Home Culture Finally, the Article on Cannabis Hyperemesis Syndrome that Readers Deserve

Finally, the Article on Cannabis Hyperemesis Syndrome that Readers Deserve

© Stock Pot Images / Bettina Chavez

A recent CBS article irresponsibly reported an increase in the controversial cannabis hyperemesis syndrome (CHS) in legal-use states. The report lacks scientific proof and, according to experts, the symptoms are so rare – it could simply be an allergy to certain terpenes, or an issue with unregulated flower.

“This drives me nuts,” began Martha Montemayor, Clinical Nurse Consultant and Director of Cannabis Clinicians Colorado.

“Yes, cannabis hyperemesis is a real thing,” she continued, “but it’s very, very rare, and does NOT mean every time you vomit in your life, it’s all because you took a puff off a joint in high school.”

She said it’s like saying the gas station egg salad sandwich you ate in 2004 is still making you sick, twelve years later.

“We have patients being refused treatment for actual flu vomiting in Denver emergency rooms because they said ‘yes’ when asked if they use cannabis.”

The controversy

Mark Malone, Executive Director of the Cannabis Business Alliance, agrees with the medical professional. He even goes a step further, suggesting that the link between CHS symptoms and cannabis use is far-reaching and unsupported.

He called it an ‘alleged disease’ because real numbers are not presented, and the fact that the study relies on information that patients “were more likely to endorse marijuana use” proves nothing.

The facts

This is a recent phenomenon affecting very few people around the world.

Since the term was coined in 2004, medical reports diagnose patients with habitual marijuana use, presenting the following symptoms:

  • cyclic vomiting
  • abdominal pain
  • compulsive showering
  • improvement of symptoms with cessation of cannabis

The 2009 study cited in the CBS article is titled Cyclic Vomiting Presentations Following Marijuana Liberalization in Colorado. The report reveals, in the end, there is no definitive link:

“Patients presenting with cyclic vomiting after marijuana liberalization were more likely to have marijuana use documented in the ED record, although it is unclear whether this effect was secondary to increased use, more accurate self-reporting, or both.”

While a few studies have generated interest in this topic, there have been no epidemiologic studies associating marijuana use with CHS.

According to the same study, “this deficit is likely multifactorial due to the lack of formal diagnostic criteria for CHS, the relatively low prevalence of this syndrome, and the social stigma regarding marijuana use that discourages self-reporting.”

Malone is one of the many cannabis experts who remain skeptical about CHS. He said the report is unfounded and not well-researched.

His opinions represent a camp of professionals who were NOT represented in either the CBS article, or the versions Huffington Post, Daily Mail, and Mary Jane’s Medicinals published on their sites.

“The industry in Colorado has not heard of this issue until this news story,” added Malone.

A third study from 2012 used a relatively small sample of 98 patients, only ten of which followed up with the researchers. In total, seven of the ten patients in the study stopped using cannabis. Six of the seven patients went into remission after stopping cannabis.

In the 2009 report, the researchers admit their interest in the subject was sparked by the few reports which suggested a ‘novel syndrome’ of cyclic vomiting associated with repeated marijuana use.

The report goes as far as to note, “despite a high rate of marijuana use in our community, the absolute prevalence of cyclic vomiting remained low, underscoring that CHS is a relatively uncommon condition.”

Other possibilities

In her medical opinion, Montemayor said cannabis hyperemesis is a real – but rare – phenomenon that appears to be strain specific.

Of the 20,000 patients she’s helped join the Colorado registry since 2010, there’s only been one reported case. She said another clinic owner, with three times more patients than hers, also has had one patient who experienced it.

In both of those cases, switching strains solved the problem.

  • In both cases, the cannabis used raised questions
  • It wasn’t tested for molds, pesticides, or any other contaminants
  • It also had not been tested for terpenes

Think of terpenes as the building blocks of essential oils, Montemayor explained. They are the little short chain isoprenes that give plants their fragrance.

So, cannabis that smells like pine trees contains some of the same terpenes found in actual pine needles. Which means if you are allergic to pine trees, you may want to avoid using cannabis that smells like pine – it’s the pinene terpene that could be causing negative symptoms.

For Montemayor, it’s clearly stemming from molds and contaminants – not the THC.

Bottom line, said Montemayor, USE TESTED MEDICINES.

Regulated for safety

Remember, the story features an Indiana man, and Indiana doesn’t have legal cannabis. CBS never addressed the lack of quality control for what he was illegally obtaining in their report. 

Malone wants to remind consumers that the cannabis industry stands behinds its products – products that are more regulated than any other food or drug in the country.

Sensationalized clickbait

The article has made its rounds, being picked up by dozens of news outlets. Besides the one-sided storytelling, CBS also threw in a pinch of classic anti-pot propaganda with a quote that feeds into the ‘stoner’ stereotype.

“Now all kinds of ambition has come back,” the patient told CBS. “I desire so much more in life and, at 37 years old, it’s a little late to do it, but better now than never.”

His level of laziness has no relevance, it’s not clinical, and not a symptom of CHS.

Readers respond

Over 500 comments flooded that article. Most readers are outraged over the lack of due diligence for the report.

  • “Doctors are known to be little more than dealers for big pharma. This was a shoddy, half-assed attempt to drag reefer madness out of the closet.”
  • “Too much competition, Big Pharma?? So you gotta go LOW???!!!”
  • “Sorry…May be an allergy in a very small number of people or something added to weed. I know too many lifelong users with no adverse physical effects. This is pure Big Pharma and the coming Jeff Sessions war on weed. Pure Propaganda.”
  • “The only thing i can find on this is that even though it is Organic, farmers can use Neem Oil, which is a product called Azamax, and they can spray this on for mites… Funny thing is, Neem Oil poisoning and Azamax can have the exact symptoms these people are talking about, and this product has become more prevalent in the last 10 years, this is around the time this disease has been popping up…”

Mary Pat Hoffman is gearing up to open a Maryland medical marijuana dispensary. A pharmacist by trade, she knows how drugs interact.

From her research on CHS, it happens in chronic users. Since the endocannabinoid system is involved in homeostasis, “it seems to be an issue with receptor regulation and the body just gets out of whack.”

“I think it has been misportrayed by the media and sensationalized a bit,” Hoffman added. “Imagine the articles we could write on side effects and ER visits from prescription drugs.”


    • You have a small mind.

      I have gone to the ER 4 times for CHS (twice in the last week). It is very real and unlike anything I’ve ever felt before. I am 35 and have smoked very heavy for the last 16 years, and the last 2 years have been crazier than ever dabbing an endless supply of live resin, vape pens, shatter, live diamonds (and only a small amount of flower now) every day. Everything I get always comes from the same reputable source I trust 100%.

      I think CHS is picking up more traction now because of how potent cannabis has become and all of the new types cannabis products available.

      I am still very pro cannabis. I just think people need to realize that you can actually overdo it. It doesn’t happen overnight it develops over a long period of time of heavy consumption.

      As of right now, I am forced to take a break from smoking, it sucks but I have no choice since it’s the only thing that has kept it from occurring again. I will definitely try to smoke a bowl of flower again in about 10 days. I think I need to let the huge amount of thc stored in my fat to go away before I try again.

        • shes not lying, I had this for an entire year …. Im considering the Organic grower that I trusted didn’t know any better and was using neem. I had seizures, so I started going to the emergency room because I was so so scared when the vomiting started. I took up to 3 baths a day not knowing what was wrong with me. it all abruptly started/stopped when I started/stopped RSO. I was so sick and so scared.

          • I’ll explain more…. I had been smoking for a few years.. I was a two hits before bedtime type of person, had a medical card. A grower was supplying me RSO for chronic pain. I used the RSO every night before bed for 15 months. I started on a teeny tiny amount and worked my dose to more and more over the months.. The sickness started when I was around 3 months on RSO … when i was worked up to a half a gram per night. I kept adding more slowly each night and worked myself up to one gram per night for awhile after this … doctors were calling it migraines without aura even though my head didn’t hurt and it felt like a full on body crisis to me.. i took migraine meds and saw a neurologist but nothing helped me. It felt like when i was 25 and overdid it with tequila …. hung off a toilet all night dry heaving for hours…. i never drank tequila again but then i went through this about three nights in a row per week.. I lost coordination and memory. i stayed in bed all days.. lucky i was already on disability for neuropathy. I cried and worried a lot. After stopping RSO, I started feeling better and I felt reborn.. suffering for so long and then feeling better can really make a person feel grateful..

      • Yep. Same here. Pens and dabs. In 53. I list 60 lbs in 3 months from CHS. Hospitalized twice. It’s very real. I have not smoked since September snd I have zero symptoms. I believe smoking flower would be fine but I don’t want to chance it. I totally overdid it on the oil pens and dabs. I wasn’t even getting high anymore. I think the thc was loading up in one spot and not dispersing which caused me not to get high snd then the cylic vomiting

        I was in denial the first hospital visit and continued to use. Twice is enough. Vomiting (or dry heaving) for three weeks

  1. This explain two of my friends had these system were long time user.I have been lucky to have friend grow out door using natural sprays had not gotten sick.I have been smoking since 9 th grade know 38.I had worked at pharmaceutical company doctor get paid to use there drug.I had lung specialist I would ask question.I take it for insomnia and back pain.its not hate way dry I tried every drug before pot.Pot has helped my heroin and meth I hated throwing up that’s why I never got hooked except for meth college was easy to get dropped out got a job quit meth been sober 20 years.

  2. It’s definitely real. If you have it. You. Elieve it. I didn’t believe it. Till I got my diagnosis and started to put all this together. I was diagnosed 7 months ago. And only smoked my own outdoor grown. And tried to cut back. From 3 grams a day to 3 grams a week. But I do seem to smoke more and more. I ran out of my own. And with in. A month of smoking top quality indoor I got sick again….. let me tell you this. The vomiting is awful 18 hours of 5 or more times an hour. Every hour.

  3. This disease is REAL, and people that have experienced it can attest to how absolutely debilitating and painful it is. You people that thing pot is some miracle drug with zero negatives are part of the problem. CBS did a great job with trying to spread awareness about this awful syndrome.

  4. This article sounds self serving. I have suffered from what I thought might be mold in the pot. But the pot I smoke is grown under the best conditions. There are studies and its been accepted as very real. I have smoked for 47 years. I get full work ups much more often than most people, and there are no other explanations for symptoms of nausea, puffy eyes, sporadic appetite, digestive problems, etc. Personally, I have always taken 2 to 3 showers a day. I’m not so sure it’s because of the relief i get, but I do feel better after taking them. I see conflicting reports on how long it takes to recover. Many say only a few days, some say it could take up to three months. Nobody enjoys pot more than i, but I will definitely not be smoking for the next 3 months. If my symptoms go away, I will smoke no more. If they don’t subside in that time frame, I might as well suffer stoned as not. I will update if relief occurs. Yes, there is a lot of B.S. about pot. But don’t be so closed minded about possible effects. ALL drugs have side effects.

  5. After spending 14 years with a mystery illness my husband quit smoking pot and his symptoms disappeared.
    Background is 35 year old male who had smoke 20 years, heavily for the past 15. Safe to say between a half ounce and a whole ounce weekly. In 2003 (Valentine’s day to be exact) was his first episode. They removed his gallbladder……
    From there we sent anywhere from 6-10 times per year in the emergency room. In 2008 a doctor suggested CHS, with little information available at the time we laughed it off.
    He has over the years had endoscopies, colonoscopies, seen multiple specialist, had multiple test and this mystery illness still persist.
    June 2016 he goes again to the ER. They admit him and he is there an entire week. Still nothing is discovered.
    Throughout the years he has removed many elements from his diet. During his last hospital stay he decided he was giving up smoking pot.
    Fast forward October 2017 over an entire year and no mystery illness. No symptoms, nothing!!!!! He had reintroduced foods and is so happy to be 100% well. I know this is rare but without an ounce of doubt am confident it exists and that he did suffer from CHS.
    Side note, he’s amazing and didn’t expect me to quit smoking.

  6. It’s VERY real people. I stopped smoking regularly, and my digestive nightmare ended. It was so brutal that I have wished I was dead literally hundreds of times. It took me from a strong 210 pounds to a freakishly emaciated 120 pounds. It was incredibly torturous.

    Marijuana is NOT the culprit; it is a carrier. I was being poisoned by azadirachtin, an organic chemical that is often used in plant growth. The banning of this chemical for marijuana growing will eliminate the problem. I am 100% sure of this. Please trust me. I gave up a very large portion of my life until I figured it out, before my many doctors did. It’s hard to accept this, as I really love marijuana. I know that I will be able to resume consuming it as long as it is free of azadirachtin.

    • Its not azadirachtin. I grew my own organic for years, zero chemicals, suffered miserably from chs. Some people just get unlucky and can’t tolerate it. Im able to keep it where the attacks aren’t as brutal, cut way back and can’t abuse it like I had previously.
      Haloperidol has been shown to help symptoms, hope a fix can be found because grass makes this world tolerable for many people.

  7. CHS is real if you’re ignorant to it then that’s all you’re ignorant to it. Don’t spout off on the comments that you believe it’s some type of propaganda because you’re going to hurt someone else that actually has it. I swear to fuck if I find any idiot on here talking that kind of shit I will personally hunt you down and fucking kill you. The pain and nausea and suffering you will experience is the worst feeling you can imagine. If you haven’t been through CHS your pussy ass has never felt real pain or trauma.

  8. Yes, the pain and suffering is so unimaginable. I called it “triple torture.” The abdominal pain is one part of the torture. The nausea is another part, and it’s worse than any type of nausea that you will ever experience. The back pain is the other part. CHS is real, and it will be the worst thing that ever happens to you.

  9. By the way, my doctors thought I had Cyclic Vomiting Syndrome, and I figured out that I actually had Cannabinoid Hyperemis Syndrome. The medical world needs to get this right, and ER rooms need to take it very seriously.
    If any of you skeptics had this ONE time/ONE episode, you would never doubt its existence.

  10. I have had the symptoms for 20 plus years .But mine come in episodes. Most of the time I feel fine but it came come on fast , don’t know what triggers it ? I was diagnosed with cyclic vomiting syndrome 20 years ago but the last time I was in the hospital the doctors said it was CHS ? Hot showers don’t work for me ? I work in the marijuana industry now , very hard to not partake…. the doctors treated me like I was a piece of shit after the blood tests came back. I have really cut back on the amount I smoke , but have not stopped. In the past it has been up to 5 years between episodes with out stopping smoking????? Hope they do some real studies soon…dont know what to think ?

  11. My episodes were sporadic; maybe a few dozen a year, with an average of about a dozen requiring ER visits. Most of my episodes happened right before, or during, bowel movements, so I always considered them to be the primary “trigger.” Once it got hold of me on a high level, even high doses of oral opiate pain medicine was unable to stop the attacks on many occasions. Getting an IV dosage did often help me overcome the horrendous episodes. At first they did, but over time, as expected, the IV became less effective. I was often treated like a “med seeker,” which always made me mad. I can honestly say that I never went to ER for a “high;” I was literally a severely dehydrated (kidneys failing), 10/10 pain patient every time I went. They could not help me fast enough, on most occasions. The pain was so severe that I wished I was dead, very truthfully.
    I really believe that anyone who experiences this can escape it, like I did, by stopping smoking for a while; several months at least. After a year of abstinence, I finally tested my ability to smoke again, in small doses. I maybe did 3-4 joints worth over two weeks, just a little at a time, with periods between smoking. I “passed.” Smoking in moderation didn’t cause a return to CHS.

  12. You don’t ask the dispensary owners about fucking cannabinoid hyperemesis, ask the people that work in the emergency department. How strange it is that a hundred percent of our cyclical vomiterss are all daily cannabis. ALL of them. And I live in a small community and there’s about half a dozen that we see if not every month then several times in a row every other month.

    My colleagues think it’s the cannabis, but the intermittent random nature of it makes me think it’s a mold or an adulterant like azamax. A person goes to dispensary buys something that’s clean and is okay for however long it takes them to finish their product. They buy from a different grower who’s used an approved product that is causing this issue and they get sick until they’re done smoking that.

    Neem oil does have the same ingredients as azamax however azamax is highly concentrated. there’s almost nothing in nature that you can concentrate to 400 times it’s normal strength and not have some kind of issues with at least a few people.

    And the last observation I made so far is that none of the people that have this are home Growers that know what’s going on there plants.

  13. Hi….I’m 45 year old male, been using pot since age 12-13. Never had any issues. About 4 years ago. Aprox 2014, I started getting my herb from local dispensaries. About a year later i began feeling upset stomach in the mornings. Nauseous feeling throughout the day.slowly I started to develop pain in my abdomen, then came the vomiting nauseous pain in the abdomen pretty much constantly. As of right now 1/24/18….I’ve been in constant pain for the past two years, throwing up,and lost about 75 lbs….down to 198 lbs…..some days the pain is so bad it knocks me to my knees .I’ve Been to see the gastrointestinal specialists a urologist, a cancer specialist, and an oncologist. I’ve had 2 endoscopy, 2 colonoscopy,chest xray,abdomen ultrasound, scrotal ultrasound,.full spectrum MRI, numerous blood test,urine samples, 24 hour urine samples, stool samples, and lastly, spent the last year….all of 2017 going back and forth to Yale in new haven ct and had my genome sequence mapped in an attempt to find out what’s wrong with me…..EVERY SINGLE TEST CAME BACK NEGATIVE………..as of this writing, I’ve decided to stop my cannabis use, since all of my symptoms seem to go hand and hand with CHS, after all of the test I’ve taken, I believe that chs must be my problem, hoping to have some improvement in my health, in the next month or so………really tired of being in constant pain with no answers from any doctors anywhere……….

  14. Curious… I have 2 daughters with a “hyperemesis” syndrome: one with hyperemesis gravidarum (x3 preganancies…(my mother had x 4 pregnancies)…0 cannabis use in both). One daughter with cannabis hyperemesis syndrome (0 gravidarum). Might there be a correlation/susceptibility?

  15. I have been hospitalized about every six months for vomiting and stomach pain for the last four years. The pain was unbearable and by the time I got to ER I was in the middle of a heart attack. I have had 4 heart attacks and each hospital visit was over a week where doctors filled me with painkillers, nausea medicine and potassium.The potassium hurt my veins so much that I screamed in pain.I am 71 years old and have smoked pot every day, all day for 20 years. My last visit to the hospital was so painful that I quit pot smoking cold turkey. After reading all the articles on this syndrome I truly believe I was literally overdosing on pot. As much as I love it, I don’t smoke anymore. I have had no further episodes, and feel great. It was hard to give it up, but when I start thinking about trying it again, I think back to the night in the hospital when I begged the doctors to let me die. It is simply not worth that kind of pain. If you are experiencing vomiting and stomach pain and are a heavy pot smoker, do yourself a big favor and give it up.

  16. My daughter will be 18 in October and is at the tail end of her 2nd CHS attack. Last April came her 1st attack where the 5th ER doctor properly diagnosed her with CHS. I thought it was a joke until I read up on it. Like many, she abstained for a couple months and decided to try again. Two months later she found herself in her 2nd full blown attack with few symptoms just days prior. Both times, they lasted about a full week with very little relief. She looses several pounds daily and the nausea keeps her from eating and getting meds down. What water she does get in comes right back out. Hours upon hours in the bathtub with the shower coming down on her provides adequate relief. The two years prior to the diagnoses was a steady building of worsening symptoms that doctors ran every test possible to try and find the cause. Feeling defeated and thinking no one believed her, she eventually lost hope and started to execute a plan to end her life. She didn’t want to die, but she couldn’t continue living month after month with no explanation and her symptoms unresponsive to meds and growing more intense. She suffers from chronic anxiety and marijuana gave her a way to live peacefully in her skin. Giving that up was difficult and she gave it her all until summer ended and her anxiety took over again. Regardless of why CHS surfaced in 2004, being an organic pesticide or strains that are 5X or more in levels of THC. There is something that is causing this to happen to a small number of users. (A type of allergy like peanuts where most people it doesn’t affect) This second time, we went to the ER and honestly told them about the CHS. The ambulance driver called it in and by the time we arrived, her nurse and doctor were aware and treated her like a low life piece of crap. They gave her a bag of saline through an iv and some nausea medicine. It didn’t take long for the saline to run through her and then the doctor came in at that time. Never asked a question. He chewed me out for asking about the Neem oil possibility. Looked at us and said “It is illegal in this state, isn’t it?” Said he was sending her home without any prescriptions to manage the symptoms and left the room. Three minutes later the nurse came in and handed me some literature on marijuana and a discharge sheet. Told her to get dressed and the exit door was to the left and down the hall. In and out in under an hour. I took her straight to another hospital under the diagnoses of CVS and she was admitted and stayed for three days. The Nurse Practioner did a drug test on her and Marijuana showed up. She took her off diladud down to plain tylenol and took away the phenagran suppositories which had become the only way to manage all of symptoms. My daughter was asked if she drank or smoked in the ER and she said she had. There was no reason for that NP to break that trust with her and do a tox screen. My daughter now knows the police are allowed to lie and do so often. She now knows that patient confidentiality is a farce. She now knows the truth does not set you free and works against you. In a couple years time, her perception of the world has grown dark and her trust level is at a bare minimum. We are both still advocates of marijuana. Alcohol is worse in so many ways and yet it is legal. That is a NO brainer to me. Let’s not fight about what is real and what is not. Let’s share our stories to find the real common culprit here & work with that truth. BTW… the suppositories were key this time in managing this from home. with the nausea under control, she was able to keep food & drink down and keep her pain meds down as well. It was still so tough on her, but she knew what it was, how to stop it, and how to manage the ugly symptoms that are unimaginable to anyone who has not experienced this. Skeptics, please keep an open mind to the possibility of CHS and the severity of it’s symptoms. Has anyone been tested for pesticide poisoning during an onset? It holds merit… We don’t wash our marijuana like our fruits/veggies and we change the form of AzaMax / Azadirachtin when smoking it. I pray that we advocates come together and share enough to find out the real truth with supporting facts to explain this fairly new mystery. Sadly, I feel the medical field has already made their mind up.

  17. First of all, I know CHS is real, too much of anything even water can damage your body. My son was diagnosed with CHS April 7,2018 after being taken to the ER with severe vomiting. He was so severely dehydrated that his kidneys had begun to fail. For those blaming it on pesticides, my son got sick from medical marijuana. My son did not believe his diagnosis of CHS until it was too late. Oct.24,2018 my son began vomiting at around 11am, I called his doctor, and they called a nausea medicine in. After getting the meds I realized it was something he was taking that wasn’t working so I called doc again and they said they would call a suppository. Brian grabbed his back and said it hurt so I instinctively thought his kidneys, so I called 911. While waiting for help my son quit breathing. I had to perform cpr on my 17-year-old son. EMTS arrived and took over cpr. My son did not survive. My 17-year-old son, my baby boy died right in front of my eyes. Yes, CHS is very real. Before anyone comes at me over him smoking, my son never smoked in my home nor had weed in my house. He was a good kid who supported his own use. I was always told weed didn’t cause vomiting and wasn’t harmful but for those with CHS it can be deadly. Brian was a real person, a son, a brother, an uncle, and so much more to so many. The pain of losing a child is beyond comprehension for anyone who hasn’t been there. No, I do not work for any pharmaceutical company as some have speculated. I am a mother sharing her son’s truth. Whether you believe it or not do your own research.