(OPGOV GLOBAL) – Emergency department visits linked to cannabinoid hyperemesis syndrome (CHS), a condition associated with frequent cannabis use that causes severe nausea, vomiting, and abdominal pain, have increased more than 500% since 2016, according to the Association of American Medical Colleges (AAMC).
Health care researchers and emergency physicians reported that the increase occurred alongside rising cannabis use and higher concentrations of tetrahydrocannabinol (THC), the primary psychoactive compound in marijuana. CHS cases have become a growing issue for emergency departments as physicians treat patients experiencing repeated vomiting episodes that can lead to severe dehydration and hospitalization.
Cannabis use has increased across the United States over the past decade. The AAMC reported that approximately 64.2 million Americans ages 12 and older used cannabis within the previous year, compared with 12.6% of the population in 2013.
The Congressional Research Service report “The Federal Status of Marijuana and the Policy Gap with States” reported that marijuana remains classified as a Schedule I controlled substance under federal law, although states have adopted varying medical and recreational cannabis laws.
As of 2024, 38 states and several U.S. territories had comprehensive medical cannabis programs, while 24 states and territories allowed recreational marijuana use for adults.
The wide availability of diverse medical and recreational cannabis products has contributed to a major surge in national usage rates over the last decade.
Photo Credit: John Hopkins Bloomberg School of Public Health
Researchers have also found that cannabis products available today often contain higher THC levels than products available in previous decades.
According to the AAMC, testing by researchers at Virginia Commonwealth University found some products contained THC concentrations far above their listed amounts, including one product measured at 34 times the labeled concentration.
CHS symptoms typically include severe abdominal pain, nausea, and repeated vomiting that may continue for hours or days. Some patients report temporary relief from symptoms through frequent hot showers or baths, which physicians often consider a key indicator.
A 2025 study published in Annals of Emergency Medicine examined the impact of CHS among more than 1,000 individuals who reported experiencing the condition.
Researchers found that many patients experienced repeated emergency department visits and hospitalizations, demonstrating the significant health care burden associated with CHS.
Diagnosing CHS can be challenging because symptoms may resemble other conditions, including food poisoning, stomach viruses, and cyclic vomiting syndrome.
Healthcare providers emphasize that open communication about cannabis use is vital for accurately diagnosing complex emergency cases.
Photo Credit: Forme Medical Center
Similar challenges in identifying and treating complex medical conditions have been examined in previous OpGov.News health coverage, including “Endometriosis: New Research In Testing And Treatment,” by Teri Tracy.
Emergency physicians have also reported that some patients do not initially connect their cannabis use with their symptoms or may not disclose cannabis use during medical evaluations.
Treatment options for acute CHS symptoms have continued to develop.
A randomized controlled trial published in Annals of Emergency Medicine found that intravenous haloperidol was more effective than ondansetron, a commonly used anti-nausea medication, in reducing nausea and abdominal pain among patients experiencing CHS.
Researchers found that patients receiving haloperidol required fewer additional medications and had shorter emergency department stays. However, physicians said the only long-term treatment shown to prevent recurring CHS symptoms is stopping cannabis use.
The increase in CHS cases comes as policymakers continue to examine the relationship between health, substance use, and government responses.
OpGov.News previously reported on California’s expansion of judicial discretion in mental health diversion through “California’s Public Safety Reset Continues: Newsom Signs AB 46 Expanding Judicial Discretion in Mental Health Diversion,” by Sarah Denos.
While emergency departments can provide fluids and medications to treat immediate complications, researchers continue studying why some frequent cannabis users develop CHS while others do not.
The medical community is continually adapting its clinical approach to balance the expansion of legal cannabis with the rising health care burden of associated illnesses.
Photo Credit: AARP
Health officials said increased awareness of the condition may help patients seek treatment sooner and provide physicians with more information to identify CHS cases.
Individuals experiencing recurring vomiting or severe abdominal pain while regularly using cannabis are encouraged to discuss their cannabis use with health care providers.
To add to or correct any information in this report, please contact me at victoria.o@lead4earth.org.
Thumbnail Photo Credit: Baker Institute
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