevalence and Correlates of Symptoms of Cannabinoid Hyperemesis Syndrome in the United States.

> **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637)
> **Publisher:** CED Clinic (https://cedclinic.com)
> **Canonical URL:** https://cedclinic.com/cannabinoid-hyperemesis-syndrome-prevalence-daily-cannabis-users/
> **Published:** 2026-04-27T22:23:18-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T10:00:32-04:00
> **Clinical Summary:** New national survey finds cannabinoid hyperemesis syndrome prevalence affects 17.8% of daily cannabis users, representing 7 million Americans with CHS symptoms.

---

CED Clinical Relevance  #85High Clinical Relevance
Evidence Brief | CED ClinicNational survey finds CHS-like symptoms affect nearly 1 in 5 daily cannabis users, representing millions of Americans with potential [cannabinoid hyperemesis](https://cedclinic.com/cannabis-hyperemesis-syndrome-virginia-er-cases-surge/) syndrome.
ChsCannabisNauseaSurveyPrevalence

National survey finds CHS-like symptoms affect nearly 1 in 5 daily cannabis users, representing millions of Americans with potential [cannabinoid hyperemesis syndrome](https://cedclinic.com/spontaneous-pneumomediastinum-cannabinoid-hyperemesis-case-report/).

What This Study Teaches Us

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.

Why This Matters
With [cannabis legalization](https://cedclinic.com/the-forgotten-history-of-hemp-in-america/) expanding and daily use becoming more common, clinicians need to recognize CHS as a relatively frequent complication of heavy [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/). This prevalence data helps calibrate clinical suspicion and counseling conversations about cannabis-related health risks.

Study Snapshot

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](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) 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

Clinical Bottom Line
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.

What This Paper Does Not Show
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.

Where This Paper Deserves Skepticism
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.

Dr. Caplan's Take
These prevalence numbers are eye-opening and suggest CHS is far more common than I see in [clinical practice](https://cedclinic.com/cannabis-reproductive-health-women-clinical-evidence/), which likely reflects both underdiagnosis and patient reluctance to report cannabis use. This reinforces my approach of routinely asking about cannabis use patterns in patients with unexplained nausea and vomiting.

What a Careful Reader Should Take Away

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 →](https://benjamincaplan.com/ask-dr-caplan)

Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/forum/cannabis-industry/)

Have thoughts on this? Share it:

[X Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Prevalence%20and%20Correlates%20of%20Symptoms%20of%20Cannabinoid%20Hyperemesis%20Syndrome%20in%20the%20United%20States.%20%40drcaplan&url=https%3A%2F%2Fcedclinic.com%2Fcannabinoid-hyperemesis-syndrome-prevalence-daily-cannabis-users%2F)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A%2F%2Fcedclinic.com%2Fcannabinoid-hyperemesis-syndrome-prevalence-daily-cannabis-users%2F)[🦅 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Prevalence%20and%20Correlates%20of%20Symptoms%20of%20Cannabinoid%20Hyperemesis%20Syndrome%20in%20the%20United%20States.%20via%20%40drcaplan.bsky.social%20https%3A%2F%2Fcedclinic.com%2Fcannabinoid-hyperemesis-syndrome-prevalence-daily-cannabis-users%2F)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan)[📝 Read more on Substack](https://doctorapprovedcannabis.substack.com/)[🔔 Subscribe via RSS](https://cedclinic.com/feed/)

Table of Contents

- [FAQ](#FAQ)[How common is Cannabinoid Hyperemesis Syndrome among cannabis users?](#How_common_is_Cannabinoid_Hyperemesis_Syndrome_among_cannabis_users)
- [Who is most at risk for developing CHS symptoms?](#Who_is_most_at_risk_for_developing_CHS_symptoms)
- [What are the main symptoms of CHS that patients should watch for?](#What_are_the_main_symptoms_of_CHS_that_patients_should_watch_for)
- [How should clinicians approach suspected CHS in their practice?](#How_should_clinicians_approach_suspected_CHS_in_their_practice)
- [Is CHS underdiagnosed in clinical practice?](#Is_CHS_underdiagnosed_in_clinical_practice)
- [Related](#Related)

## 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.

 [https://cedclinic.com/contact/](https://cedclinic.com/contact/)
 

Physician-Led, Whole-Person Care
A doctor who takes the time to truly understand you.
Personal care that starts with listening and is guided by experience and ingenuity.

Health, Longevity, Wellness
One-on-One Cannabis Guidance
Metabolic Balance

 [Leave a Message](https://cedclinic.com/contact/)
 [Metabolic Care](https://cedclinic.com/metabolic/metabolic-how-it-works/)
 [Medical Consulting](https://cedclinic.com/book/)
 [Cannabis Care](https://cedclinic.com/book/)
 

 [https://cedclinic.com/contact/](https://cedclinic.com/contact/)
 

 

### Related

---

### Verification & Medical Governance

- **Lead Clinical Author:** Benjamin Caplan, MD
- **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House).
- **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`).
- **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/).
- **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637).
- **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).
