Cannabinoid Hyperemesis Syndrome: what it is, why it’s dangerous, and CHS treatment options
Cannabinoid Hyperemesis Syndrome sounds rare—until it hits home. People who use high-THC cannabis daily can develop waves of severe vomiting, belly pain, and dehydration so intense they land in the ER. Many take scalding hot showers for brief relief, then the cycle starts again. Hospitals now see thousands of cannabis-related nausea and vomiting visits each year, and a growing share involve Cannabinoid Hyperemesis Syndrome. The only proven long-term fix is stopping THC, but there are effective CHS treatment options that can calm the storm fast and help you recover for good.
Navigating This Guide
This hub page serves as the entry point for deeper exploration. Use the links below to dive into specific areas of Marijuana addiction:
- Withdrawal Timeline
- Mental Health
- Marijuana Intervention
- Overdose
- Cannabinoid Hyperemesis Syndrome (CHS)
How CHS starts, what it feels like, and who’s at risk (street names included)
CHS usually develops after heavy, long-term cannabis use—often daily, for years. It can follow flower, vape carts, dabs/wax/shatter, rosin, edibles, or mixed products. Street names you may hear: weed, pot, bud, Mary Jane, ganja, kush, skunk, carts, oil, 710, dabs. Potency matters: modern concentrates can reach 60–90% THC, which pushes risk higher.
Most people pass through three phases:
- Prodromal phase (days to months): morning nausea, early satiety, bloating, and anxiety about eating. Many still attend work or school but feel “off.”
- Hyperemetic phase (hours to days): relentless vomiting—sometimes every 15–30 minutes—with cramping belly pain, sweating, dizziness, and compulsive hot showers or baths for short relief. Dehydration builds quickly, urine turns dark, and people can faint on standing.
- Recovery phase (days to weeks): symptoms fade with cannabis abstinence, appetite returns, and showers aren’t needed. If THC use restarts, the cycle often comes back.
Why hot water helps: Heat activates skin receptors that compete with pain/nausea signals, briefly “distracting” the nervous system. It’s a temporary trick—not a cure—and can lead to burns or scalds if water is too hot.
Dangers & data you should know
Dehydration and electrolyte loss. Repeated vomiting strips fluids and salts, leading to low potassium (which can trigger heart rhythm problems), low sodium, and kidney stress. Many CHS patients need IV fluids; some are admitted for 1–3 days to correct imbalances.
Injuries from forceful vomiting. People can develop esophageal tears, gastritis, or aspiration pneumonia if they inhale vomit—especially when exhausted or sedated.
ER trends and costs. Emergency departments report a sharp rise in cannabis-related visits over the past decade, and clinicians recognize CHS far more often now. Many patients have multiple ER visits before the right diagnosis, which drives up costs and delays real relief.
Mental health toll. Panic, sleeplessness, and food avoidance are common during flares. The fear of vomiting can lock people into isolation, missed work, and school failures.
Relapse pattern. Data from clinics show that symptoms usually resolve within days to weeks of stopping THC and return when use resumes—even at lower amounts. This “on/off” pattern is one of the strongest clues that CHS is the cause.
CHS treatment options: from the ER to long-term recovery
When a flare hits, you need fast stabilization and a clear plan to prevent the next one. Here’s what care typically looks like:
1) Acute care (ER or urgent care).
- IV fluids and electrolyte replacement to reverse dehydration.
- Targeted anti-nausea strategies. Standard meds (like ondansetron) may help, but many patients improve more with topical capsaicin cream (rubbed on the belly, upper arms, or back), short-acting antipsychotic antiemetics in medical settings, and benzodiazepines in select cases for severe anxiety. Decisions belong to clinicians; don’t self-medicate.
- Heat therapy with caution. Warm (not scalding) showers or heating pads can take the edge off; avoid burns.
- Avoid opioids. They can worsen nausea and constipation and raise dependence risk.
- Lab checks. Providers often monitor potassium, sodium, kidney function, and watch for red flags (blood in vomit, chest pain, fainting).
2) Definitive treatment (the part that keeps it gone).
- Full THC abstinence is the cornerstone. Most people feel markedly better within 24–72 hours, with appetite and sleep normalizing over 1–2 weeks.
- Medication support for sleep, anxiety, or reflux may be used short-term.
- Nutrition & hydration plan: small, frequent meals; oral rehydration; limit caffeine until fully recovered.
- Relapse-prevention plan: write down triggers (stress, social scenes, certain friends/places) and a script for saying no.
3) Preventing the next ER visit—behavioral care that works.
- Cognitive Behavioral Therapy (CBT) helps you identify triggers, manage cravings, and replace wake-and-bake routines with simple morning rituals (hydration, light snack, brief walk).
- Motivational Interviewing (MI) aligns change with your goals—sports, school, parenting, work.
- Contingency Management (CM) offers small, same-day rewards for goals met (session attendance, negative tests), boosting success in the first 60–90 days.
- Family support & boundaries (no using at home, no driving high) reduce conflict and protect recovery.
4) Special situations.
- Teens and young adults: brains are still developing; frequent high-THC exposure raises risk for attention and mood problems. Involve family, school supports, and peer recovery.
- Pregnancy: vomiting has many causes in pregnancy. If you use cannabis, do not stop or start any medicines on your own—work with obstetrics and addiction-informed clinicians to create a safe plan.
- Co-occurring anxiety, depression, ADHD: treat both substance use and mental health together for better outcomes.
5) Practical home steps after discharge.
- Set water and electrolyte goals (clear urine by afternoon is a good sign).
- Try bland foods first (toast, rice, bananas, broth).
- Keep showers warm—not hot.
- Sleep at regular hours; dim screens after dark.
- Schedule follow-ups before you leave the ER or clinic.
