Introduction: When Cannabis Causes “Scromiting”
Imagine feeling so nauseated that you’re both screaming and vomiting at the same time. It sounds like a nightmare, but it’s a real phenomenon some heavy cannabis users experience – so much so that it’s earned the nickname “scromiting” (screaming + vomiting), my.clevelandclinic.org. Emergency rooms across the country are seeing a surprising uptick in patients who use cannabis and arrive suffering from relentless vomiting, intense abdominal pain, and dehydration. This condition perplexes many, especially because cannabis is often known for reducing nausea. So, what’s going on?
The culprit is a paradoxical syndrome officially called Cannabinoid Hyperemesis Syndrome (CHS) – a condition virtually unheard of two decades ago, but now increasingly recognized as a public health concern, jamanetwork.com. CHS primarily affects long-term, frequent cannabis users and is sending more people to the ER than ever before. One recent nationwide study found that CHS-related emergency visits spiked from about 4.4 per 100,000 visits in the mid-2010s to over 30 per 100,000 by 2020. Another analysis of young adults (ages 15–24) identified more than 55,000 suspected CHS emergency visits between 2006 and 2020, with an average 28% increase each year – a trend that aligns with rising cannabis use and potency. In Nevada, cases of cannabis-linked vomiting roughly doubled after recreational marijuana was legalized, journals.plos.org. Clearly, something has changed in the landscape of cannabis use, leading to more people landing in hospitals with this severe vomiting syndrome.
Why are CHS cases rising, and what can you do to protect yourself? In this article, we’ll break down what CHS is, why it’s becoming more common, how to recognize the symptoms, and steps you can take to stay safe while using cannabis.
What is Cannabinoid Hyperemesis Syndrome (CHS)?
Cannabinoid Hyperemesis Syndrome is a condition that only occurs in people with a history of long-term, heavy cannabis use. In simple terms, CHS causes recurring cycles of severe nausea, vomiting, and abdominal pain after prolonged cannabis exposure my.clevelandclinic.org. It’s as if the body’s reaction to cannabis flips: instead of calming the stomach, chronic use in susceptible individuals triggers unrelenting sickness.
Patients with CHS often suffer episodes so intense that they can vomit up to five times per hour and may become dangerously dehydrated. Intriguingly, many discover a bizarre coping mechanism: hot baths or showers. Taking a hot shower can bring temporary relief of symptoms, and CHS sufferers often resort to compulsive hot bathing for hours on end to soothe their nausea. (This unusual behavior is a big clue doctors use to distinguish CHS from other vomiting illnesses.) Unfortunately, once the bath is over, the vomiting usually returns.
Because “hyperemesis” literally means excessive vomiting, the syndrome’s name describes exactly that — cannabinoid-induced excessive vomiting. First reported in medical literature in 2004, CHS remained relatively under the radar for years, jamanetwork.com. Many cases were likely misdiagnosed as cyclic vomiting syndrome (CVS) or stomach flu. Even today, not everyone recognizes the link between cannabis and this extreme illness. As a result, patients might bounce between doctors and undergo expensive tests before getting the correct diagnosis. One survey found that 85% of people with CHS had to visit an emergency department at least once for their symptoms, and nearly half required hospitalization for dehydration and pain control. Clearly, CHS is more than just a “bad reaction” – it can be a serious medical condition that disrupts lives and health.
Symptoms and Red Flags
CHS typically develops after years of frequent cannabis use (often daily or almost daily). Not everyone who uses cannabis will get CHS – researchers are still investigating why some people are susceptible while others are not. news-medical.net. But for those who do develop it, the syndrome tends to follow a pattern of worsening episodes. Key symptoms and warning signs include:
- Persistent nausea, often worse in the morning.
- Repeated bouts of vomiting and retching (retching = dry heaves) that can occur in cycles over 24-48 hours. In severe episodes, vomiting can occur multiple times per hour.
- Intense abdominal pain or cramping during episodes, clevelandclinic.org. Patients often describe it as a gnawing or burning pain in the stomach.
- Temporary relief with hot showers or baths. Many CHS sufferers find that only a hot bath eases their nausea. They may take unusually frequent or prolonged hot showers to cope.
- Reduced appetite and weight loss over time due to fear of eating (to avoid triggering vomiting), my.clevelandclinic.org. Some people become afraid to eat or drink because it might make them throw up again.
It’s worth noting that in the midst of a CHS attack, people often use more cannabis, thinking it will settle their stomach – after all, we know cannabis can help nausea in chemotherapy patients. Unfortunately, in CHS, this does not work; in fact, using more cannabis only makes the vomiting worse in a vicious cycle. This can be very confusing and distressing for someone who has always viewed marijuana as a remedy, not a cause, of nausea.
If you or a friend experience these kinds of symptoms and have a history of heavy cannabis use, consider CHS as a possibility. Many patients suffer through multiple bouts before realizing that cannabis might be the trigger. Being aware can save you from needless ER visits and misery.
Why Are CHS Cases on the Rise?
You might be thinking, “I’ve smoked for years and never had this problem,” or “Why are we only hearing about this now?” There are a few important reasons why more cannabis users are showing up in emergency rooms with CHS in recent years:
- Higher Cannabis Use (and Abuse) Rates: Cannabis legalization and changing social attitudes have led to more people using cannabis regularly. As of 2025, nearly half of Americans live in states where recreational marijuana is legal,l jamanetwork.com. With wider access, there’s been a surge in daily or near-daily use – and heavy use is a major risk factor for CHS. In one study, about one-third of frequent cannabis users who came to an ER for nausea/vomiting met the criteria for CHS. Simply put, the more people who use cannabis heavily, the more CHS cases we’re likely to see. And indeed, research shows CHS has been increasing since the early 2000s, alongside growing cannabis consumption.
- Increased THC Potency: Today’s cannabis isn’t the same as what your parents might have used. Legal markets have popularized high-potency products like concentrates, oils, edibles, and high-THC vape cartridges. These can deliver much larger doses of THC and other cannabinoids to your system than traditional smoking. Studies suggest that using high-potency cannabis (for example, vaping concentrates) may raise the risk of CHS jamanetwork.com. Higher potency means a heavier hit to the body’s endocannabinoid receptors – potentially overstimulating the system that regulates nausea and vomiting. This overstimulation is the leading theory for why CHS occurs: essentially, the body’s cannabinoid receptors are thrown off balance by chronic heavy exposure, paradoxically triggering nausea rather than preventing it my.clevelandclinic.org.
- Greater Awareness and Diagnosis: Another reason we’re “suddenly” seeing more CHS is simply that doctors are getting better at recognizing it. Fifteen years ago, many physicians had never heard of cannabinoid hyperemesis syndrome. A chronic cannabis user coming to the ER vomiting might have been misdiagnosed with gastrointestinal flu or cyclic vomiting syndrome. Now, with more cases being reported, emergency doctors are more alert to CHS. This means what used to be hidden is now being counted. During 2020-2021, CHS diagnoses in ERs rose sharply (coinciding with both increased cannabis use and heightened clinical awareness), and even after a slight dip post-2021, they remain well above pre-2020 levels. As one medical study noted, CHS now accounts for a growing share of vomiting-related emergency visits, jamanetwork.com, underscoring that it’s not just better reporting – the real incidence has grown.
- Stress and Pandemic Factors: Interestingly, the COVID-19 pandemic might have played a role, too. The early 2020s saw many people under high stress and stuck at home, which for some meant using more cannabis to cope. In fact, the largest jump in CHS cases on record occurred during 2020 and 2021. Researchers believe pandemic-related factors – like increased isolation, stress, and substance use – likely catalyzed the rise in CHS during that period. While the world has opened up again, CHS rates have settled only slightly lower and remain higher than they were before, suggesting that many people continued heavy cannabis habits formed during that time.
All these factors combine to create a “perfect storm” for CHS: more users, starting younger, consuming more potent products, more frequently. And because cannabis has a benign reputation and even medicinal uses, people might push their consumption without realizing there could be severe gastrointestinal consequences. As Dr. Andrew Meltzer, an emergency physician who researches CHS, put it, this syndrome could represent a “costly and largely hidden public health problem” if trends continue
The High Price of CHS: Health Impact and Treatment
Cannabis is often touted as harmless, but CHS is a stark reminder that even natural products can have serious side effects when overused. CHS is more than just uncomfortable – it can lead to dangerous health issues if not addressed. Repeated vomiting can cause dehydration, electrolyte imbalances, and even acute kidney injury in severe cases. Patients often arrive at the hospital exhausted, malnourished, and in agonizing pain. “It’s not an exaggeration to say CHS can ruin someone’s quality of life,” notes one medical expert, given the cyclic pain and hospital trips it causes, news-medical.net. In fact, the Cleveland Clinic warns that CHS “can lead to serious health complications if you don’t get treatment for it.” my.clevelandclinic.org This means IV fluids for dehydration, antiemetic (anti-vomiting) medications, pain relief, and sometimes sedation are needed to stabilize the patient during a flare-up.
The irony is that traditional anti-nausea drugs often don’t work well in CHS. Emergency physicians have found that alternative treatments, like capsaicin cream (a chili pepper extract applied to the skin) or certain antipsychotic medications, can sometimes help when typical nausea meds fail. The capsaicin cream idea came from the observation that hot showers help CHS; both heat and capsaicin are thought to activate certain receptors (TRPV1 receptors) that might reduce vomiting signals. Still, these are short-term fixes. The only true way to stop the cycle of CHS is to stop using cannabis altogether.
Pro Tip: A hot shower or rubbing capsaicin cream on your belly might give temporary relief during a CHS episode, but it won’t cure the problem. The only proven cure for CHS is quitting cannabis, my.clevelandclinic.org.
For someone in the throes of CHS, that advice can be hard to swallow – especially if cannabis has been a daily habit or a way to manage anxiety or pain. But regaining one’s health is the immediate priority. The good news is that once cannabis use stops, the prognosis is excellent. Patients typically enter a recovery phase where, over days or weeks, the vomiting and nausea subside and eventually disappear. Appetite returns, normal life resumes, and the specter of “scromiting” fades away. However, if the person resumes heavy cannabis use, there’s a high chance the horrible symptoms will come back. CHS often relapses in people who quit and then start using again regularly.
Staying Safe: How to Enjoy Cannabis Without CHS
Does CHS mean no one should ever use cannabis? Not necessarily. Most cannabis users will never experience CHS. The syndrome appears to require a “perfect storm” of heavy, long-term use and individual susceptibility. But moderation and mindfulness are key. Here are some tips to reduce your risk while still benefiting from cannabis responsibly:
- Use cannabis in moderation: Avoid using cannabis every single day for long stretches. Regular breaks (sometimes called “T-breaks” or tolerance breaks) might help reset your system and reduce the chance of developing CHS. Remember, many CHS sufferers were daily users (over 40% in one survey used more than 5 times a day!) before they got sick. news-medical.net Cutting back could make all the difference.
- Be cautious with high-THC products: Ultra-potent strains, dabs, and edibles can deliver huge doses of cannabinoids. If you choose to use these, do so sparingly. Consider mixing in lower-THC or CBD-rich products to give your endocannabinoid system a breather. The stronger the cannabis, the more stress on the receptors that control nausea.
- Listen to your body: If you notice unexplained nausea or vomiting and you’re a frequent user, don’t ignore it. It could be the early prodromal (warning) phase of CHS, my.clevelandclinic.org. Pay attention to patterns. Do symptoms improve when you take a break from cannabis? That’s a red flag. Don’t just push through and smoke more to feel better – that’s a common trap with CHS and will worsen the situation.
- Stay hydrated and seek help early: Vomiting can dehydrate you quickly. If you’re unable to keep fluids down, seek medical care. It’s much better to get IV fluids and anti-nausea treatment early than to tough it out and end up with kidney complications. If you suspect CHS, let the healthcare providers know about your cannabis use honestly. There is no judgment – doctors are increasingly aware of CHS and will understand the situation better if you share the full picture.
- Educate your circle: CHS might sound uncommon, but with cases rising, it’s very possible someone you know could develop it. If you have friends or family who use cannabis heavily, mention CHS casually or share this information. You could save them from a lot of pain by simply putting this syndrome on their radar. As one research team emphasized, increasing awareness of CHS among both healthcare providers and patients is crucial now.
Conclusion: Knowledge is Power
The rise of cannabinoid hyperemesis syndrome is a reminder that as our society’s relationship with cannabis evolves, so do the challenges. The good news is that CHS is 100% preventable and curable – it doesn’t strike people who use cannabis infrequently, and for those affected, quitting the drug leads to full recovery. The bad news is that it’s an extremely unpleasant way to discover your limits with cannabis.
As cannabis users or supporters, we should approach this topic without stigma or panic, but with open eyes and respect for the substance’s effects. Cannabis can provide relief and enjoyment, but it’s not harmless for everyone in large doses. By understanding CHS, you’re already taking a big step toward protecting your health.
So, if you love cannabis, enjoy it responsibly. Stay vigilant about how your body reacts. And if that “wonder plant” ever makes you violently ill, know that you’re not alone and not crazy – CHS is real, and help is available. Sometimes the best medicine is recognizing when to take a step back. Your well-being comes first. Stay informed, stay safe, and spread the word so that fewer people have to learn about CHS the hard way.
By staying educated on conditions like CHS, you can continue to make informed, healthy choices. Here’s to enjoying the benefits of cannabis without any unwelcome trips to the ER!
Sources: Supporting research and public health data have been referenced throughout this article for accuracy and further reading. Key references include studies published in JAMA Network Open on the increase of CHS-related ER visits, public health analyses of trends post-legalization, and medical guidance from the Cleveland Clinic on CHS symptoms and treatment.
