Cannabis Hyperemesis Syndrome Polarizes the Cannabis Community

Depending on who you ask, CHS could either be a legitimate medical condition, an over-reported occurrence, a misdiagnosis, or a hoax.
Cannabis Hyperemesis Syndrome Polarizes the Cannabis Community

Cannabis Hyperemesis Syndrome (CHS) is one of the subjects most likely to start a lively discussion in the cannabis community. The condition is thought to induce several cycles of vomiting, abdominal pain, dehydration and other adverse symptoms. 

While CHS has its share of support, some in the cannabis and medical communities disagree with the current narrative. Depending on who you ask, the syndrome could either be a legitimate medical condition, an over-reported occurrence, a misdiagnosis, or a hoax. 

With a slight uptick in research as of late, CHS may soon be on its way to being better understood. However, additional research is required to further understand CHS, or whatever it is that is causing people pain. Until then, a spirited debate continues among many.

Seeing CHS as a Valid Medical Condition

Those that endorse the validity of CHS often discuss the pain associated with the syndrome. The abdominal pain is reported to be immense and cyclical. Holding down food or liquids becomes a near-insurmountable task. In most cases, these symptoms are reported to last days or much longer. 

Little is reported to provide relief from CHS symptoms. Some claim capsaicin is effective. However, studies and patient feedback suggest hot showers or baths are the best remedies, though temporary. The cycle of symptoms is said to be halted only after cutting cannabis entirely out of one’s life. Some CHS patients have reported returning to consuming cannabis after a break. In contrast, others describe an inability to consume without their symptoms returning.

CHS proponents typically cite a 2004 study as its introduction to the public. The study provided a limited subject pool, focusing on 19 South Australia patients across numerous hospitals in 2001. The examination concluded that several years of ongoing consumption were required to trigger CHS. Of the patients evaluated, six returned to cannabis either right away or after an undetermined amount of time, with each experiencing similar symptoms once again. 

In the years since, additional studies have supported the claims made in 2004. However, in most cases, investigations are of limited subjects, or at one location over some time. While unable to provide conclusive findings themselves, these studies do provide glimpses into the possible reality of the condition. However, additional studies are required to verify any results. Like most subjects in cannabis lacking concrete lab research, anecdotal evidence from doctors has helped fill the void to a degree. While helpful in cases, self-reported evidence can only go so far in providing answers. 

Jessica Walters, the chief medical researcher for CannaMD, called the pathophysiology of CHS “poorly understood” at this time. Walters supports cannabis use as a medical option while acknowledges that it produces adverse effects in some. In that case, patients are typically recommended to abstain from consuming for at least seven to 10 days to find symptom relief, according to the medical researcher. 

The most notable CHS advocate and patient currently in the cannabis community is likely Alice Moon. A former edibles reviewer, Moon was diagnosed with ongoing symptoms for two years. She told High Times that doctors initially believed it was acid reflux, leading to her to quit drinking. With the symptoms persisting, a litany of tests would follow. Eventually, her doctor diagnosed Moon with CHS. “Everything showed up normal,” said the CHS advocate. “So, it was a process of elimination.” Eventually, she said, the doctor came back with a diagnosis, “Cannabis was making me sick.”

Moon has garnered a fair share of support in the cannabis community. That said, others continue its validity as a condition. 

Questioning and Denying CHS

While CHS has gained prominence in circles, skepticism and doubt remain. 

Doubts remain over the classification of CHS. In one case, Boston primary care physician Peter Grinspoon, MD expressed concerns regarding the condition’s similarity to cyclical vomiting syndrome (CVS). Other possibilities for the cause of the symptoms the doctor mentioned included an unknown source for the vomiting, namely a non-cannabis substance.

Of the notable non-medical professional names questioning the frequency of CHS is activist and Harborside founder Steve DeAngelo. In June 2019, DeAngelo voiced concerns over the syndrome, saying its occurrence was quite rare if it existed at all. In the months since DeAngelo spoke with Moon after the two clashed several times on social media. After speaking, DeAngelo would then say the condition did exist but noted its rarity. 

Those supporting a misdiagnosis have pointed towards a chemical found in the pesticide neem oil as a possible culprit. This theory suggests that the poison azadirachtin, a compound in neem oil, creates CHS-like symptoms, triggering a misdiagnosis. This occurs as some believe that the pest and mildew remover remains on particular strains of flower, causing consumers to become severely ill when consumed. 

CannaMD’s Walters noted that incidences of CHS are on the rise. While this could be attributed to previously undefined cases, the impact, if any, of neem oil deserves further research. Walters stated that “the suggestion that chemicals, involved with new cultivation methods and mass production of the plant, may play a part warrants further review.”

Others, like cannabis entrepreneur and activist Kyle Turley, say CHS is not a concern at all, because, according to him, it isn’t real. Recently, Turley tweeted, “CHS is a mythical condition that affects those who have yet to discover their strains and use CBD daily.” The month before, the CBD advocate tweeted, “CHS is a myth created by those against understanding the cannabinoid system, all day every day!” Like DeAngelo, Turley and Moon have tangled online over CHS and statements both have made. 

With numerous perspectives, the discussion around CHS, its validity and frequency are likely to be ongoing until additional research provides the community with clarity. Aside from maybe those subscribing to the myth theory, most agree that patients have some condition better worth understanding. Be it CHS, CVS, neem oil or another thing altogether, people deserve clarity and accurate diagnoses. 

With hope, further research from larger subject pools will help provide certainty one way or another.

  1. The bottom line, CHS cannot be considered a serious disease for recreational consumers, since all it takes to cure it is to stop consuming marijuana – or take a long break.

    1. WoW…Just like alcoholism cannot be considered a serious disease because all it takes is to stop drinking…….Drug addiction is not a serious disease because all it takes is to stop drugs……..The other side is most doctors and Hospital ER’s are not aware of this Disease so many people end up in the hospital year after year…..It is a serious disease please do some research before you throw out such a cavalier wrong statement…Peace

      1. Whoops. — Where did you get the idea marijuana is addictive? Addiction involves withdrawal symptoms that are so severe, they compel continuous use to be avoided. — Marijuana doesn’t have them, so is NOT addictive. – That’s one of the many things consumers like about it. We can take it or leave it. In earlier times, we often had “dry spells.” Nobody jonesed. We just did something else until a new crop came in.

        1. hahahaha what a load of bullshit buddy……Marijuana is addictive!!!! dont get me wrong I love pot ,smoking and in foods,etc. But if u can honestly say its not addictive u have not been full on smokimg pot continuously for a long period of time!!! Anyone that is a serious pot smoker would have experienced Mood swings and especially when u have none to smoke and come down,or have none in the morning most ppl get an irritated feelimg and short tempered and/or irratable. Also many ppl ho smoke pot continuously have problems sleeping when they are not high or or have a smoke of weed before bed. People also experience loss of appetite when they arent high or havent smoked any pot recently before a meal or feed,once stoned get appetite back immediately in moost cases.

          Also i have Hyperemesis from chronic marijuana use for over 30 years.I had a Stomach Ulcer for a few years in my late twentys and now its healed and all gone but i still get severely sick approxiamately one or two days a month which i just keep vomiting chronically for twenty-four hours 0r so normally, and the only thing that i have found relieves any of the symptoms is an extremely hot shower as hot as physically tolerable…..i often use all of the hot water in three or four friends and families showers each time im sick from the Hyperemisis.

          1. I have been in the hospital for this 5 times the pain was so severe. And i too find a hot shower helps. Also a heating pad. Just had a bad bout last week. Only lasted a day and no vomiting this time. Feel your pain

          2. It’s not the weed, the weed is bring out symptoms of the real issue. Don’t be a fool, fooled by fools!

        2. You sir saying that Marijuana is not addictive and does not give withdrawls. You are a darn fool. You ABSOLUTLY feel the lack of desire to eat and and you feel shifty for at least a week after you quit smoking. Idk what planet your on but this is a reality. Not some nonsense. I love smoking pot. But I get CVS and stopping smoking is the ONLY thing that has ever helped it. It has been a battle through my 30,s coming to this conclusion.
          Marijuana is emotionally addictive 100% and people do experience withdraws.

        3. I am not sure that is the definition of ‘addiction’. Addictions can be physical, mental and emotional – all defined by cannot be without. Meth is not a ‘physical’ addiction, but it definitely can be addictive. Please don’t trivialize the concept.

        4. Uh are you good lol? Marijuana does have those symptoms for long term high dosage users, I work in a dispensary and part of our training was to educate people that 1 in 3 people actually over use marijuana creating a dependency and withdrawal symptoms. Anyone not dealing with CHS related issues shouldn’t even be commented here .

        5. Marijuana can be highly addictive I’ve struggled for 37 years to quit I never last long & always end up smoking everyday again eventually with vomiting & being really sick for 2-3 days always ending up in hospital . Trust me it’s real alright! as soon as I stop smoking the vomiting stops which can be anywhere from 2-5 times a month for 2-3 days at a time & is horrific & very real, much worse than any normal stomach bug & the sweats are ferocious. I had every test the Drs could think of & nothing showed up. The vomiting stopped when I stopped smoking pot. I was clean for 12 months & began smoking again & within 4 months it was back again. I’m quitting for good now it’s just not worth it.

      2. Congratulations: you have taken the original post and responded with a textbook example of reduction to absurdity. The comparison to alcoholism — which is a genetic condition that results in a cellular need for poison — is absolutely inappropriate and inaccurate at every level. You’ve reacted to an intelligent post with hyperbolic emotion rooted in ignorance. Breathe.

      3. Alcohol and cannabis are not equals and should never be considered so. One can be used 24/7 with very little effect on daily life, the other will make you lose control of your brain and body. Alcohol is poison and will destroy every system in your body. Yet, weed, is bad? CHS? Is a diagnosis for the lazy doctors that won’t properly care for people. We are numbers and tge easy fix is the only option the take.

    2. If one ingests too much or smokes too much or its some damn heavy weed, yeah, you just might get sick. It’s temporary….

    3. I was diagnosed with CHS in July of 2022. I have been having bouts sporadically since spring of 2014 but I never told the ER doctor I smoked because it was illegal in VA. I feel like marijuana is an easy scapegoat and that CHS is a myth. It just doesn’t make sense that this came about recently when people have used marijuana for thousands of years. The argument that it’s stronger now doesn’t make sense either. As a teenager I couldn’t get the stronger strains regularly so I smoked higher amounts of the weaker stuff. CVS makes more sense as I have had stomach issues since I was a baby and they said I had a milk allergy. Completely bs I drank milk and ate dairy for years.

  2. i promise you, CHS is real. I have been living with someone for 26 years… 15-20 of them he was sick with some mystery illness that could take him out for days. we were going to gastros who couldn’t find anything.

    in the beginning… it was one day here and there over a year… by the end of his progression he was sick 3-4 times a week for weeks on end that culminated in another hospitalization in October while they worried if his kidneys had failed. Thankfully they had not and he regained 100% function.

    Two weeks before this last hospitalization, I found CHS online and was asking… maybe it’s the weed. He fought this process saying, quit saying it’s the weed. but i kept saying it and eventually he quit to shut me up. once his system had cleared (about 14 days) – so did ALL of his symptoms. it totally was the weed. he’s now healthy, happy and never looking to toke again because after all the CHS stories he’s read, he knows it’ll happen again and worse. He has no desire to smoke (which is great) and doesn’t want to re-enter the slippery slope of wanting it so he’s abstaining completely. I’m so proud of him. He’s 6 months clean and absolutely no symptoms. You can’t tell me (or him) that CHS isn’t real.

    1. So it’s real, but not serious. – The only problem is not checking for it when you begin suffering. Again, since all it takes to cure it is stop smoking, it’s not a serious disease.

      1. You’re a fucking idiot. It’s not serious because you don’t have it? How do people like you make it this far in life

      2. bro i have had this sickness on and off for 10 years you do not want to get these belts they are aweful and make you feel like death with the constant vomiting. i have used cannabis everyday over twice a day and i feel like it is the weed causing my problems so i have decided to cut right back to one session at night, well will do my best.

      3. It is serious!!! Why else would it put you in hospital on a drip with dehydration. Vomiting constantly for 24-48hrs half hourly with chills, severe sweats, worst headaches ever, stomach cramps, pain & diahrea, weight loss, can’t eat or drink. 2-4 episodes a month!! How is that not serious?!?!!!!!!! What is serious is the shit they’re putting in the hydro pot these days to try & make it better but they’re making it worse!!! I’m done!!!

      4. Yeah, you are seriously ignorant John, and clearly have no idea what you’re talking about. There is plenty of medical literature on this and I suffered from CHS for 10 years, was hospitalized 16 times before being diagnosed, and spent over $100,000 on treatment in the meantime. I was very addicted to Marijuana since age 16, physically and psychologically. So please stop spreading misinformation. It’s a very serious disease that should be discussed more openly.

    2. Calling someone “clean” because they have chosen to refrain from cannabis is ludicrous, and it makes me doubt the authenticity of your entire narrative.

      1. Whether the word “clean” is appropriate or not is a separate issue that has nothing to do with the many witnesses who have personal experience with CHS and the severe symptoms involved. These are mostly people who really like pot. It really is serious too since it can and has led to renal failure and death for those who refuse to quit after a clear diagnosis.

  3. It’s real, and so is Neem oil contamination in some cases. But even with organic cannabis properly grown without any remaining pesticides, there are cases of CHS. Read the CHS talk page on Wikipedia. The dispute is over the numbers. Some believe that there is a slope of CHS effects. Others believe that a certain threshold has to be reached before the CHS effects kick in. More scientific study is needed.

    1. The fact still remains, it’s easily cured by stopping consumption. So it’s only a serious disease for medical marijuana consumers.

        1. You could say that, but it would be wrong and wouldn’t have much to do with the discussion. – Do you think heart disease is easily cured?

  4. Speaking first hand I was in the hospital twice within 24 hours. I was told both times go home you consumed too much cannabis and have CHS. I was throwing up for hours and could not stop. I was asked to leave the hospital since it was just CHS they said. I found out two days later during a surgery that I had C-Diff and EColi. So I think personally medical professionals are not sure of how to handle stuff relating to cannabis and it is causing misdiagnosed cases.

    1. Yikes. – That is my main fear of going to a hospital. That I become someone’s mistake. – Chalk up another harm of the fraudulently enacted, marijuana prohibition. 83 years of the world’s largest propaganda campaign has not only destroyed many millions of innocent people, it has created a sea of ignorance and mis-information that stretches even into the medical profession.

    2. CHS is absolutely real whether the exact science of it is known or not. Many have been examined thoroughly and often for alternate causes with no other cause for the full range of CHS symptoms found. These same people have found that the only thing that works is abstinence. Your misdiagnosis is unfortunate and we all know doctors make lots of mistakes but with Trump and covid and people smoking more in legal states CHS is showing up in hospitals a lot.
      I also want to say that the Neem Oil hypothesis has problems since neem oil is used on many edible crops and we should be seeing these symptoms from food if that is the case. Not saying there is nothing( and it would be cool with me if that was isolated as the cause but considering my own experience and the certain lack of neem oil involvement I am dubious) there but we need more research and we need to accept that pure well tended bud may make some people so sick they have to quit.Far from being truly rare, it could be as high as 20% of daily users. CBD is no cure, my first vomiting episode came from a largish dose of cbd, then from cannabutter twice and now I quit smoking or any form and intend to use an edible at most 5 or 6 times a year if that. I have moved to Qigong as primary mental therapy and it works well for me though I do miss weed sometimes. If you have no problems from cannabis be thankful but don’t think people who are getting sick are lying. It just poisons the water. We all need to move beyond the all too common my side/ your side approach.

  5. Severed side effects can come from any botanical source or pharmaceutical sources. You listen to big Pharma ads and listen to the listed side effects you think to yourself why in the hell would I take this drug the Dr. prescribed me because what I am suffering
    from with the side effects are worse sounding and can be absolutely deadly to some. To understand CHS you have to take into consideration how was the tincture or flower or concentrate made and whether it is a knock off of the teal product or it could be a gastrointestinal disorder that causes nausea and vomiting. People can get a CHS effect from IBS and Colitis and Chrons Disease. So we cannot decipher if it is an allergic response to the product injected or not. There is no differential diagnosis of why you are nauseated and continue to dry heave and of vomit liquids. When you are dealing with gut health there are many variables. I would try building your gut health up. Try some Probiotics and go to a excellent Gastroenterologist and get examined for leaky gut syndrome. This too can cause issues. And remember we are one people on this planet but all different in how we Perceived and what we think the issue is and is not.that is differential diagnosis. I know CHS because I was a grower and we were the pioneers of the growing industry and made huge amounts of money! But I am actually glad things have changed. I miss the money sure, especially now! But my wife cannot eat edibles like brownies. She will be honoring the Priceline god for hours and days with CHS. So you have to understand every Body is different. I am in medicine and I would have to go on a long medical terminology diatribe here. But like Chief Dan George said in a great movie; Little Big Man. George says; Sometimes the magic works, and sometimes it doesn’t. Try ingesting peyote buttons un prepared right and you almost have to go through a gauntlet of vomiting in order to get to the wonderful high! I remember when they started cutting LSD w. strychnine! But you learn that a little micro dose of what can be highly poisonousness, can get you high, like micro dosing LSD now is so popular.
    Just remember you may have underlying stomach or gastrointestinal issues that need to be checked. Food allergies and poor gut health etc.

    1. John I understand your thought here and please don’t think people that have suffered with CHS or what ever it gets called haven’t thought of leaky gut diet stress poisoning IBS hpylori ECT ECT ECT. It’s statements like yours that completely over looks the obvious. I was a leader in this legalization movement since 1991 have championed this movement ran the largest dispensary in the nation, came up with the grading scales and quality control for dry product concentrate and edibles. I have also suffered from CHS before anyone even though of it. It started with me in 1987 n yes it still gets me. Just this yes I was hospitalized for a week in the critical care unit. It is serious when the public doesn’t know everything. Some folks like Turkey n Di Angelo who are bias because of the money they make for legalization. How do these guys sleep at night. One day when the science gets to the point we understand all the receptors in the body and can test for their functionality we will then know what’s up. To all those who think this is BS or easily fixed well to you I say let hope you don’t get it.. Anyone want to know more please drop me a line I’ve been following and interviewing cannabis users about this since 1991. Guess who’s on the list of folks that suffered from this or are now? I’d be glad to share. Just because someone doesn’t believe it or think it’s so rare there’s not a problem doesn’t make it true.

  6. I had never heard of CHS before. I am 57 and have been smoking since I was 14. Almost all of my friends are long term smokers, a few of which are extremely heavy smokers, yet very successful. I have never known anyone who has had any problem with cannabis. Of course, I also have friends who don’t care for it or gave it up for whatever reason. Just never heard of anyone getting sick from it. Now back in the 80’s we did get extremely sick from smoking “paraquat pot”. That produced pretty much the same symptoms described as CHS.

    1. Same experience here, going back to the 1970’s. – I don’t doubt that CHS is real, just that’s it’s rare and easily cured. Unfortunately, it has been hyped up a lot by prohibitionists who are desperate to find some significant harm of marijuana they can scream about.

    2. I’m 57 also and have been smoking for 40 years. About 2 years ago I started to get severe nausea that would come up totally unexpectedly, with sweating & chills and finally vomiting. This happened every month for 6 months. At first it lasted only a few hours. Then longer, 24 hours or so. The only relief were hot showers as long as the water lasted. ( it takes 18 min for my tank to reheat!😜).
      Finally I had a bout that lasted 2 days. I went to emergency, was immediately diagnosed with CHS, given IV fluid & pain meds and felt better. But as soon as I got home, symptoms returned! Vomited all night, returned to ER in the morning, after a initial blood test, my triponin levels were so high they said I was having a heart attack. I’m rushed to angiogram. Angiogram and echocardiogram are clear.
      No heart attack. And I’m still nauseated & stomach cramps. I was admitted & had mri & ultrasound. Nothing conclusive.
      After 4 days in the hospital on pain meds (and no weed) the stomach cramping stopped and I was able to eat again.
      Felt better within a couple days.
      I quit smoking weed for about 30 days researching CHS. I was able to successfully start smoking by choosing specific organic & lower thc products.
      There are times I try a new products ( or hit someone else’s weed) and start to feel the reaction. If I immediately get in a hot shower at the first sign of symptoms, I can usually stop an attack. May take a couple showers in a row!
      But the point is I love weed and i really want this talked about more, not to Hurt the weed industry, but to bring awareness that’s it isn’t so rare. I hope they find what causes CHS and find a plant we sufferers can smoke safely!

    3. Sorry Jeff but how many people do you know that have died from the covid? See my point just because your close friends haven’t developed this condition doesn’t mean other have not. Unless you have experienced this or actually know someone who has you opinion is just that.

  7. While CHS may truly effect people. As a long time cannabis user and medical patient I have been using cannabis for a little over 10 years. When I first moved to Denver Colorado 4 years ago was the first time I encountered symptoms like CHS. Doctors told me I could be allergic to cannabis so I stopped for a month and In that time my GERD was worse then ever after having nasty nausea and vomiting I started looking into the fungicides herbicides and pesticides that are used in commercial cannabis cultivation and I found that the majority of these substances can cause all the symptoms of CHS. So now I only consume cannabis from 100% organic living soil cultivating dispensaries living soil is a method that uses no non organic pesticide herbicide or insecticide instead in living soil there are Millions of small organisms living in healthy soil which is rich in organic matter. These living organisms make soil alive and give it a good structure and texture. A living soil ecosystem nurtures and nourishes plants by providing a healthy medium to take roots and through a steady supply of nutrients. Before we let the scientists decide whether CHS is a real cannabis related problem I believe there should be more research collected from all sorts of dispensaries not just single sources research. Ultimately I don’t believe there is sufficient data to make a claim that cannabis alone causes CHS.

  8. Indeed, the usage of cannabis as a medical option while acknowledges that it produces adverse effects in some. In that case, patients are typically recommended to abstain from consuming for at least seven to 10 days to find symptom relief.

  9. I’ve dealt with this since 2006… I dont want to hear it either, but I abused it, and this is what happened.
    Vomiting for days and sometimes weeks. I hate it, but its real.. good luck people (use moderation) or quit, it’s not worth it.

  10. Okay for anyone still wondering, bathing and showering kicks off the Dive Reflex and your body knows it shouldn’t be barfing when it’s underwater. More to the point, I think it’s strange that the same symptoms which cannabis is frequently meant to help with (nausea, GI discomfort, vomiting) are strangely the same as CHS. I agree completely with the sentiment that teetotalers are clutching at anything that can give Cannabis a bad rap.

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