Cannabis Hyperemesis Syndrome Cases In Virginia ERs Up By Nearly 29%

Why It Matters

The spike in CHS admissions signals emerging strain on emergency services and underscores the need for clinicians and policymakers to address cannabis‑related health risks as legalization spreads.

Key Takeaways

• CHS ER visits rose 29% from 2020 to 2024.
• Total cannabis‑related ED visits average 31,000 annually in Virginia.
• Symptoms include vomiting, nausea, abdominal pain, and compulsive hot showers.
• Abstinence resolves CHS; supportive care manages acute episodes.

Pulse Analysis

Virginia’s emergency departments are grappling with a notable uptick in cannabis‑related encounters, driven largely by the emergence of cannabis hyperemesis syndrome (CHS). Data from the Virginia Hospital & Healthcare Association reveal a 29% increase in CHS diagnoses over a five‑year span, mirroring a broader rise in overall cannabis abuse, dependence, and poisoning cases. This pattern coincides with the state’s progressive legalization framework and the proliferation of high‑potency THC products, which extend exposure for frequent users and amplify the risk of chronic adverse effects.

Clinically, CHS presents a distinctive constellation of severe vomiting, persistent nausea, abdominal discomfort, and an unusual compulsion for hot showers that temporarily eases symptoms. While the exact pathophysiology remains elusive, research points to prolonged, heavy cannabis consumption—often initiated in adolescence—as a key risk factor. Diagnosis is challenging because symptoms overlap with other gastrointestinal disorders, leading to repeated emergency visits and extensive diagnostic workups. Awareness among emergency physicians is critical to differentiate CHS from more common causes of emesis and to initiate appropriate counseling.

Management hinges on cannabis cessation, which typically resolves the syndrome within weeks, supplemented by supportive measures such as intravenous hydration and anti‑emetic therapy. The growing burden on emergency services highlights a public‑health gap that policymakers must address through education campaigns, standardized screening protocols, and funding for targeted research. As legalization expands nationwide, proactive strategies will be essential to mitigate CHS incidence and safeguard both patients and healthcare resources.

Cannabis Hyperemesis Syndrome Cases In Virginia ERs Up By Nearly 29%

Image: Cannabis hyperemesis syndrome · Photo credit: Getty Images

The number of emergency department (ED) visits in Virginia for cannabis abuse, dependence, poisoning, and cannabis hyperemesis syndrome (CHS) has been increasing. Data from the Virginia Hospital & Healthcare Association’s Data Analytics Team, covering 2020‑2024, show that ED visits for CHS grew by nearly 29 % over this five‑year period.

During the same period, there were a total of 172,778 adult ED visits for diagnoses of cannabis abuse, dependence, or poisoning—an average of over 31,000 visits per year, peaking at 37,690 in 2022. ED visits specifically for CHS totaled 24,960, rising from 4,027 in 2020 to 5,175 in 2024.

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What Is Cannabis Hyperemesis Syndrome?

Cannabis is a plant also known as marijuana, weed, pot, ganja, Mary Jane, and many other names. Its main psychoactive substance is tetrahydrocannabinol (THC), along with other cannabinoids such as cannabidiol (CBD).

Hyperemesis means severe or prolonged vomiting ( “emesis” = vomiting; “hyper” = excessive). A syndrome is a collection of symptoms. CHS symptoms typically appear after prolonged, heavy cannabis use over many years.

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What Are Cannabis Hyperemesis Syndrome Symptoms?

Common symptoms include:

• Repeated vomiting

• Persistent nausea

• Intense abdominal discomfort or pain

• Loss of appetite

• Frequent showering or bathing (many patients find hot water temporarily relieves symptoms)

A term often used to describe the combination of severe abdominal pain and vomiting is “scromiting,” a blend of “screaming” and “vomiting.”

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What Are the Causes of Cannabinoid Hyperemesis Syndrome?

Research on the exact cause of CHS is limited. Not every long‑term, regular cannabis user develops the syndrome. Possible mechanisms involve overstimulation of receptors in the endocannabinoid system of the brain, but why this occurs in some individuals and not others remains unclear.

Risk factors suggested by existing studies include:

• Using cannabis at least once a week for 10–12 years

• Beginning regular cannabis use during adolescence rather than later in life

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How Do You Treat Cannabis Hyperemesis Syndrome?

The most effective treatment is to stop using cannabis. While abstaining, patients may need supportive care such as:

• Intravenous fluids and electrolytes to stay hydrated

• Anti‑vomiting medications (though they often provide limited relief)

• Pain relievers (e.g., capsaicin cream, acetaminophen, ibuprofen)

• Hot showers or baths (which can temporarily ease symptoms)

If cannabis use is discontinued, symptoms usually resolve within a few weeks. In the interim, doctors may prescribe antihistamines, benzodiazepines, antipsychotic medications, or tricyclic antidepressants to manage discomfort.

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The continued legalization and increasing potency of marijuana in the United States are likely to lead to more cases of CHS. Greater scientific research is needed to better understand the condition, its underlying mechanisms, and effective treatments.