When Cannabis Stops Soothing and Starts Hurting: The Rise of CHS
What if a substance trusted for relief slowly became the cause of relentless suffering?
For a growing number of cannabis users, that unsettling reversal is real. After years of routine use—often without a single warning sign—some people find themselves trapped in cycles of uncontrollable vomiting, crippling abdominal pain, and repeated emergency room visits. The condition responsible is cannabinoid hyperemesis syndrome (CHS), and despite its severity, many patients and even clinicians are still unfamiliar with it.
Medical professionals are now sounding the alarm as CHS cases increase alongside widespread cannabis use. The American Medical Association (AMA), led in part by Dr. Michael Suk of its Cannabis Task Force, has intensified efforts to educate healthcare providers about cannabis-related harms that often go unrecognized. In a major step forward, October 2025 marked the introduction of a dedicated diagnostic code for CHS (R11.16), allowing hospitals to track and study the condition more accurately.
A Condition That Defies Expectations
CHS is particularly confusing because it contradicts what many people believe about cannabis. THC is well known for suppressing nausea and is frequently prescribed to chemotherapy patients. Yet with long-term, frequent exposure, the body’s response can reverse. Chronic stimulation of cannabinoid receptors—especially in the gut—can disrupt normal digestive signaling, overriding the brain’s natural anti-nausea mechanisms.
The result is a pattern of recurring symptoms: intense nausea, severe abdominal pain, and repeated vomiting episodes that can last days. During peak phases, patients may vomit multiple times per hour, leading to dehydration, weight loss, and exhaustion. The distress is so extreme that many describe feeling as if their body is shutting down.
Why CHS Often Goes Undiagnosed
CHS was first identified in 2004, but awareness spread slowly. Many patients cycle through emergency departments for months or years before receiving a correct diagnosis. Symptoms closely resemble food poisoning, stomach viruses, or gallbladder issues, and some patients hesitate to disclose cannabis use, assuming it couldn’t be the cause.
The newly established diagnostic code is expected to change that. With standardized reporting, researchers can better understand how common CHS is, who is most at risk, and how best to intervene early—before repeated hospitalizations occur.
Who Develops CHS—and Who Doesn’t
Most CHS patients have used cannabis daily or near-daily for many years. Medical centers such as Cedars-Sinai report that symptoms typically emerge after a decade or more of consistent use, though some cases appear sooner. Younger adults between 18 and 35 remain the most affected group, but doctors increasingly see older patients as well.
Not everyone who uses cannabis heavily develops CHS. Genetics, liver enzyme differences, and individual receptor sensitivity likely play roles, though no definitive markers have been identified. What is clear is that once CHS appears, continued cannabis use almost always worsens it.
The Three Stages of CHS
The syndrome progresses through three recognizable phases. Early on, the prodromal phase brings morning nausea and vague discomfort that can linger for months or years. This progresses to the hyperemetic phase, marked by nonstop vomiting, severe pain, and frequent ER visits. Recovery begins only after cannabis use stops completely, with symptoms slowly fading over weeks.
Temporary Relief—and a Permanent Solution
Many patients discover that hot showers or heating pads provide brief relief, likely by activating temperature-regulating pathways in the brain that dampen nausea signals. Capsaicin cream applied to the abdomen can have a similar effect. These methods, however, only mask symptoms temporarily.
The only proven cure for CHS is total cessation of cannabis. Reducing use is not enough. Even a single relapse after recovery can trigger symptoms again, making CHS a lifelong vulnerability once it develops.
Medical Risks and Emergency Care
Untreated CHS can lead to serious complications, including kidney injury, electrolyte imbalances, aspiration pneumonia, and in rare cases, death. Emergency treatment focuses on IV fluids, symptom control, and medications like haloperidol, which appear more effective than standard anti-nausea drugs. Without stopping cannabis, most patients return to the hospital repeatedly.
The Challenge of Quitting
Stopping cannabis can be difficult, especially for those who rely on it for anxiety, sleep, or pain. Some patients struggle to accept that a substance they associate with relief is the source of their suffering. Support services are essential, and resources like the SAMHSA helpline (1-800-662-4357) can provide counseling and treatment referrals.
Conclusion
Cannabinoid hyperemesis syndrome exposes a critical gap between perception and reality. While cannabis can offer short-term relief for some conditions, long-term daily use carries risks that are still widely underestimated.
CHS is not rare, not harmless, and not resolved by moderation—the only cure is complete cessation. As awareness grows and diagnosis improves, patients have a real chance to recover fully. The key lies in recognizing that even substances seen as benign can have serious consequences when the body’s balance is pushed too far, for too long.