Surge in Cannabinoid Hyperemesis Syndrome Cases Raises Alarm

A recent study conducted by researchers at the University of Illinois Chicago reveals a significant increase in emergency department visits linked to cannabinoid hyperemesis syndrome (CHS) in the United States. The condition, characterized by severe and painful vomiting episodes, has become more prevalent, particularly among younger adults who use cannabis regularly. This finding raises concerns about the potential health risks associated with long-term cannabis use.

The study examined emergency room records from across the country, focusing on visits between 2016 and 2022. Researchers found that diagnoses related to CHS have surged since the onset of the COVID-19 pandemic, indicating a troubling trend that healthcare professionals need to address. Lead author James Swartz, a professor at UIC’s Jane Addams College of Social Work, emphasized the growing importance of recognizing CHS in emergency medicine. “Cannabinoid hyperemesis syndrome is real, and it’s becoming a more routine part of emergency medicine in the U.S.,” he stated.

Understanding Cannabinoid Hyperemesis Syndrome

Individuals suffering from CHS experience cyclical episodes of intense nausea, vomiting, and abdominal pain. An acute episode can last from one to two days, often leaving patients in extreme discomfort. This phenomenon, colloquially referred to as “scromiting,” combines screaming and vomiting, reflecting the severity of the condition. Although CHS is thought to occur primarily in those who have used cannabis chronically for several years, the exact cause remains unclear. Researchers speculate that overstimulation of cannabinoid receptors in the gastrointestinal tract may play a role.

The rise in CHS cases aligns with increased cannabis legalization across the U.S. and possibly higher concentrations of tetrahydrocannabinol (THC) in contemporary cannabis strains. The study documented approximately 100,000 suspected cases of CHS during the research period. Initially, rates of CHS remained stable, but starting in 2020, emergency room visits surged. Although there was a decline in cases in 2022, they remained above pre-pandemic levels, indicating a sustained issue.

Implications and Recommendations

The findings, published in JAMA Network Open, highlight the need for increased awareness and understanding of CHS among healthcare providers. The study notes that prior to the pandemic, doctors struggled to classify CHS as a distinct medical condition, which complicated diagnosis and treatment. Researchers used diagnoses related to cyclical vomiting syndrome and cannabis use as a proxy for CHS during this time.

Researchers suggest that the pandemic likely contributed to the rise in CHS cases through increased stress and isolation, leading to higher cannabis consumption. They wrote, “The COVID-19 pandemic likely catalyzed the rise in CHS through stress, isolation, and increased cannabis use.”

Despite the alarming rise in cases, it is essential to recognize that CHS remains a relatively rare side effect of cannabis use. The only effective way to prevent CHS episodes is to cease cannabis consumption altogether, although symptoms may take weeks to resolve. Swartz cautioned that while the findings should not induce panic, they underscore that cannabis usage comes with risks, particularly at higher doses and with long-term use.

Earlier this year, CHS was officially included in the latest edition of the International Classification of Diseases (ICD), enhancing the ability for healthcare professionals to diagnose and track the condition. Nevertheless, the authors stress the importance of clinical awareness to prevent misdiagnosis and unnecessary medical tests. They advocate for further research to understand the underlying causes of CHS and why it affects only certain long-term users.

The rising incidence of CHS serves as a reminder of the complexities surrounding cannabis consumption and the importance of informed decision-making regarding its use.