#75 Strong Clinical Relevance
High-quality evidence with meaningful patient or clinical significance.
If you use cannabis daily and experience recurring episodes of severe vomiting that hot showers seem to relieve, you should discuss cannabinoid hyperemesis syndrome with your physician before your next emergency room visit.
Cannabinoid hyperemesis syndrome is a paradoxical condition in which heavy, long-term cannabis use causes cyclical episodes of severe nausea, vomiting, and abdominal pain, often relieved temporarily by hot showers or baths. The syndrome is thought to involve dysregulation of cannabinoid receptors in the gut and hypothalamus, particularly with chronic high-potency THC exposure, though the precise mechanism remains under active investigation. Definitive resolution typically requires complete cessation of cannabis use, and patients frequently cycle through emergency departments multiple times before receiving an accurate diagnosis.
“CHS is not rare, not mysterious, and not a reason to dismiss cannabis medicine broadly, but it is a clear signal that dose, frequency, and potency matter enormously in clinical cannabis use.”
Cannabinoid Hyperemesis Syndrome (CHS) represents a paradoxical and poorly understood complication of chronic cannabis use that clinicians need to recognize. Patients present with cyclical severe nausea and vomiting that often improves dramatically with hot showers or baths, a pathognomonic feature that distinguishes CHS from other causes of hyperemesis. The syndrome appears linked to high-potency products and frequent consumption patterns, suggesting dose and duration matter in vulnerability. Recognition is critical because affected patients often undergo extensive workups for other conditions while the most effective intervention remains cannabis cessation. As consumption patterns evolve toward higher cannabinoid concentrations, clinicians should maintain a lower threshold for considering CHS in chronic users presenting with refractory nausea and vomiting.
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