Cannabis hyperemesis syndrome — with severe vomiting, abdominal pain and temporary relief through compulsive hot bathing — is increasingly affecting adolescents and young adults.
As cannabis use among youth rises in Canada — and THC potency reaches record highs — emergency departments are seeing a surge in cases of a once-rare condition: cannabis hyperemesis syndrome (CHS).
Characterized by relentless vomiting, abdominal pain and temporary relief through compulsive hot showers or baths, CHS is increasingly affecting adolescents and young adults. Yet few people — including many clinicians — know it exists.
Canada ranks among the highest globally for youth cannabis use, with 43 per cent of 16-19-year-olds reporting use in the past year. Usage peaks among those 20–24 years, with nearly half (48 per cent) reporting past-year use.
This rise in regular, heavy use coincides with a 400 per cent increase in THC potency since the 1980s. Strains with THC levels above 25 per cent are now common. As cannabis becomes more potent and accessible, clinicians are seeing more cases of CHS, a condition virtually unheard of before 2004.
CHS unfolds in three phases:
Prodromal phase: Nausea and early morning discomfort begin. Users increase cannabis consumption, thinking it will relieve symptoms.
Hyperemetic phase: Intense vomiting, dehydration and abdominal pain follow. Hot showers or baths provide temporary relief — a hallmark of CHS.
Recovery phase: Symptoms resolve after stopping cannabis entirely.
Diagnosis is often delayed. One reason is because CHS mimics conditions like gastroenteritis or eating disorders, leading to costly CT scans, MRIs and gastric emptying tests. One telltale sign — compulsive hot bathing — is frequently overlooked, despite its strong diagnostic value.
Youth face unique risks. The brain continues to develop until about age 25, and THC exposure during this critical window can impair cognitive functions like memory, learning and emotional regulation. Heavy cannabis use is associated with heightened risks of anxiety, depression, psychosis and self-harm.
Results There were 12 866 ED visits for CHS from 8140 individuals during the study. Overall, the mean (SD) age was 27.4 (10.5) years, with 2834 individuals (34.8%) aged 19 to 24 years, 4163 (51.5%) females, and 1353 individuals (16.6%) with a mental health ED visit or hospitalization in the 2 years before their first CHS ED visit. Nearly 10% of visits (1135 visits [8.8%]) led to hospital admissions. Monthly rates of CHS ED visits increased 13-fold during the 7.5-year study period, from 0.26 visits per 100 000 population in January 2014 to 3.43 visits per 100 000 population in June 2021. Legalization was not associated with an immediate or gradual change in rates of ED visits for CHS; however, commercialization during the COVID-19 pandemic period was associated with an immediate increase in rates of CHS ED visits (incidence rate ratio [IRR], 1.49; 95% CI, 1.31-1.70). During commercialization, rates of CHS ED visits increased more in women (IRR, 1.49; 95% CI, 1.16-1.92) and individuals older than the legal age of cannabis purchase (eg, age 19-24 years: IRR, 1.60; 95% CI, 1.19-2.16) than men (IRR, 1.08; 95% CI, 0.85-1.37) and individuals younger than the legal age of purchase (IRR, 0.78; 95% CI, 0.42-1.45).
When I had a gallstone induced pancreatitis they tried to tell me this is what I had. Luckly they still ran some blood work and got me scheduled for emergency surgery.
It was pretty annoying having the doctor trying to blame my severe pain on cannabis use though :/
When I was a kid it was alcohol poisoning and lots of kids even in my rural community died in ditches and at bush parties. There were 300 kids in my high school. Grades 9-12. We had 6 deaths from alcohol. Either consumption or drunk driving. I'd be interested to know how many kids are dying from cannabis ingestion or accidents related to.
I am an old fellow who has been using cannabis almost daily since 1966. I have never heard of these symptoms. I hang out with many other old people with similar profiles. I have asked around nobody has heard of these symptoms. This article reads like bad AI.
And I am an old fellow that has been using cannabis daily since 1993 and I can tell you first hand cannabis emesis is absolutely a thing and is exactly as described, AND is relieved by hot showers.
It comes from CHRONIC high dosages such as vaping, concentrates, and those who smoke joints like cigarettes.
I have had these symptoms in my 30s when I used to grow and make tinctures, but I didn't need a doctor I just stopped smoking for a few days and then kept it light.
I'm a daily user for years and I've never heard of this. I wonder if it has to do with the way they're consuming it. Shady vapes from the internet could be causing trouble, not the thc itself.
Do this report have actual numbers of youth "landing in the ER with vomiting from cannabis use", or is this just percentages, none which seem directly related?
This is just the symptom of a much bigger underlying issue. We can talk about regulation all we want or even banning it, but it won't solve the big problem of what young adults have to face today in society at large. They are ill prepared for the real world, bombarded by social media influences 24/7, this is just another coping mechanism they've turned to.
Excessive use of alcohol, vapes, sugar etc. are all just as bad. But hey, the stats are saying 16-19 year olds at 43 percent - last I checked the legal age to purchase cannabis was 19 in Canada. So, anything under that would be considered illegal and I'd solely place the blame on the parents - just like any other substance abuse. Alas, that still doesn't solve the mental pressures that these young adults will need to face (housing, employment opportunities, global factors - climate change etc.). We can educate all that we can, but it won't change the reality. The reality is that it takes real political will and a strong mandate from voters (we all know our federal government is like a bunch of companies in a trench coat and that needs to change) to actually FIX the money side of problems. I am not surprised that the 20-24 year old's use cannabis (48% claimed by the article) - record inflation anyone? high groceries? lack of good livable wage employment? housing?
Here's my hot take, cannabis gets more bad rep than alcohol when alcohol, IMO, is worse.
I don't buy this "increased potency" argument as it sounds like the same anti-weed shit they've been saying since the 90s. We had concentrates and hash and vaporizers in the 2000s. Potency of the flower doesn't matter much when you can rip volcano vapes from dawn till dusk. All these "CHS" stories also always mention the dumb "hurr Cannabis psychosis" shit which is the other Hallmark of old anti weed propaganda that makes me skeptical.
Idk, it kind of feels like hysteria or some related comorbidity with munchies. I've definitely known people who make themselves sick over and over again from eating too many Doritos
I’ve worked in a parc, we were not security but prevention guy that walk the parc talking to teen getting high, and kids were always saying « the weed now is way more potent that it your time ». Bullshit !
Before legalization, pretty much every cannabis magazine and website was being cited as saying it was totally safe. Even mocked people for thinking otherwise.
That changed public opinion, and experts were ignored. These risks were known many years ago, so why has the industry been allowed to keep selling stronger strains, marketing to young people, and making these drugs available everywhere?
Now that the consequences are being seen, what are we going to do about it? This shit is being sold at every street corner, sometimes multiple cannabis shops at the same intersection. It's nuts.
I've read a little about it once in a while. Apparently one of the ways to treat this is to administer haloperidol, an antipsychotic, to relieve the symptoms. It's not a very long lasting condition either, especially if the user can recognize that weed's causing it and just stops for a little while.