Cannabinoid Hyperemesis Syndrome: A Rising Complication

Cannabis, commonly known as marijuana, is a psychoactive plant that has been used for both medicinal and recreational purposes for centuries. It contains over 100 biologically active compounds known as cannabinoids, the most notable of which are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is responsible for the euphoric and hallucinogenic effects associated with cannabis use, while CBD is often utilized for its potential therapeutic benefits, such as pain relief and anti-inflammatory properties. Despite its widespread reputation for alleviating nausea and stimulating appetite, chronic cannabis use has been linked to a paradoxical condition known as cannabinoid hyperemesis syndrome (CHS). CHS is a disorder that paradoxically causes abdominal pain, nausea, and uncontrollable vomiting in long-term cannabis users rather than alleviating pain and reducing nausea. Misdiagnosis of this condition is extremely common, and it is often confused with cyclic vomiting syndrome (CVS). The underlying pathogenesis of CHS is not completely understood, though several mechanisms have been proposed. Although considered rare, there has been a steady increase in CHS diagnoses in the Emergency Department (ED). This article summarizes the symptoms, pathogenesis, treatments for CHS, and differential diagnoses to further increase our understanding of this condition.