A recent study conducted by researchers at the University of Illinois Chicago indicates a significant rise in cases of cannabinoid hyperemesis syndrome (CHS) among Americans. This condition, characterized by severe and cyclical vomiting, has led to an increase in emergency department visits, particularly among younger adults. The findings highlight the importance of increased awareness among healthcare professionals regarding this debilitating health issue.
According to the study, which analyzed emergency department visits across the United States from 2016 to 2022, there were approximately 100,000 cases of suspected CHS recorded. Prior to the COVID-19 pandemic, the annual rates of CHS remained stable. However, starting in 2020, there was a noticeable surge in suspected cases, peaking in 2021. Although there was a decline in cases in 2022, the numbers still remained above pre-pandemic levels.
Researchers employed a proxy method to identify cases of CHS, focusing on patients diagnosed with cyclical vomiting syndrome alongside cannabis use, as CHS could not be distinctly diagnosed for record-keeping until recently. The study’s lead author, James Swartz, emphasized the growing recognition of CHS within emergency medicine in the U.S., stating, “Cannabinoid hyperemesis syndrome is real, and it’s becoming a more routine part of emergency medicine in the U.S.”
Understanding Cannabinoid Hyperemesis Syndrome
Individuals suffering from CHS experience intense abdominal cramps, nausea, and vomiting that can last from one to two days. This condition can be so severe that patients may cry out in pain during episodes, a phenomenon that has been colloquially termed “scromiting.” While CHS is thought to develop primarily in those who use cannabis chronically, the exact reasons for its onset remain unclear. Researchers suspect it could be linked to overstimulation of cannabinoid receptors in the gastrointestinal system.
The rise in CHS cases parallels the expansion of cannabis legalization in the U.S., as well as the increasing potency of cannabis strains. “The COVID-19 pandemic likely catalyzed the rise in CHS through stress, isolation, and increased cannabis use,” the researchers noted in their publication in JAMA Network Open. The study underscores the need for healthcare providers to be more vigilant in diagnosing and treating CHS, especially given the potential for misdiagnosis and unnecessary testing.
Managing and Treating CHS
While CHS is a distressing condition, it is manageable and treatable. Temporary relief for acute episodes can often be achieved through hot baths or showers. However, the only definitive way to prevent CHS from recurring is to cease cannabis use altogether, which may take weeks for symptoms to resolve completely.
Despite the rising incidence of CHS, it remains a relatively rare condition among cannabis users. “Our findings shouldn’t be interpreted as a reason to panic, but they do reinforce that cannabis is not risk-free, especially at higher doses and with long-term, heavy use,” Swartz cautioned. Earlier this year, CHS was officially included in the latest edition of the International Classification of Diseases (ICD), allowing for more accurate diagnoses and tracking of the condition.
The study concludes that, while awareness of CHS is increasing, there is still a pressing need for further research to understand its causes and why it affects only a subset of long-term cannabis users. Increased clinical awareness and timely diagnosis are essential for managing this emerging health issue effectively.
