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[The cannabinoid hyperemesis syndrome-A narrative review]
Udo Bonnet1,2
1Klinik für Seelische Gesundheit, Evangelisches Krankenhaus Castrop-Rauxel, Akademisches Lehrkrankenhaus der Universität Duisburg-Essen, Grutholzallee 21, 44577, Castrop-Rauxel, Deutschland. udo.bonnet@uni-due.de.
Der Nervenarzt
|July 21, 2025
Summary
Cannabinoid hyperemesis syndrome (CHS), linked to chronic cannabis use, is increasingly seen following legalization. Sustained cannabis abstinence is the only cure for this severe condition, requiring interdisciplinary care.
Area of Science:
- Gastroenterology
- Toxicology
- Psychiatry
Context:
- Cannabis legalization has led to a rise in cannabis-related cyclic vomiting.
- Cannabinoid hyperemesis syndrome (CHS) is now a recognized diagnosis under ROME-IV criteria.
- Increasing cannabis use, particularly high-potency strains, correlates with CHS prevalence.
Purpose:
- To review the characteristics and management of cannabinoid hyperemesis syndrome (CHS).
- To inform healthcare professionals in Germany about the expected increase in CHS cases post-legalization.
- To highlight the diagnostic challenges and treatment approaches for CHS.
Summary:
- CHS is a severe physical disorder characterized by cyclic vomiting, often presenting in emergency departments.
- Differentiating CHS from cyclic vomiting syndrome (CVS) requires assessing cannabis abstinence; mixed forms are common.
- Effective acute treatments include hot showers, haloperidol, and topical capsaicin cream, though abstinence is key for recovery.
Impact:
- CHS presents an interdisciplinary challenge involving gastroenterology, neuropsychiatry, and addiction services.
- Early recognition and management are crucial due to potential life-threatening abdominal comorbidities.
- Sustained cannabis abstinence is the only definitive treatment for CHS, emphasizing the need for integrated care models.
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