Introduction to Cannabis Hyperemesis Syndrome in Youth

Symptoms and Diagnosis of Cannabis Hyperemesis Syndrome

CHS typically presents in three distinct phases: prodromal, hyperemetic, and recovery. The prodromal phase often includes early morning nausea and abdominal discomfort, which is frequently misattributed to other causes, leading to delays in diagnosis (Seabrook et al., 2025). During this phase, individuals may mistakenly believe that continued cannabis use alleviates their symptoms, thus perpetuating the cycle of use.

The hyperemetic phase is marked by severe vomiting, dehydration, and abdominal pain, often requiring medical intervention due to the risk of electrolyte imbalances and other complications (Seabrook et al., 2025). Unique to CHS is the compulsive behavior of seeking relief through hot showers or baths, providing a momentary respite from symptoms. This behavior is commonly misunderstood and can lead to misdiagnoses, as many healthcare providers may not associate these symptoms with cannabis use.

In the recovery phase, symptoms gradually resolve, typically within days of cannabis cessation, though they can reappear if cannabis use is resumed. Diagnosis of CHS is primarily clinical and is guided by the Rome IV criteria, which require a history of prolonged cannabis use, cyclic vomiting, and resolution of symptoms upon abstinence (Seabrook et al., 2025).

Table 1: Phases of Cannabis Hyperemesis Syndrome

Treatment Strategies for Cannabis Hyperemesis Syndrome

The primary and most effective treatment for CHS is the cessation of cannabis use. Evidence suggests that approximately 96.8% of patients experience complete symptom resolution upon stopping cannabis (Seabrook et al., 2025). However, many individuals struggle with cessation due to dependency or misconceptions about cannabis’s therapeutic effects.

Supportive Care

In acute settings, management typically involves rehydration and electrolyte correction. Antiemetics, such as ondansetron, have limited efficacy in CHS and may not significantly alleviate symptoms (Seabrook et al., 2025). Some studies suggest the use of topical capsaicin cream for nausea relief, although more robust clinical trials are necessary to establish its effectiveness.

Psychosocial Interventions

Given that a significant proportion of youth with CHS may also experience mental health issues, such as anxiety or depression, integrating psychosocial support into treatment plans is essential. Therapies aimed at addressing underlying psychological conditions may improve overall treatment outcomes and enhance adherence to cannabis cessation efforts (Seabrook et al., 2025).

Public Health Implications of Cannabis Hyperemesis Syndrome

The rise in cannabis legalization across various jurisdictions has led to increased accessibility and consumption among youth, which can exacerbate the public health crisis represented by CHS. The potential for increased CHS cases highlights the need for targeted public health interventions, including:

1. Education and Awareness: Enhanced educational initiatives in schools and healthcare settings to inform youth about the risks associated with cannabis use.
2. Screening Practices: Systematic screening for cannabis use in patients presenting with cyclic vomiting and associated symptoms to facilitate early diagnosis and intervention.
3. Policy Development: Advocating for policies that limit youth access to cannabis and promote harm reduction strategies.

Table 2: Public Health Recommendations for CHS

Future Research Directions for Cannabis Hyperemesis Syndrome

Ongoing research is imperative to better understand the pathophysiology of CHS, particularly the mechanisms through which cannabis induces these severe gastrointestinal symptoms. Future studies should focus on:

1. Longitudinal Studies: To investigate the long-term effects of cannabis on gastrointestinal health and the prevalence of CHS among varying demographics.
2. Clinical Trials: To explore the efficacy of various treatment modalities, including pharmacological and psychosocial interventions.
3. Mechanistic Research: To elucidate the biological pathways involved in CHS, which may lead to the development of targeted therapies.

Table 3: Research Directions for CHS

FAQ Section

What is Cannabis Hyperemesis Syndrome?

Cannabis Hyperemesis Syndrome is a condition associated with chronic cannabis use, characterized by recurrent episodes of severe nausea and vomiting, which typically improve with cannabis cessation.

What are the symptoms of CHS?

Symptoms of CHS include cyclic vomiting, abdominal pain, nausea, and a compulsive need to take hot showers or baths for relief.

How is CHS diagnosed?

CHS is diagnosed based on clinical symptoms, history of cannabis use, and symptom resolution upon cessation of cannabis. The diagnosis follows the Rome IV criteri

What is the treatment for CHS?

The primary treatment for CHS is cannabis cessation. Supportive care includes rehydration and electrolyte management, with limited efficacy from antiemetic medications.

What are the public health implications of CHS?

The increasing prevalence of CHS among youth necessitates greater public health awareness, targeted educational initiatives, and policies to limit youth access to cannabis.

References

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3. Allen, J. H., de Moore, G. M., Heddle, R., & Twartz, J. C. (2025). Cannabinoid hyperemesis: Cyclical hyperemesis in association with chronic cannabis abuse. Gut. Retrieved from https://doi.org/10.1136/gut.2003.036350
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6. Kumar, A., & Vallabhaneni, P. (2025). Anxiety disorders presenting as gastrointestinal symptoms in children – a scoping review. Clinical and Experimental Pediatrics
7. Malesci, R., Salomè, S., Freda, G., Serra, N., Manna, G., Del Vecchio, V., Quatrano, C., Capasso, L., Raimondi, F., & Fetoni, A. R. (2025). Impact of congenital cytomegalovirus infection on vestibular dysfunction and hearing outcomes in a cohort of children. Scientific Reports. Retrieved from https://doi.org/10.1038/s41598-025-98150-5
8. Kim, M. H., et al. (2025). Impact of Opioid and Cannabis Use on Low-Dose Amitriptyline Efficacy in Cyclical Vomiting Syndrome: A Real-World Study in the United Kingdom. Journal of Pediatric Gastroenterology and Nutrition Reports. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12075911/