How Long Does It Take To Recover From Cannabinoid Hyperemesis Syndrome?

Cannabinoid hyperemesis syndrome (CHS), or cannabis hyperemesis syndrome, is still a relatively recent discovery. The first known case occurred in 2004.

CHS produces repeated cyclical vomiting in some people who have a history of long-term cannabis (aka marijuana) use. Not much is known about this syndrome, but recovery is possible through stopping cannabis use.

While CHS was initially considered rare, cases have risen sharply alongside increased cannabis legalization and use. A 2024 study found that CHS-related emergency department visits doubled in the U.S. and Canada between 2017 and 2021, most commonly among males between 16 and 34 years old.

What Is Cannabinoid Hyperemesis Syndrome?

Because CHS has only recently been identified, there is still a lot that is not known about it. However, cases of it have increased since the legalization of cannabis in several states.

CHS is believed to come about as a result of long-term and excessive cannabis use, specifically prolonged exposure to tetrahydrocannabinol (THC), the compound that produces the “high.”

The increased potency of cannabis products available today, with THC concentrations significantly higher than in past decades, may also be contributing to the rise in CHS cases.

One of the ironies of CHS is that its symptoms are centered around the digestive tract. Cannabis is often medically used to help with severe nausea and to stimulate appetite in cancer patients.

It is believed that it is the overstimulation of cannabinoid receptors in the endocannabinoid system through the long-term or heavy use of Cannabis that leads to CHS.

Symptoms Of CHS

The symptoms of CHS center around the abdomen and include abdominal pain, persistent severe vomiting, and repeated episodes of vomiting due to stomach inflammation.

This means that a person experiencing CHS can have 12 to 15 episodes of vomiting a day. A person may vomit four or five times during each episode.

The symptoms of CHS often follow three phases:

• the prodromal phase, which consists of abdominal pain and morning nausea
• the hyperemetic phase, which consists of persistent nausea, repeated bouts of vomiting, and ongoing stomach pain
• the recovery phase, in which symptoms stop because the use of cannabis has stopped

How Is Cannabinoid Hyperemesis Syndrome Diagnosed?

CHS is difficult to diagnose because the pathophysiology of severe and episodic vomiting can resemble many other health issues.

One example, and the most likely alternative diagnosis, is cyclic vomiting syndrome. In fact, the commonly used diagnostic criteria for CHS include “stereotypical episodic vomiting resembling cyclical vomiting syndrome in onset, duration, and frequency.”

Diagnosis of CHS is usually made by:

• the diagnostic criteria called the Roman IV criteria
• the elimination of other possibilities through a pregnancy test, endoscopy, CT scan, and blood tests by a healthcare provider, often done in the emergency department
• drug screenings following cessation of symptoms, coinciding with the cessation of cannabis use

Treatment Of Cannabinoid Hyperemesis Syndrome

Treatment involves symptomatic care until the determination of the condition can be made. This usually includes anti-nausea and antiemetic medication.

Unfortunately, transitional antiemetic medications such as ondansetron are typically ineffective.

Doctors may elect to prescribe one or more of the following medications:

• antipsychotic medication such as haloperidol
• benzodiazepines (short-term)
• capsaicin cream

Many people who have been diagnosed with CHS report that they get symptomatic relief from hot showers or hot baths. While the mechanism is not fully understood, hot showers are thought to involve activation of TRPV1 receptors, which may temporarily override cannabinoid receptor overstimulation.

Complications From CHS

CHS is not, in and of itself, dangerous. However, complications can arise from it that can be harmful, namely dehydration and electrolyte depletion, requiring IV fluids.

Prolonged dehydration, which can be caused by repeated bouts of vomiting, can lead to urinary tract infections and kidney failure.

People with persistent symptoms of cannabinoid hyperemesis syndrome can also experience weight loss.

CHS carries a significant healthcare burden. A 2025 survey-based study published in Annals of Emergency Medicine found that among people with CHS, 85% reported at least one emergency department visit and 44% reported at least one hospitalization. Daily use before symptom onset was nearly universal, and over 40% reported using cannabis more than five times a day.

Treatment For Cannabis Addiction

The only effective treatment for CHS is to stop using cannabis. Since the chronic and excessive use of cannabis is what instigates CHS, people with symptoms of CHS may require addiction treatment.

Cannabis does have a few medical uses, but misuse of the drug can lead to negative side effects similar to other forms of misuse.

Cannabis use disorder can negatively impact mental health by causing:

• damage to the central nervous system (of which CHS is considered one result)
• anxiety
• psychotic symptoms
• impaired coordination
• mood disorders

People who have misused cannabis may experience withdrawal and need help sorting through the mental health issues or past trauma that led to addiction.

Treatment options for cannabis use disorder include behavioral therapy at group and individual levels, peer recovery support, and more.

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Written by the Addiction Resource Editorial Staff