What Is Cannabinoid Hyperemesis Syndrome?

Cannabinoid Hyperemesis Syndrome

Habitual heavy marijuana use over the course of years can cause periodic bouts of intense vomiting called cannabinoid hyperemesis syndrome.

Clinicians and researchers have only recently differentiated the condition from the nearly identical cyclic vomiting syndrome. The difference between the two comes down to cause; cyclic vomiting syndrome can be caused by stress and anxiety, over exertion, overeating, bacterial or viral infections and some other causes.

Cannabinoid hyperemesis syndrome, however, is exclusively caused by heavy chronic cannabis use, though researchers don’t understand why.

What are the symptoms of cannabinoid hyperemesis syndrome?

The essential criteria for cannabinoid hyperemesis syndrome is, of course, that of long-term cannabis use. The condition is marked by severe nausea and vomiting that runs in cycles of about 48 hours. Hot showers or baths that tend to reduce the nausea, and hot bathing is a hallmark of the condition. The cycle can be punctuated by weeks with no symptoms.

Cannabinoid Hyperemesis Syndrome proposed criteria
A proposed criteria for cannabinoid hyperemesis syndrome from Puttathan et al. (2012).

According to the National Institute of Diabetes, Digestive and Kidney Diseases, the following are the symptoms and signs of both cyclic vomiting syndrome and cannabinoid hyperemesis syndrome:

  • retching, or making an attempt to vomit
  • heaving or gagging
  • lack of appetite
  • abdominal pain
  • diarrhea
  • fever
  • dizziness
  • headache
  • sensitivity to light

The course of the condition starts with a “prodrome” phase, during which you may feel nauseous, sweaty and pale. This leads up to the vomiting phase during which you may suffer intense nausea and abdominal pain, retching and vomiting. The recovery phase is when the symptoms subside, and that leads into the well phase, during which you experience no symptoms until the next bout with the condition.

Why do people get cannabinoid hyperemesis syndrome?

Because of weed’s well-known anti-nausea properties, people with cannabinoid hyperemesis syndrome tend to self-medicate by ingesting more marijuana, which makes the problem worse.

The primary clinical use for pot is as an anti-emetic (anti-vomiting) and anti-nausea drug, so cannabinoid hyperemesis syndrome seems paradoxical.

The dozens of cannabinoids in marijuana, especially Delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD) have profound effects on the appetite and digestive system, which is why one of the primary medical uses of pot is to increase appetite and reduce nausea in cancer and HIV/AIDS patients.

This is because marijuana mimics the body’s own natural cannabinoids, which are neurotransmitters that interact with cannabinoid receptors on nerve cells to regulate all sorts of functions throughout the body, including appetite.

Still, scientists don’t have any good theories as to why heavy pot usage can cause these cycles of vomiting.

Who gets cannabinoid hyperemesis syndrome?

Diagnosis rates for cannabinoid hyperemesis syndrome have risen along with gains in the movement for cannabis legalization, but casual marijuana users aren’t the ones who get cannabinoid hyperemesis syndrome. Most cases described in the medical literature happen to chronic heavy users.

“Most patients are daily and very heavy users of cannabis and have been doing so for years, often decades, before the vomiting episodes begin,” according to a 2010 study in the Canadian Journal of Gastroenterology.

According to a 2012 meta-analysis of health records published in the journal Pharmaceuticals, 40 to 50 percent of men diagnosed with cyclic vomiting syndrome reported marijuana use; it’s only recently that health authorities recognized cannabis-induced cyclic vomiting as a separate condition.

For some reason, men under 40 are more likely to experience this syndrome than women.

What is the treatment for cannabinoid hyperemesis syndrome?

Hot showers or baths seem to reduce nausea in people suffering from cannabinoid hyperemesis syndrome, but the first thing you should do for treatment is to stop ingesting marijuana. Symptoms should resolve within a couple days once you quit smoking. If you’ve been smoking long enough to have developed cannabinoid hyperemesis syndrome, then you might find some difficulty in taking a break. If so, find help in this article.




“Cannabinoid Hyperemesis Syndrome”
Jonathan A. Galli, MD, Ronald Andari Sawaya, MD, and Frank K. Friedenberg, MD

Current Drug Abuse Review

Dec. 2011


“Association of Marijuana Use and Cyclic Vomiting Syndrome”
Mithun B. Pattathan, Reza A. Hejazi, and Richard W. McCallum


July 2012


Cannabinoid hyperemesis
Stephen Sullivan, MD

Canadian Journal of Gastroenterology

May, 2010


Cyclic Vomiting Syndrome
National Institute of Diabetes, Digestive and Kidney Disease

About Nicco Reggente, PhD 167 Articles
Nicco is the co-founder and CEO of WoahStork and Strain Genie-- two companies dedicated to bringing to life his passion of bringing personalized medicine to the cannabis industry. Nicco received his PhD from UCLA in cognitive neuroscience with a focus on machine learning applied to neuroimaging datasets. He previously received two B.As from NYU in Psychology and Philosophy.

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