This Painful Syndrome Is Sending Cannabis Users to the ER – Are You at Risk?

Long-term cannabis users may be unknowingly at risk for a painful and costly condition called cannabinoid hyperemesis syndrome, which causes severe nausea, vomiting, and abdominal pain.

A new study from George Washington University reveals the alarming disease burden, with most sufferers requiring emergency care. The research highlights a strong link between early cannabis use and higher hospital visits, suggesting an urgent need for awareness. While emergency treatments can provide short-term relief, the only true cure is stopping cannabis use.

Cannabinoid Hyperemesis Syndrome: A Growing Concern

A new study examines the impact and risk factors of cannabinoid hyperemesis syndrome (CHS), a condition affecting long-term, frequent cannabis users. Researchers at George Washington University report that CHS causes recurring nausea, uncontrollable vomiting, and excruciating abdominal pain, often leading to repeated hospital visits.

“This is one of the first large studies to examine the burden of disease associated with this cannabis-linked syndrome,” says Andrew Meltzer, professor of emergency medicine at the GW School of Medicine & Health Sciences and lead author of the study. “Our findings suggest that cannabinoid hyperemesis syndrome could represent a costly and largely hidden public health problem.” While the exact prevalence of the condition is unknown, many experts say that the condition is on the rise as the number of daily or near daily users of cannabis has increased in the US.

Surveying the Impact of the Syndrome

To better understand the condition, Meltzer and his team surveyed 1,052 people who reported experiencing CHS. The study gathered data on their cannabis use patterns, including how often they consumed it, how long they had been using, the age they started, and whether they required emergency or hospital care.

Key findings of the study:

• 85% reported at least 1 emergency department visit and 44% reported at least 1 hospitalization associated with the hyperemesis symptoms.
• Early age of cannabis initiation was associated with higher odds of emergency department visits.
• Daily use of cannabis before the onset of the syndrome was nearly universal, with over 40% of respondents reporting they used marijuana more than 5 times a day.
• Prolonged use was common with 44% reporting using regularly for more than 5 years before the onset of the syndrome.

The Costly Toll of the Syndrome

The new research suggests that the condition may impose a heavy burden on individuals who suffer from it as it often results in pain, vomiting, and costly trips to the hospital. Emergency room doctors can stabilize the patient and help alleviate the acute symptoms but the only known way to stop the episodes of excruciating abdominal pain and repeated vomiting is to stop using cannabis, Meltzer says.

Although this study had some limitations, including self-reported use of cannabis, Meltzer says it suggests a substantial risk of this painful and costly condition, especially for users who begin daily use of cannabis as adolescents. He says more research is needed to understand why some people suffer from the condition after prolonged cannabis exposure and others do not. In addition, it is unclear why cannabis changes from a drug that has been known to ease nausea and vomiting, especially among patients undergoing chemotherapy, to causing nausea and vomiting in a subset of people.

Raising Awareness Among Clinicians and Patients

Meltzer says it is important for clinicians to advise those with frequent cannabinoid use or hyperemesis about the risks and subsequent disease burden. He says many patients don’t realize that the syndrome is connected with their use of cannabis. Physicians should explain that and advise patients on resources to help them quit, he says.

Reference: “Cannabinoid Hyperemesis Syndrome is Associated with High Disease Burden: An Internet-based Survey” by Andrew C. Meltzer, MD, MS, Callen Morrison, MD, Aditya Loganathan, MD, Soroush Shahamatdar, MD, Alice Moon, BA, Ryan Heidish, MD, Michael Makutonin, MD, Yan Ma, PhD, Runjia Li, MS and Ziva D. Cooper, PhD, 20 February 2025, Annals of Emergency Medicine.
DOI: 10.1016/j.annemergmed.2025.01.008

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