Cannabis Hyperemesis Syndrome

[Drownomatic]

I don't get sick from smoking as much as I do from being exposed to a plant near harvest or during harvest it seems. No problems in veg but once in flower especially late flower I have to be carful of my exposure or headache and nausea come on strong.

Especially landrace sativa.

 

[Olderfart]

Finally have a few minutes to sit down from some craziness.

So I had post about this on a Facebook group recently in a New Zealand growers group, where someone that claimed up and down that this isn't a real thing. In my opinion, it's how credible you believe science and medical science is, but this isn't anything new.

The earliest reported cases of Cannabis Hyperemesis Syndrome (CHS) were described in 2004 by Australian researchers Allen J. H., Allen et al. (2004) in the journal Gut, in a case series of 19 chronic cannabis users experiencing cyclical vomiting and abdominal pain, noting symptom relief with cannabis cessation and hot baths, highlighting its recent recognition in medical literature.

One of the most famous stories about CHS is Alice Moon, who if you've ever researched about this in the past few years, you probably know her story:

Weed Makes Me Throw Up: The Story Of Alice Moon, Her CHS, And The Hate She Gets For It

Cannabinoid hyperemesis syndrome (CHS), the mysterious illness triggered by marijuana use, and Alice Moon's experience with it.

www.forbes.com

There is also a controversy over her story with Ethan Russo, a neurologist and psychopharmacologist, who go back and forth on the topic in a rather bitter debate over causation and correlation and criteria set for testing.

Quoted from the article:

“Ethan has more experience researching cannabinoids than almost anybody else. He’s been doing it for decades,” says Peter Grinspoon, a physician at Massachusetts General Hospital and an instructor at Harvard Medical School. Grinspoon describes Russo as “a leader” in the field, with “broad knowledge of both disease and cannabis.”

The feud between a weed influencer and scientist over puking stoners

A scientist went looking for genes that cause cannabinoid hyperemesis syndrome. But a public spat with a cannabis influencer who suffers from the disease may have derailed his research.

www.technologyreview.com

My Personal Deep Dive​

Real or Myth?​

Cannabinoid Hyperemesis Syndrome is considered a real medical condition based on extensive clinical evidence, an identified set of diagnostic criteria (including the Rome IV criteria, which is a set of guidelines for diagnosing functional gastrointestinal disorders like irritable bowel syndrome (IBS) based on specific symptoms and their frequency), and a growing scientific understanding of its pathophysiology (the study of how a disease, injury, or other condition affects a patient, including both physical and functional changes.)

The World Health Organization (WHO) has added Cannabinoid Hyperemesis Syndrome to its diagnostic manual, based on guidance issued by the agency on October 1st, 2025. This now establishes a newly dedicated, standardized code for CHS called R11.16. The importance of this is that previously, clinicians had to use general codes for nausea and vomiting (like R11.2) along with a separate code for cannabis use.

The new designated ICD-10 code (ICD stands for International Classification of Diseases, 10th revision) represents a step forward in providing more definitive care for patients struggling with the syndrome.

The WHO employs over 8,000 public health experts, including scientists, doctors, and epidemiologists, who coordinate the world's response to health challenges.

Known replicable diagnostic evidence for CHS:​

Symptom reversal:

The most compelling evidence is the cyclical nature of symptoms shared among users reporting it. Patients find relief from nausea and vomiting only after ceasing cannabis use, and the symptoms return upon resuming it.

Unique symptom relief:

A key diagnostic feature is the compulsive need for hot showers or baths, which provides temporary relief from pain and nausea. This specific behavior is not typically associated with other vomiting syndromes.

Chronic cannabis use:

A history of long-term, often daily, cannabis use is a prerequisite for CHS. Studies show a strong link between early cannabis use and higher hospital visit rates for this syndrome.

Clinical data:

Research studies have documented cases of CHS, including one that found a significant increase in emergency department visits for the syndrome between 2017 and 2021 in North America, according to PBS.

Science, Data, Studies, and Trials​

There are numerous published papers and documentation found at the National Center for Biotechnology Information (considered a highly credible source of scientific and medical information and part of the National Institutes of Health (NIH) and the National Library of Medicine (NLM.) It's considered a respected and authoritative source for biomedical research and data, providing resources like PubMed which is widely used by scientists, medical professionals, and general public for reliable scientific information. Here are a few good reads on the topic:

https://www.ncbi.nlm.nih.gov/books/NBK549915/

Here's a great article from Frontiers:

https://www.frontiersin.org/.../ftox.2024.1465728/full

Here is a case report and review of pathophysiology for CHS from CM&R (Clinical Medicine and Research):

https://www.clinmedres.org/content/12/1-2/65

What do the opponents say?​

"Oh, it can't possibly be real, because it didn't happen to me."
"It MUST be something else, it can't possibly be this thing that I enjoy doing."
"It's the use of all these pesticides and PGR's in unregulated cannabis."​

No one wants to admit this thing they love and enjoy that provides so many benefits could also have drawbacks. Pretending like there aren't drawbacks to cannabis is almost disgusting. Like who are we really defending or helping by ignoring science and data, the same science and data we praise and love when it's in our favorable spotlight?

Opponents of CHS claim that it's not real because the cause is still hypothetical.

The rebuttal to this is that from a scientific standpoint, something can be considered "real" even if the exact cause is unknown, because we can observe the effects of, use indirect inference, rely on probability, accept fundamental concepts, and demonstrate the reality of things through consistency of patterns, predictions, and interactions.

While the exact underlying mechanisms (referencing back to pathophysiology) are still being researched and debated, the clinical syndrome itself is well-documented in medical literature and the diagnostic criteria has been established.

The "hypothesis" is about HOW cannabis causes these symptoms, not whether or not these symptoms have been systematically observed and recorded (to which they have.)

In spirit of scientific theory, a scientific hypothesis can become real in the sense that it's strongly supported by evidence, but can also be potentially proven wrong (falsifiable), which is the very key to science (it's easy to put the blinders on when there is limited supporting evidence in the early stages of research.)

It's going to be through better research, studies, and trials that we'll be able to more accurately pinpoint why these things occur (not WHETHER they occur, because we KNOW they occur,) which will lead to more ACCURATE DIAGNOSIS by doctors, and less MISDIAGNOSIS by doctors, which I have found a number of patients have shared in their stories of being wrongly diagnosed with CHS when there were other underlying conditions.

The problem with all this is that none of the research, other apparently than Russo's, examine the question of whether there is a strong genetic component to this condition. IMO, there is absolutely no question that the conditions exists, that it depends on heavy cannabis use, that it is an absolute bitch of a problem if it occurs, and that complications could kill you. For the only definitive attempt at research on the genetics issue to be sewered by a social influencer is a tragedy for us all. Had the research been better supported by a larger sample size, it may well have not only clarified the issue much better than it could with genetic samples from only 28 participants, it could have been the catalyst to encouraging further funding of research on this important topic. I am trained professionally in both statistics and research design, my opinion here is informed.

This must be incredibly frustrating and saddening for Russo, who by any reasonable account has dedicated much of his professional science career doing his best to study cannabis, and to do so with scientific rigor, honesty, and transparency. It actually pisses me off to see him and his efforts compromised by this bs.

 

[WildBill]

Nicotine reacts with the endocannabinoid system….magnifying the effects of cannabis.

View attachment 1771454

I suspected as much.

I vary my method of cannabis intake along with Different strains. I try to follow whatever pain I have And try to medicate with the most appropriate herb. Now that does occasionally turn into something 'quite different' when I combine different methods and strains. Sometimes those combos can whack you quite hard!

I'm kind of thinking that this naturally occurring method may offer some protection against ECS, It might help with tolerance also. How much that protection could be is unknown, but I do think it is a possibility.

 

[DoobieGrows]

Quick question…. Of the CHS sufferers…. Who also uses nicotine products?

I smoke death sticks unfortunately...