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Cannabinoid Hyperemesis Syndrome

Although typically the use of cannabis based medicinal products, particularly CBD, is very safe, with studied remedial value for numerous indications including chronic pain, spasticity, and anxiety, in some rare cases cannabis use can lead to complications. Cannabinoid hyperemesis syndrome is one potential complication of excessive recreational cannabis use.

Indeed, we can’t be entirely certain that the cause is purely cannabis related. Unregulated substances can contain numerous impurities or toxins, and pesticide contamination is one suspected candidate for this presentation of symptoms.

About cannabis hyperemesis syndrome

Cannabis hyperemesis syndrome, sometimes known as Cannabinoid hyperemesis syndrome (CHS),is characterised by severe stomach pain and cyclical periods of acute vomiting. Bloating, nausea, weight loss and diarrhoea are also commonly reported side effects of the condition which, if left untreated without hospital admission, could lead to dehydration.

Cannabinoid hyperemesis syndrome is highly rare and tends to occur only in daily, long-term recreational cannabis users.This is thought to be because cannabis’s interaction in the digestive tract makes individuals more likely to experience nausea and vomiting, particularly after repeated use of cannabis means certain brain receptors stop responding to the drug in the same way as they did with initial use (where anti-nausea affects are more common).


There are typically three main stages that CHS symptoms are divided into: the prodromal, the hyperemetic and the recovery phases.

Prodromal phase

This phase is characterised by early morning nausea and abdominal pain. Most people are still able to keep to their normal eating patterns during this phase. Often, many people mistakenly use more cannabis in an attempt to counteract the nausea they are experiencing. This, of course, only tends to make the symptoms worse. This phase can last anywhere between months and years.

Hyperemetic phase

Symptoms that are experienced during this phase include:

  • Repeated cycles of vomiting
  • Abdominal pain
  • Continued nausea
  • Dehydration symptoms
  • Decreased food intake and consequential weight loss

This phase is particularly characterised by chronic and overwhelming vomiting. Many sufferers find that taking frequent hot showers eases the nausea they are experiencing, which is thought to be due to hot temperature’s effect on a part of the brain called the hypothalamus which affects the body’s regulation of temperature and vomiting.

This phase continues until the individual affected stops using cannabis.Once they have stopped using cannabis, the recovery phase can begin.

Recovery phase

In this phase, once cannabis use has ended, the symptoms go away and regular eating patterns can resume. However, symptoms can come back if the affected person begins using cannabis again.

How is it diagnosed?

Like many conditions, cannabinoid hyperemesis syndrome is characterised by persistent vomiting. This common symptom makes it hard for healthcare professionals to diagnose CHS as they will have to rule out other causes of the vomiting. Based on the other symptoms the individual is experiencing, the healthcare professional may test for:

  • Pregnancy
  • Anaemia
  • Infection
  • Pancreatic and liver issues
  • Other drugs that may be causing the vomiting
  • Abdominal issues

As CHS was only recently discovered, many healthcare providers know little about it. Therefore, the issue may not be spotted for many months or years, or it may be confused with cyclical vomiting disorder. The only way the diagnosis can be confirmed is by monitoring improvement after quitting cannabis use as there is currently no singular test for this specific issue.


It is important to remember that cannabinoid hyperemesis syndrome, if we accept this as an accurate term for these observed symptoms that appear to correlate to some degree with cannabis use, is very rare generally and currently unobserved when using medicinal cannabis in a clinical context. It is also good to remember that despite the symptoms of CHS being undoubtedly serious, CHS tends to clear up quickly after cannabis use is stopped.

Further investigation and research into cannabis use (both recreational and medical) is thoroughly encouraged by The Academy, particularly through the use of our own online coursesevidence base and whitepapers. Specific information on medical cannabis versus herbal medicine can be found in our free introductory course.

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