As cannabis legalization spreads across the U.S., physicians are increasingly concerned about the health risks associated with heavy, long-term marijuana use. One condition, known as cannabinoid hyperemesis syndrome (CHS), is drawing particular attention for sending chronic users to emergency rooms with symptoms of severe vomiting, pain, and nausea. Researchers are working to raise awareness of this rare but severe syndrome, while some experts advocate for more stringent government oversight of the burgeoning cannabis industry.
What is Cannabinoid Hyperemesis Syndrome?
Cannabinoid hyperemesis syndrome is a relatively new and poorly understood condition characterized by persistent nausea, vomiting, and intense abdominal pain. It primarily affects heavy cannabis users, often emerging after years of regular, almost daily use. According to the American College of Gastroenterology, symptoms can be severe, with patients at risk of dehydration, seizures, kidney failure, and in rare cases, cardiac arrest or even death.
The syndrome, first identified in 2004, has become more prevalent as cannabis use has become more widespread. CHS tends to affect users after about a decade of chronic marijuana use, presenting as recurrent episodes of intense sickness. The condition has led to the colloquial term “scromiting,” a combination of “screaming” and “vomiting,” to describe the often excruciating symptoms that can leave patients screaming in pain as they vomit.
A Unique Symptom: The Soothing Effect of Heat
One of the unusual characteristics of CHS is the temporary relief patients often experience through heat. Hot showers or baths can momentarily soothe symptoms, and patients sometimes rely on hot water for hours at a time to manage their pain and nausea. Reports from The New York Times reveal that some patients have even burned themselves with scalding water or resorted to pressing their bodies against hot surfaces in desperation.
Despite its prevalence among CHS sufferers, the exact reason heat alleviates symptoms remains unknown. It is thought that cannabis affects the body’s endocannabinoid system, which regulates functions like pain, sleep, and digestion. However, researchers have not determined why only certain long-term cannabis users develop CHS while others do not.
Why is CHS on the Rise?
Experts link the rise of CHS cases to the spread of cannabis legalization and the increase in tetrahydrocannabinol (THC) content in commercial cannabis products. In the 1990s, cannabis typically contained around 5% THC, but modern products can reach THC levels as high as 99% due to advancements in cultivation and product engineering. Today’s cannabis market offers vape pens, edibles, and other high-potency products that provide faster, more intense effects than traditional cannabis.
The increased potency has led to greater hospital visits for cannabis-related illnesses, including CHS, as doctors work to address this emerging condition. Neuroscientist Yasmin Hurd, lead author of a 2017 National Academies of Sciences, Engineering, and Medicine report on cannabis health effects, emphasized that understanding of today’s high-potency cannabis products is limited. “There’s a difference in legalizing the original cannabis on the planet and the products that exist today,” Hurd said.
Hurd warns that without more robust research on the health effects of cannabis, framing it as a safe, legal drug is “misleading at best and dangerous at worst.”
The Need for Public Health Guidance
The medical field has struggled to keep pace with the changing cannabis landscape. As cannabis has become legal in many states, researchers and health experts have called for increased public health guidance, education, and research on the drug’s long-term effects. The recent National Academies 2024 report, for example, underscores the need to approach cannabis policy through a public health lens. According to Leana Wen at The Washington Post, the report advises that the federal government should reclaim control over cannabis regulation, which currently varies greatly between states.
Many public health experts argue that the federal government’s decision to allow a patchwork of state-level legalization has resulted in a largely unregulated cannabis industry. The variation in policies across states has, according to Wen, led to inconsistent standards that may not prioritize consumer safety.
Moving Forward: Research and Regulation
Despite the increasing legalization of cannabis at the state level, there is a clear need for more comprehensive, evidence-based research to better understand both the potential benefits and risks of cannabis use. CHS serves as a potent reminder of the potential dangers of long-term, heavy cannabis use and the importance of balancing accessibility with regulation.
By providing clearer public health guidance and investing in rigorous research, health officials and policymakers hope to address the risks of high-potency cannabis products. For chronic users experiencing symptoms like those of CHS, increased awareness and early intervention could prove lifesaving. Until more is known, however, health experts caution cannabis users to be mindful of their consumption and its potential health impacts.
