Cannabis hyperemesis syndrome, or cannabinoid hyperemesis syndrome, is not well understood and seems to be a new illness that mostly affects heavy cannabis users. Since the first recorded case in 2004, much has been speculated about this mysterious and literally sickening syndrome. Is it cannabis intolerance? Is it neem oil poisoning? And what’s with the hot baths?
Cannabis hyperemesis syndrome sounds like William Randolph Hearst rose from the dead and cursed cannabis lovers with the worst thing his undead brain could conjure.
“You will vomit uncontrollably! You will assume cannabis will help because it is a proven anti-emetic, but it will make it worse! Vomiting episodes will last up to a week! Conventional anti-emetics will not work! Your doctor will not know what is causing it! BWAHAHAHAAAA!”
Joking aside, this is a gruesome condition and there’s no denying the correlation between cannabis use and the onset of cannabis hyperemesis symptoms, and the corresponding cessation of those symptoms within an average of three months of stopping cannabis use.
Cannabinoid hyperemesis should be considered in younger patients with long-term cannabis use and recurrent nausea, vomiting, and abdominal pain. Cessation of cannabis use should result in the improvement of clinical symptoms. Studies with higher rates of follow-up are needed, and validation of the proposed diagnostic criteria is required.
Symptoms of cannabis hyperemesis syndrome
The literal translation of ‘hyperemesis’ is ‘hyper-vomiting’. This is the primary symptom. It manifests as prolonged periods of violent nausea and vomiting which last one or more days per week. Severe abdominal pain accompanies the sickness.
These episodes of hyperemesis happen to the majority of sufferers about every one to four months, which causes weight loss, dehydration, and understandably a lot of stress! Many are hospitalised, and need to be given intravenous hydration and medical treatment.
This stage is preceded by what is termed the prodromal phase, where sufferers feel morning nausea, fear and as though they may vomit at any moment. This symptom is also accompanied by abdominal discomfort, despite which people usually manage to maintain regular eating.
Because these symptoms are quite vague and could have many different causes, this phase can go on for years and only be seen as part of cannabis hyperemesis syndrome once the hyperemesis stage has begun.
Hot baths, cannabis hyperemesis syndrome, and cyclical vomiting syndrome
All these symptoms are also seen in an equally rare and literally nauseating affliction, cyclical vomiting syndrome (CVS). The two conditions share one more symptom, and it’s very unusual. In both cases, people have reported finding relief by taking hot baths or showers. As neither condition responds to conventional anti-emetics, what is known as ‘compulsive bathing as learned behaviour’ is extremely common because it is one of the very few things that seem to help.
There is even an anecdotal report of a young man having plates of food next to his shower because hot showers were the only thing that made him feel well enough to eat. Almost 70% of patients diagnosed with cannabis hyperemesis syndrome or cyclical vomiting syndrome reported using hot baths or showers to alleviate their symptoms.
Cannabis hyperemesis syndrome and cyclical vomiting syndrome actually have all of the following symptoms in common:
- Repeating cycles of stomach pain, extreme nausea, and vomiting
- Periods of feeling relatively well, or only having nausea, between the vomiting episodes
- Conventional anti-emetics don’t work
- Hot showers or baths do work
- Weight loss (unsurprisingly)
- Extreme thirst, sometimes linked to vomiting up water being less painful than trying to vomit with an empty stomach
- Sufferers are under 50 years old
Related post
What’s the difference between cyclical vomiting syndrome and cannabis hyperemesis syndrome?
When it comes to making a diagnosis, physicians are beset by problems. Firstly, little is known about either syndrome. It’s common for patients to go through years of painful and invasive tests before a diagnosis is reached because many other diseases and health problems are initially suspected and then have to be ruled out.
Often, physicians may not have even heard of these afflictions, making it even harder to diagnose them! According to a 2017 German medical study, it takes about ten years for a definitive diagnosis to be made. The same study also points out the many symptoms that cyclical vomiting syndrome and cannabis hyperemesis syndrome have in common:
“…both [are] characterised by recurrent episodes of heavy nausea, vomiting … and comparative well-being between the episodes… Literature is inconsistent concerning clinical features which allow to differentiate CVS from CHS”.
In fact, the only initial prerequisite for a potential diagnosis of CHS disease as oppose to CVS is chronic cannabis use. Comorbidities listed as indicating cyclical vomiting syndrome instead of cannabis hyperemesis syndrome are migraines, psychiatric illnesses, and rapid gastric emptying, also called “dumping syndrome”. Those that indicate cannabis hyperemesis syndrome are delayed gastric emptying, or gastroparesis, and the cessation of cannabis use leading to the end of the hyperemesis.
In other words, if you use cannabis and have hyperemesis problems, and then you stop using cannabis and the problems stop too, this is basically what confirms the diagnosis!
What is the connection between CHS disease, cyclical vomiting syndrome, hot baths, and chili peppers?
Despite some reports that cannabis hyperemesis is unique as a syndrome in causing its sufferers to only find relief from crippling nausea by taking hot baths, cyclical vomiting syndrome shares this feature. Because conventional anti-emetics don’t work on either affliction, this is a strong indication that one of the two is present. Research published in January 2018 points to the reason why bathing becomes ‘learned behaviour’ in people suffering from CHS, and a possible cause for CHS itself.
Although far more research is needed, there is a strong hypothesis that long-term exposure to cannabinoids desensitises certain receptors, rendering them inactive. The transient receptor potential vanilloid subtype 1 (TRPV1) receptors are activated by high temperatures, cannabinoids, and capsaicin – the chemical in peppers that makes them ‘hot’ and causes a burning sensation when they are eaten.
The TRVP1 receptors are present throughout the digestive system. When activated, they exercise a strong anti-emetic effect. Exogenous phytocannabinoids can trigger this, which is why cannabis works as an anti-emetic. However, when over-stimulated by (in this case) continual exposure to cannabinoids caused by cannabis use, they can temporarily ‘burn out’ and become inactive.
The theory is that this throws the digestive system so far off balance that the symptoms of CHS result – first the (potentially years-long) prodromal phase of nausea and discomfort, eventually the excessive vomiting. In a ‘fight fire with fire’ manner, applying the other factors that stimulate TRPV1 receptors – heat and capsaicin – cause them to start working again.
Not only is this theory borne out by the common reports of hot baths taken by sufferers of both syndromes (67% of them according to research mentioned earlier) but when capsaicin cream was applied to the abdomens of cannabis hyperemesis syndrome patients, they reported a lessening of symptoms within a matter of hours.
So far only 15 patients have been treated like this and the results recorded, but this is already very promising for a problem that has so far proved resistant to solving by any other means than “give up cannabis”.
Related post
Cannabis hyperemesis syndrome – the new reefer madness
Despite the lack of hard evidence that cannabis hyperemesis is caused by cannabis (as opposed to being linked to cannabis use), the mainstream media have leapt on it as proof that cannabis is indeed the devil’s lettuce. The free UK Metro paper attempted to claim the word ‘scromiting’ was coined in US emergency rooms as they flooded with affected cannabis consumers, although this claim was effectively debunked.
In 2015 the tabloid Daily Mail, which seems to swing between being rabidly for and rabidly against cannabis depending on which stance will generate the most outraged headline, warned that cannabis hyperemesis is likely to “drain hospital resources”, despite only two cases having been reported in the UK at the time.
Several studies and quite a few news reports have said that CHS is on the rise, and linked this to the increasing number of places where cannabis is legal for recreational and medicinal use. However, this is as yet unproven.
The first case of cannabis hyperemesis in the Netherlands was reported in 2005 despite cannabis having been decriminalised there since the early 70s, and it certainly isn’t an epidemic. There are no reported cases in Portugal (decriminalised 2001), nor Uruguay (legalised in 2017).
It could be simply that there are more reported cases, specifically in the US, because more people now feel able to tell doctors about their cannabis use without fear of repercussions. However, there is one more factor that correlates to cannabis hyperemesis which should be examined.
Could neem oil cause cannabis hyperemesis?
Neem oil is a natural pesticide which is certified for organic use in the US. The growth of the legal cannabis industry in the US, together with the eagerness of many licensed cultivators to produce an organic product, has led to an increase in the use of products containing azadirachtin, the substance derived from the neem tree which kills pests.
Symptoms of neem oil poisoning are somewhat similar to symptoms of CHS – and abate in the same way when the exposure to neem oil and its derivatives ceases. This hypothesis has mainly been raised by cannabis aficionados rather than doctors, and it is possible that conventional science just doesn’t know enough about how cannabis is grown to make the connection. There are currently 139 products containing neem oil that are registered with the Organic Materials Review Institute and available in the US.
However, it is not authorised for use in Canada (it’s actually illegal to use it as a pesticide there), nor in the UK, where rates of cannabis use among the population are closely comparable to the US but reported cases of cannabis hyperemesis syndrome are far fewer.
The Albanian connection
In 2013, a slew of poisonings were reported in Albania. Over 700 people “sought treatment (…) for the effects of planting, harvesting, pressing and packing the cannabis in the village of Lazarat”. Notorious at the time for its lawlessness and industrial-scale cannabis production, Lazarat hosted about 2000 people working in the cannabis fields.
The people needing treatment were almost all women and children, who were more likely to be handling and processing the cannabis than simply cutting the plants down, and far less likely to be deliberately ingesting any of it – especially when their employers only paid €8 per 10 processed kg.
Their symptoms were “bouts of vomiting, stomach pain, irregular heartbeats and high blood pressure”. At the time, this was blamed on the cannabis alone. It’s extremely unlikely that this is the case. These are also possibly the symptoms of neem oil poisoning.
It’s not possible to prove that neem oil was being used as a pesticide on the fields of cannabis in question. It is certain though that neem oil has been encouraged as an organic fertilizer throughout Albania, with 400 neem trees introduced there in 2005 as part of a ‘Raincoat Package’, along with training of local farmers in how to use it. This is circumstantial evidence, but it is evidence nonetheless.
So what next?
There are no definite answers to the questions of what causes cannabis hyperemesis syndrome, why it has only emerged in the last two decades of thousands of years of cannabis use, and whether or not it should even be called cannabis hyperemesis syndrome instead of ‘mystery emesis syndrome’ or ‘possible neem poisoning emesis syndrome’. What we can conclude, however, are the following points:
- Cyclical vomiting syndrome and cannabis hyperemesis syndrome only differ in two respects – the sufferer’s (self-confessed) use of cannabis, and the gastric emptying speeds. There is no indication that people diagnosed with CVS have been tested for cannabis use so it seems to be down to the individual to inform the doctors about it. Based on this, is it possible that some cases of CVS are actually CHS?
- Neem oil poisoning shares some symptoms with CHS. Neem oil is used on cannabis as an organic pesticide in both legal and illegal farming. If the neem oil remains on the cannabis flowers, it can be easily ingested by people who are unaware of its presence.
- The efficacy of hot baths and capsaicin cream in treating CHS suggests that the hypothesis of the TRPV1 receptors becoming over-stimulated by cannabinoids points to not all cases of cannabinoid hyperemesis syndrome being caused by neem oil, as these treatments would have no effect on neem oil poisoning.
What to do if you think you have cannabis hyperemesis syndrome
Firstly, stop ingesting cannabis. Whether it’s neem oil or not, you need to give your system a rest; cannabis hyperemesis syndrome symptoms take one to three months to abate. If you keep having symptoms after this time, it could be that something else is wrong, but the only way to rule out cannabis hyperemesis syndrome is to stop using cannabis.
Secondly, see your doctor and explain what you think is happening. You might need extra fluids and in extreme cases, an IV drip to replace lost liquids.Have you had CHS, or do you know someone who has? What do you think could be the cause? Please let us know your thoughts in the comments below.
- Disclaimer:This article is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your doctor or other licensed medical professional. Do not delay seeking medical advice or disregard medical advice due to something you have read on this website.
I have just registered here to congratulate and thank sensiseeds for including this information on their commercial website. i had found this section looking up connections between my stomach problems and my cannabis use. My doctors were clueless, too polite, idiots? and wouldn’t tell me this stuff. I’m not at the vomiting stage yet, but man oh man, this has not been a fun year. stopped smoking, cured it, started smoking, bingo, here i am again. Glad it’s legal, I guess, wish it were the stuff of Los Angeles in the 60’s, which it aint, and in the US, the citizens can make up our own minds..but business rules, elites want some of us out of the picture, doing our mind masturbation thing, like TV, so I tell people I see in smoke shops, when I was an inspector, Please don’t be too stoned to vote, but, thank you sensi for at least having a section, although well buried, on this topic. Sincerely.
I am taking quad tincture (1/4 of thc,cbd,cbda,thca) for 3 and 1/2 years but never experienced CHS. I am taking 3/4 dropper 3 times a day. Does it happen to smoker only?
Other articles say that CHS does not match up with Neem oil poisoning as well but where is the testing showing what symptoms come of SMOKING Neem oil? They are all based on INGESTION.
Hey everyone, it’s 2021 and society is reopening again, yay.
So, I’m here because my CHS flared up again.
I started smoking heavily at age 18 with my medical recommendation.
Around the ages of 20-24, I’d wake up with awful nausea.
At that time, I did just about everything to fix it. I went to the hospital to do tests, I went to a natural doctor who gave me some sweet pills that helped a bit.
Nothing worked and I learned to live with it, until it went away. Of course, it went away when I stopped smoking weed. My dad was the only one who blamed the weed, and of course I didn’t believe him and thought he was just a hater.
The thing is though, he was right.
For those 4 years of daily nausea, I was very thin and developed anorexia the last 2 years.
I stopped smoking weed because of anxiety, and I did it when I quit alcohol. This in turn led to my anorexia resolving, since I had stopped vomiting every morning after drinking.
Basically, I thought my morning nausea went away because I’m finally at a healthy plump weight, and because my body was no longer using alcohol for some calories and being poisoned for it.
I began smoking again recently. It started out socially, then I bought my own pipe to smoke on my own and smoked a SHIT TON of leftover keif I had gathered when I went to trim on a weed farm a few months back.
I also started to smoke vape pens at work, so I wouldn’t get in trouble.
It’s resulted in a progression in nausea. Very subtle at first, until today when I had to leave work early to go home and be sad in peace.
When the nausea started, I assumed it was my prescribed Ritalin since I’d vomit after taking it a few times.
I searched “Is weed making me nauseous” this morning, after a rough night of being super nauseous after working out the day before. It was really weird that I felt awful after exercising.
After reading other peoples’ stories (especially in this chat), I know now that it’s no coincidence that while all other stressors in my life are out (anorexia, alcohol, bad relationships), the only thing that’d changed recently is how much weed I consume.
Someone left a comment about developing this after trying to lose weight and their theory of how it’s released from fat cells, and I hope one day there’s more research done on that. I’m not fat, I work out 3 times a week, if I’m anything it’s a little chubby.
I think it was the repeated keif consumption (no flower, I was trying to save money), the three bags of edibles I destroyed over 3 days, and the concentrated vape pen that sealed the nausea.
I haven’t smoked at all today (my pipe broke over the weekend, the keif kept it too hot and the glass was weak), yet my nausea is still lingering.
I feel so bad. So, so bad. I’ve been sober from alcohol for nearly two years now, and I feel chronically hung over. I’m not used to feeling nauseous anymore, so it’s really depressing me. Like another commenter said, you don’t want to live like this.
I joined the Facebook group mentioned by another comment, and from this day one I’m not smoking at home. I’ll try smoking socially again, since it didn’t affect me immediately when I restarted with flower at small doses, but for now I can’t. I really, really can’t.
I’m SO sorry to know others suffer from this- I feel quite lucky that the times I DID vomit, it stopped after 30 mins. Reading your stories is really helping me as I lay crying in bed. I know I’ll feel good again someday, but for now my body hates me for smoking weed as much as it hated me for drinking alcohol.
The more I think about it, the more I wonder how much weed had to do with me developing anorexia. I did have eating issues before, but the issues stemmed from not being PHYSICALLY ABLE to eat. I never stopped eating because I was trying to- it was just easy to not eat when I was always nauseous in the morning until later in the evening.
Good afternoon Elvira,
Thanks you so much for your comment, and for sharing your very detailed experiences with cannabis.
The experience with cannabis is very subjective on both a physical and mental level, and the reaction that we each have to the same strain or dose can be very different.
Kief is made from concentrated trichomes and has a far greater THC content than regular flower. Therefore, experts recommend waiting for 15 to 20 minutes after using consuming cannabis to see how the feelings develop, and if you like what you are experiencing. Wait until the feelings start to recede before indulging again.
It is definitely my hope that this article can serve as a kind of online gathering point for others so that they can compare experiences and possible solutions, and not feel so alone!
This article on 3 Healthier Ways to Use Medicinal Cannabis might also be of interest to you.
Thanks again for you comment, and I hope you continue to enjoy the blog!
Have a great day!
Mark
Hello.
I was taken to the ER with extreme dehydration. After 2days non stop vomitting. CHS was the verdict. Interesting I had diarrhea a few days before and dizzynizz. So I used more and more of Cannabis (stronger strains like “amnesia”) because I wanted to get some relief (wanted hunger and fix for dizzy). But my tolerance was to high and didn’t have any “high/stoned” effect anymore , so I experiminted with a tolerance break… Because of the covid lockdown I used cannabis more and more (hyperbolic use).
So when I stopped the first day I had a panic attack after an emotional telefonecall, then the dizzynizz was emidiatly worse and I started vomitting (2 days later ER). After 100hours of no use, the feeling of stomach age went away (not 100%)
now very interesting to know: I sprayed my plantbuds (stupidly) with neemoil (I was misinformed). Also in the week before I started using hennepseedoil in my morningshakes. And 2days before the vomiting I also used some CBD oil.
1 month before I bought the “de verdamper” because of a higher high/€ (before I used the volcano).
Use increased and increased, it is interesting my story because of the know neem oil and other things I ingested.
Also some weed was treated with H2O2… and I might have forgotten some buds so maybe some mold spores also came in my body.
Cannabis saved my life when I was drugged for years with Ritalin. So cannabis is my passion, that’s why I share my story. The more information the better. Now growing my own inside so I will not need any neemoil and crap like that. Will grow old strains as “euphoria” and “citral” to test further.
Respect to all. Peace
Hi Quinten,
Thanks for your comment and sharing your experiences. As you say, the more information we can share, the better. Good luck with your gardening!
With best wishes,
Scarlet
Thank you so much for your article and the comments. I have had 4 episodes of this, to which me and my doctors thought it was due to chronic period symptoms, (in the last 5 years, when I had an episode, I had my period same time.) I smoke everyday, and a lot. I have for about 8 years. Episodes consist of hot/cold flushes, feeling like I’m going to pass out, cramping/ abdominal pain, nausea and vomiting. This latest episode that occurred 3 days ago has by far been the worst to which I was panicking so much thinking I would die that it was making me sicker and weaker due to too much carbon dioxide from hyperventilating and increasing my heart rate. I’m trying to remember what I was told so I’m sorry if anything sounds off.
On the 30th jan at 9pm I woke up feeling off, like a bit of acid feeling/ bile/ nausea feeling in my stomach. I continued to smoke weed thinking it would help the feeling which I was veryyy wrong to do.
I Knew something was wrong, and I knew this feeling, so I quickly went to the bathroom and began to throw up. the nausea had no breaks, except for maybe 1 minute after throwing up like “thank goodness that bile is gone” – however, I would start to feel it build up again shortly after. I was camping, so i went to drive 40 mins to the closest hospital, but i couldn’t stop feeling like I was going to throw up so My sisters partner drove us to the hospital, to which we stopped twice for me to vomit.
The hospital gave me these wafer pills to put under my tongue and panadol which I threw straight up. They then repeated the anti-nausea and pain medicine through the drip. I believe it was ondansetron, which took the pain level down 1 point out of ten, making it a 6/10 versus 7/10.
I felt like I was riding an elevator. when I would breathe in it was like I was floating out of my body and when I would exhale it would be that drop feeling you get on roller coasters. I really had to control my breathing too and slow it down as the elevator feeling and pain and exhaustion and dehydration was scaring the shit out of me. This made them think it could be extreme vertigo but they decided my diagnosis was CHS based on weed consumption and blood test results showing weed levels. I asked to be discharged after about 9 hours as I was so tired and just wanted to go home and have a hot shower it was all I could think about. I go home, shower, and it helps. no weed, and tried to sleep.
day 2 – I think I am all better, its the period that was really bad, but this is not true. I had a couple cones and shortly after, the acid/ unsettled feeling in my stomach returned and I felt very off. I went home, threw up for about 10 hours until I called the ambulance. At a different hospital closer to home now, they decide its CHS aswell, CT scanned and ECG’s and theories of gallstones and gastro but diagnosed it CHS.
Day 3- still haven’t slept more than probably 2 hours. I am exhausted, pretty much passing out in the shower, and the vomiting becomes this violent scream/cry/ wretch as I have nothing in my stomach. Feels like I need to poo too but couldn’t push because stomach was so sentisitve and hadn’t eaten so that effected it too. I called the ambluence again, went to private this time to avoid waiting in the waiting room throwing up and grunting, pale and sweaty for hours again. I haven’t touched weed in 24 hours and the symptoms are subsiding, all still there but at a much more tolerable level. I haven’t thrown up in about 7 hours however I do have nexium and those wafer tablets for nausea that I am taking.
going to attempt some vegetable plain broth tonight as the doc recommends, no bread, nothing substantial, and NO SKULLING WATER!! have a sip of water every now and then if you absolutely need to. Otherwise, go and get an IV fluid drip if you can’t stomach water as not to get dehydrated from sweating and hot showers. threw out all my weed stuff just before. I am not going to touch it again no matter how much I love it, it’s not worth this. I couldn’t go pick up my puppy either that I’ve been waiting 8 weeks for. thank God my breeder is amazing and is looking after my pup till I am all better. time to start living without weed!
thanks for reading my experience and I hope this can offer some insight to CHS and make you feel less alone in your symptoms. As reading what everyone said really helped me feel not so alone in this and that it’s real.
Hi Tatyana,
Thank you so much for sharing your story, and for your kind words about my article – I’m very glad that it, and the comments, helped you. CHS sounds absolutely awful, and the more people recognise the early symptoms of it, the better for everyone. I hope you feel better really soon, and are able to pick up your puppy!
With best wishes,
Scarlet
I was officially diagnosed with CHS at least 5 times before I quit smoking. I didn’t believe that smoking was the cause until I read an article about a kid who died of multiple organ failure after continuing to smoke despite being told he had CHS and reading articles claiming that showers are the main thing differing from CHS and CVS. I spent 3 days straight in the shower, literally sleeping in the bathtub propped up/away from the water because I started violently puking every time I tried to get out. I was going to the ER once a month on average for 2 years straight, usually feeling better after being given IV fluids and IV anti-emetics. I have (and had) prescriptions for zofran, promethazine, meclizine, and was using tums regularly but they didn’t work anywhere near as well as the IV versions of them. I was also having severe and chronic dehydration due to the constant fluid loss from puking. I didn’t feel fully better until 3-5 months after stopping smoking. However, I always suspected it was more related to the pesticides used than the cannabis itself because only certain brands made me sick, making it clear to me that it had nothing to do with strains or any other likely-suspected causes. Even still, anytime I smell cannabis, some brands make me sick to my stomach, have extra mucus/runny nose, and my eyes watering and other brands make me crave smoking again. After reading this article and several of the linked articles, this all lines up with having pesticide caused issues, possibly from neem oil specifically. Thank you so, so much for sharing all of this information in such a well laid-out way. I’ve always wanted to find the true cause so that we (humanity) can start working to prevent future cases.
Also, if anyone knows of places doing studies on CHS, please reply to my comment and let me know because I have yet to find any and I really want to help find and prove the cause of CHS.
Hi Regina,
Thanks so much for sharing the details of your experience, and for your kind words about my article. If I find any information about studies into CHS, I will add them to this comment and to the text. I hope your health continues to improve!
With best wishes,
Scarlet
It isn’t pesticides. I went that route and almost died. You have to just be honest with yourself and realize that unfortunately.. unfortunate doesn’t even begin to express the misfortune of people like us.. but unfortunately you can’t use any cannabinoids again. No cbd no delta 8 no cbg no cbn. Nothing. You have an allergy to cannabinoids. I tried every other molecule on the market and right now I’m laying in excruciating pain in my bed because I foolishly tried to use delta 8 thinking it wouldn’t bind as heavily to my receptors. Cannabis and hemp are just not in the cards for us.
The same thing happened to me bob, you are not alone.
My daughter had CHS. She was hospitalized six times in two years. The vomiting was incredibly violent. She would vomit 5 to 6 times about every 15-20 minutes. Her heart rate and blood pressure would skyrocket and then plummet. But each time she was taken to the hospital, they would give her medication that might slow it down for a while. More than once she was sent home, and before we even finished the 20 minute drive, I would have to pull over before she was vomiting violently again. After a couple of times of that we stood our ground to have her admitted. It was awful. Each time it would take a cocktail of anti-emetics over five days to get it to stop. Twice her gastro paresis was to the point were absolutely nothing left her stomach and her intestines collapsed. Happy to say she finally believed it was the weed that was causing it and finally given up smoking it. Almost 2 yrs now no problems
After 3.5 years of gastric issues and just coming out of another episode; the most protracted and intense in recent memory, my mum asked if my ‘wacky backy’ might have ought to do with it. Nah, course not this is gastric.
To be fair I’d been cutting out foods I thought were triggers, and taken intolerance tests to aid, but it was still a minefield and still the episodes came.
Having had enough I googled ‘cannabis and the stomach’ and quickly found some great info on this and think I now have a way forwards.
Long term smoker, medium (in my head, define medium though) daily use.
Lifestyle change coming on and hoping for brighter days!
i also have chs. i thought about the possible origins of this illness.
i find it strange that it is just being a problem the last 20 or so years. i think it may have something to do with specific strains. maybe through the use of chemicals for forced mutations or to feminize seeds there was a mutation that made something in the plant not like it is supposed to be. maybe ithas to do with the onsane trichome cover we see in more and more strains.
so somehow a mutation appeared maybe with a trait that was favourable for the breeder (trichomes or smell or whatever) then they bred it into other strains and now it is circling in many strains and nobody knows where it came from and that there is a problem.
Why does there seem to be lots of infants born to pot smokers and the infant has major upper Gi-digestive problems. Its the passing thru of the genes from parents to infant on conception.
Hi there,
Thanks for your comment. I’ve never heard of the phenomenon you mention, please could you provide sources? Regarding your second point, cannabis does not alter genes or add them to bodies; what you say is physically impossible.
With best wishes,
Scarlet
Being regularly exposed to cannabis while in the womb may be a factor in developing chs as an adult. I’ve noticed this anecdotally among myself and others who have suffered with chs. Mine started in my early 20s, decades before it was even a known thing, and my mom was a heavy smoker during her pregnancy. Same story with several people I know personally.
Why is the Neem plant allowed to be used in the USA. I know of a person who died in late 90s. For about 15 years he was in and out of V.A. Hospital because of vomiting and others symptons. VA. SOCIAL WORKER told family the man had paraquat poison. Of coarse nothing was ever resolved. Man died and yes he smoked marajuana all day every day. He was allow to continue to smoke pot. At that time was told the officals were spraying the plants to keep people from growing and selling. Top line not bottom line, research must be continued. Stop allowing Neem plant to be used in Usa or any where. My Lord God say , “What is done in the dark, WILL come to the LIGHT.”
I have ben smoking heavily, for 35 years. About 12 years ago I began having all of this happen to me 3-4 times a year. My previous Doctor and I were perplexed. I would be stubborn and not go to the ER for 4-5 days when sick until I was in dire shape, and have been admitted to ICU several times, last year suffering %100 kidney failure after an episode and could have died. In August this year when the medics showed up AGAIN they told me of this syndrome, which I argued with. Then my new Dr. said there was something effecting the GI of heavy users and I argued. Now I look this up and it is EXACTLY me right down to the 24hour day baths and chugging water to throw up to deal with the agonizing stomache pain. I fill 5 gallon buckets vomiting ! I think my dearest friend cannabis has somehow unbelievably turned against me. I’m leaving the disbelief stage and moving on to acceptance……. Goodbye Mary Jane. Thanks for the years!
Hi Debbie,
I’m very sorry to hear about your condition, but I am relieved that this article has helped you understand it! I hope you feel better very soon. If you can, please check back and let us know how you feel after you stop using cannabis.
With best wishes,
Scarlet
Hi guys, I want to talk seriously about Cannabinoid Hyperemesis Syndrome which is a legit medically published condition that was first described in the early 2000’s.
I have had it 3 times in exactly 10 years, and there doesn’t seem to be much first hand info or widespread knowledge of this very real and very horrible sickness. I have needed medical care twice and will outline what happened leading up to the sickness coming on each of the three times.
Please note** anti-emetic drugs like Stemetil etc. don’t always work there is a tablet called Nexium (Esomeprazol) that stops too much stomach acid and this has helped a little. The only other things that help all are very, very hot water and absolutely no smoking for at least 24 hours.
These common denominators were present over the past 10 years just prior to getting CHS symptoms:
Weight Loss – 3/3 times CHS came on I was in the middle of a diet/losing weight, this is I think the main cause – THC can stay in your fat cells for months and when you lose weight it is released and comes flooding back into your system along with the new cannabinoids you smoke and you are essentially overdosing. This is very important because all three times this has happened I was losing weight and on a diet (symptoms were not caused by change in diet or lack of food, water etc.)
Bongs – 3/3 times CHS happened I was smoking between 30-50 cones of very strong hydro cannabis daily (i’m embarrassed to admit this) never happened with joints
Kush Strains/Purple Strains 3/3 times CHS came on I was smoking Kush and or Purple strains (1st time Purple Kush, 2nd time Purple Chemdawg, 3rd time Violator Kush)
Tobacco – 2/3 times I was smoking tobacco and the syndrome happened but I never mixed it with cannabis in a bong to consume only having a cigarette afterwards.
Angostura Bitters – 2/3 times the night before CHS came on I had consumed angostura bitters in water (no alcohol) and angostura bark is know to treath stomach disorders. I know it’s unlikely a cause but it was present and worth noting.
I’d bet my life it is to do with the THC in your fat cells flooding your system that causes this overdose, but these are just the common denominators present before all three episodes of CHS over 10 years.
FIRST CHS EPISODE 2008, I was smoking close to 40 cones of cannabis a day and 15 roll your own tobacco cigarettes. I got some Purple Kush and it was extremely strong, I loved it but after a week I would get these gassy burps and feel a sickly pressure was building in my stomach all the time not long after smoking. One morning I woke up and smoked a bong straight away and then I was anxious, ill, throwing up bile, shaking and I thought I was poisoned and the only relief I got was when I had a very hot bath, then when I would get out of it I would instantly feel ill again. I thought I was going crazy.
My mother took me to the Dr’s who had no idea what was going on, I was throwing up every minute and was in a bad state, the Dr. gave me an anti-emetic injection and some Nexium tablets and I got better and quit bongs from that day forwards and resumed smoking joints a few weeks later with no ill effects. I thought the whole thing was from contaminated cannabis I had consumed and nothing bad happened until September 2016.
SECOND CHS EPISODE I learned about CHS sometime in 2011 and couldn’t believe other people had experienced the same symptoms and relief from very hot water. At this time I stupidly bought a bong and got up to smoking close to 30 cones a day of Purple Chemdawg until the exact same symptoms occurred, I felt them coming on though early and only had a brief bought of vomiting and I immediately quit smoking and threw out my bong and didn’t need medical intervention this time, but it scared me because weeks afterwards, out of the blue despite not smoking cannabis this nausea would hit me.
THIRD CHS EPISODE November 2018 I stupidly bought a bong again and some Violator Kush and was up close to consuming 40 cones a day and the same thing happened again, I know I must be insane to keep pushing myself to this. I awoke last Sunday morning with nausea, that feeling of anxiety and the sick pressure in my stomach, I smoked a pipe and made a coffee and then began throwing up, lots of bile and I couldn’t keep any liquids down. I booked in to see my GP and had a very hot shower and then felt amazing and cancelled the appointment. After an hour the symptoms came back and I showered again but the relief only lasted 10 minutes. I took an anti-nausea tablet and but threw it up, then I booked into the GP again.
I explained to the GP that I was ill with CHS and they thought I was bonkers and questioned me thoroughly about other drug use. I explained my history and the situation when I was last at the clinic for CHS and she gave me an injection of Stemetil and some Nexium and I slept in the observation room for 20 mins and felt better and went home.
So that is my history. I’m on a long cannabis break now and I truly hope this info can be used or at the very least considered by serious medical researchers, as I’ve had this three times I personally feel very alone and on the cutting edge of understanding and dealing with this very real ‘thing’ and I really want to get the word out there. Thank you very much guys for reading and I would really like to hear what you think.
Hi Bob,
Thank you so much for sharing your experiences, and giving so much detail. There is still so little that is known and understood about CHS, even among the cannabis community (when this article was first published, there were many comments about it on Facebook along the lines of “I’ve never had this and I’ve been smoking for years so it doesn’t exist” and even “why are you spreading negative propaganda?”).
It is definitely my hope that at the very least, this article can serve as a kind of online gathering point for other sufferers so that they can compare experiences and possible solutions, and not feel so alone!
With best wishes,
Scarlet
i have supposedly suffered from this and still am but not everything is the same.a hot shower would kill me, i need to be cold, i sweat like crazy and cannot stop vomitting with EXTREME violence.the pain is unbarable, ive contemplated suicide as the hospitals here are useless and every time have me waiting over 6 hours to be seen while i lie on the floor screaming and vomitting. also morphine seems to totally stop it for me, but im pretty sure its a dosage thats borderline overdose. and it stops for me after a few days in hospital with the vomiting ceasing after a few hours once im given cyclizine ondansatron and lots of morphine. also it only happens at most frequent once every 6 months and that was when i quit weed to see if it was because of it. so i dont know, i had a ct scan in spain that showed i had a inflammed and intusscesspted small intestine, i think might really be sick.
I had my first experience with CHS several days ago. Woke up. Felt off. Starting vomiting. Swearing. More vomiting and incredible feelings of “wretching” that i have never experienced. It was like my insides were possessed and I simply could not find physical comfort. Then reading about hot showers, I jumped in and at least I quit puking so readily. But so thirsty and by now not keeping anything in. So now it’s “do I go to ER now or risk it?” I almost called 911. I didn’t, because I made it to the ER driving, albeit with 3 stops.
Gave me Haldol 2mg (antipsychotic) which actually took some edge off. Then sedative via Ativan. Fell asleep. Bliss. Forced rest. IV. Thank you God.
Home later that day. Woke up next day ok. Day after that, puking again. Not as severe. No ER. Hadn’t smoked since 1 puff morning of initial ER visit. Sick all day, by toilet 2 hrs. Oh, doctor prescribed capsaicin cream for next time (in lieu of hot showers). Worked ok, but you have to remember that in no way do you feel normal while showering. You just feel a little bit less like you want to die. And I mean that. You do want to die.
Hi Wendell,
Thanks for your comment and sharing your experiences with us. I hope you’re feeling ok now.
With best wishes,
Scarlet
I just talked with my MJ dr. Re: me symptoms Of bouts of nausea, eventually diarrhea and stomach pains every day. Started when I was referred for thc/cbd for back problems. Works great for pain relief but these new symptoms caused me to stop completely a few weeks ago just to see, the nausea and stomach ills have gradually disappeared! Dr. Gave me this name to look up, I’ve never heard of it. I am not a chronic user, never used before 7 months ago so that is different. Did not experience vomiting yet, or use of hot showers. I thought I must be allergic! He suggests trying cbd alone, slowly increasing dose until pain relief is obtained, if it works and no symptoms come up. My experience was the thc worked much better for pain.
I hope this helps others!
My first experience was in 1998 vomiting for 3 days doctors at hospital didn’t have a clue in the following year’s I would experience it at least once every 3 months few near death experiences due to dehydration and not getting to hospital for fluids after 5 or more days of almost constant vomiting bile reflux my veins had collapsed and I remember it being a struggle to get fluids into me due to veins being missed I did find the article about chs within weeks of it being published because my older brother also was having regular problems with it and someone at the hospital gave him the article on a pamphlet around 2003/2004 in the Adelaide hills of south Australia growing weed was very common and accepted so people were not afraid to tell doctors they smoke it immediately set alarm bells ringing with the hot baths and showers for relief as I would find myself trying to sleep in a hot bath at times because these hot cold chills and bouts of vomiting, nausea would last for days only getting temp relief when I was submerged in hot water and it was same for my brother we both smoked daily for at least 10 years prior there was a massive change in strain quality about 1993 it all went indoors but no sickness started till 1998/99 still a regular occurrence for us both now but glad to see it being recognized finally as this one pamphlet was not backed by any other study at the time and no info anywhere else about it, i tried to spread the word ten years ago but no one ever heard anything about it my opinion after all these years is most likely pesticide poisoning but my thoughts back in the day were people not flushing the chems and nutrients solutions in the final weeks of grow before harvest and I thought also that bacteria in bong water or the bong itself maybe responsible it is certainly worthy of further study.
Are the symptoms of pesticide poisoning relieved by hot showers? No. And if anything about chs has been determined by science it’s that it is caused by cannabinoids! Many desperate, weed-loving sufferers have grown their own clean product with disappointing results. Despite the feelings of marijuana proponents (that would include me) chs is forcing us to rethink the way it is used medically. CHS is probably the result of increased potency of strains developed.
Hi Chris,
Thank you for your comment. I agree that symptoms of pesticide poisoning are not relieved by hot showers, although they are similar enough to CHS that I do wonder if some cases of the former are misdiagnosed as the latter. Please could you let me know your sources for the statement “if anything about chs has been determined by science it’s that it is caused by cannabinoids!” as I was unable to find any scientific evidence of a link between cannabinoids and hyperemesis when I was researching and writing this article? I could only find circumstantial evidence, and proof of correlation but not causation. If there is more up to date evidence, I would like to be able to update this article with it as there is a lot of controversy and speculation around this topic.
Thanks in advance, and with best wishes,
Scarlet
Rea,I sing everyone wants to point at causality… reality is it could be one of the things listed, or worse, some sort of compinding effect. What if it’s neem poisoning that somehow gets exacerbated by cannabinoids? Is it possible hot showers feel better to those with this specific type of poisoning? Tempting to simplify like that, but still too many questions.
People who have only smoked synthetic cannabinoids are showing the same symptoms
Hi Bob,
That’s really interesting, please could you send me a link to your sources? Or is this from personal knowledge from people you know?
With best wishes,
Scarlet
I have not experienced the same..if I grow my own clean..I feel great! Unfortunately can’t try out anyone’s mystery grown..i will swell up in my face hands and feet. I also produce a large amount of mucus..which I cough up and or blow out… my head will feel like my Blood pressure is high and the nausea is absolutely unbearable and my heart will feel like its going to pop…taking benadryl helps my symptoms when I feel the swelling coming on..then I need to drink a substantial amount of water considering when this happens I believe my body is trying to clean out the neem and I need to pee constantly. I full heartedly believe its the Neem oil…I just wished people would use ladybugs or mantis instead of something that kills bugs directly on something that is smoked and consumed…KEEP IT CLEAN PPL!! THIS SHIT IS SERIOUS..
My 20 year old son got diagnosed last week with CHS. He’s had a “sensitive” stomach for years, sometimes we suspected dairy/lactose intolerance. He managed a lot of times with probiotics, drinking 2-4 oz aloe Vera water first thing in the morning and of course ridiculously long showers. I encouraged peppermint essential oil topically during these episodes but come to find out clove oil can be beneficial. And he said he got relief from an oil blend called thieves which had clove oil in it. I read basil, clove, and chamomile may be helpful for this. I also read up that it’s similar to having a migraine in your stomach. And that possibly a keto diet( high fat-200gms or more!! moderate protein-like 60GMs, and low carb20-25 carbs can be amazingly helpful and can help heal your gut. And of course, abstain from canabis. Good luck to those who have found yourself in this situation. My son says he wants to quit but it’s his journey and very hard to be on the sidelines watching and knowing. He has had a rough past 3 years and was trying to just smoke pot for his “anxiety”. I’ve also read a great book called the mood cure by Julia Ross that had recommendations for people in recovery for simple, not expensive amino supplements. But I have to watch my codendance here and I understand I can’t change him, or his choices. I’m a bit of an over researcher but trying to keep myself in check, and go to several meetings a week myself.
I have this and it was the second worse pain I’ve ever had… if you experience it stop smoking weed and it will go away. Life may suck for A LOT of people without weed but it’s worth it. I quit and it went away. If I smoke now the pain comes back in my stomach… it’s not worth it.
Would be very interesting to have somebody such as yourself, who experiences recurrence of symptoms with re-attempted cannabis use, try cannabis that is 100% known to be grown without any pesticides.
This would allow for some insight into whether neem oil or other residues could truly be linked with CHS.
Hi Michael and Jeffery,
I absolutely agree, this issue really needs researching and I think the mainstream medical profession in most places either legally can’t, or isn’t experienced enough, to tackle it properly. If the cannabis community can gather anecdotal evidence, that would be a start, at least.
With best wishes,
Scarlet
Yes— would be very helpful.
So I have had reoccurring symptoms of nausea and vomiting as well as abdominal pain. When I got an upper endoscolopy they said that I had a stomach ulcer. They also told me if I smoked weed it would never heal. I would smoke weed for about a month and then a mouth later I would get symptoms but I never felt sick right after I smoked. Later I found out that I actually had gastric erosions and when I got a second opinion they said that nothing in my stomach was causing these symptoms. I was told that I either have cvs or chs. And because I was using cannibis I pretty much ruled out cvs given that every-time I would smoke, later down the line my symptoms would come back, this happened 3 times 2 times going to the ER. I guess the most logical thing to do is to stop smoking all together I haven’t smoked for 3 months and I haven’t had any symptoms, I just wonder if I stop long enough could I potentially use cannibis in moderation without symptoms ever coming back? It took around 2 years to actually figure out what was causing this.
I like how you emphasize the part that ”Life may suck for A LOT of people without weed but it’s worth it”
Like you and i both know that was absolutely necessary to add, lol.
I don’t have CHS but honestly this ”overcharging the receptors” theory makes a lot of sense to me. Sometime last year i was starting to feel nausiated especially during mornings. Occasionally i’d vomit just to feel better like my whole body felt like shit. I wasn’t eating too well either, i’m vegan but had problems with diet because this country hasn’t caught up with all the good vegan food yet but anyway.
Was really worried i was practically dying and a regular supply of multivitamins fixed a lot of issues + eating well also makes life a lot easier.
I wasn’t smoking the cleanest weed back then either. You guys should ask your hippy friends (trust me, you know a guy, who knows a guy) where the cleaner weed is at. Since i switched suppliers i’ve been getting cheaper and cleaner weed and stronger weed than i’ve ever been smoking in my life. The trim alone was stronger than any bud i’ve smoked in Amsterdam.
Also this might be graphic but for years i’ve been coughing up black shit and when that first happened it worried me ofc but i figured every chronic abuser has the same problem BUT when i switched supplier to a guy who has way cleaner weed i’ve been coughing way less almost no black shit anymore and been feeling generally way better.
Also learning to smoke responsibly is a big part in feeling healthier sometimes you are smoking strains that are completely counter productive to what you want to achieve without knowing it so look up what strains your consuming cause then you know what to expect from your weed and get it as clean as possible
TRUST ME, it is WORTH asking around! Especially if you don’t have medicinal grade dispensaries. Even in Amsterdam they don’t have the cleanest weed in the coffee shops (you’d be surprised)
Anyway learning about CHS puts some things into perspective as to why i was feeling so shitty last year apart from some other health issues that i’ve been working on.
Marijuana use can be healthy
Marijuana abuse is something else though. Look into dry herb vaporizers!
And edibles.
And T breaks 😀
For 13 years I suffered from this at the extreme end of the scale, it went pretty much undiagnosed for 11 yrs at which point I was diagnosed with CVS after previously being tested for hundreds of conditions. I would end up vomiting to the point where I would end up with full body muscle spasms and go into kidney failure, this would last from 5 to 14 days at a time. Nothing the doctors gave me would relieve the vomiting, the only thing that helped was sitting in a hot shower or bathtub, which I would have for pretty much 24 hrs a day. My vitals got so bad that the doctors told me 8 to 10 times that I should have been dead or in a coma. My body rejected any fluids that I put into my body, I have a lot of information from my experience with this if you would like to contact me.
I don’t smoke cannabis or take neem but I have had a vomiting problem for years.i vomit if I rush,go up or down stairs,brush my teeth etc but it’s not good,it’s that I’m constantly mucousy & (I hate to be graffic-sorry) but my left ear leaks.Doctors don’t seem to know why & no suggestion has really been made.I do get sudden cramps & diarrhoea but no massive or long lasting stomach pains.Does this sound like cvs?
Mel, it sounds like you have an infection in your gut. I highly suggest looking into functional medicine- particularly by Chris Kresser or Mark Hyman. They treat gut health, from the root, unlike conventional medicine which only focuses on symptom management, and rarely acknowledges the gut. Best of luck.
you prob have cvs not che…
Hi! I have a question about your symptoms? After you stopped smoking, how long after did it go away? And did anything help? How does it get better?
It’ll go away in about a week.
3 days. No weed. Once out of the major vomiting/body temp fluctuations, still 2 more days of feeling off. Some people apparently take longer.
I don’t know if i have CHS but i have smoked weed for so many years and a lot of it, like 5-10 joints per day) but only recentely i started to have very very strong nausea after smoking weed, if i don’t smoke anymore nausea will go away in a day or two..not completely but enough for me to want to live because when i have that nausea is so bad that i would rather die than feel like that :(. It completely drain me, and meds like metoclopramide are useless..i can’t take hot baths because i have some heart arrhythmias and hot baths will make my heart to beat at around 200 BPM ! (I have PSVT). I love your ideea about neem oil poissoning, weed that i currently buy smells a little weird, very subtle but my nose know very very well the smell of a good and clean weed. So i will give a try, and try buy it from another place. And i really really hope that i don’t have this fucking nightmare ! 🙁
I recently had this happen to me. Luckily the doctors working on my case figured it out. I too, took hot showers, to help with my pain and comfort. I couldn’t even hold a sip of water. I was using the cannabis pens like two I a week. I was released from hospital today. I would love to find out more. I
Leanne, I highly suggest if you have Facebook there is a support group for people suffering with this, it’s called chs recovery group. It has helped me so much, everyone is so nice and helpful.
did u ever get sick from second hand thc smoke? I have CHS and all of sudden i have started to get symptoms for second hand smoke