As cannabis use among youth rises in Canada — and THC potency reaches record highs — emergency departments are seeing a surge in cases of a once-rare condition: cannabis hyperemesis syndrome (CHS).
Characterized by relentless vomiting, abdominal pain and temporary relief through compulsive hot showers or baths, CHS is increasingly affecting adolescents and young adults. Yet few people — including many clinicians — know it exists.
Canada ranks among the highest globally for youth cannabis use, with 43 per cent of 16-19-year-olds reporting use in the past year. Usage peaks among those 20–24 years, with nearly half (48 per cent) reporting past-year use.
This rise in regular, heavy use coincides with a 400 per cent increase in THC potency since the 1980s. Strains with THC levels above 25 per cent are now common. As cannabis becomes more potent and accessible, clinicians are seeing more cases of CHS, a condition virtually unheard of before 2004.
CHS unfolds in three phases:
Prodromal phase: Nausea and early morning discomfort begin. Users increase cannabis consumption, thinking it will relieve symptoms.
Hyperemetic phase: Intense vomiting, dehydration and abdominal pain follow. Hot showers or baths provide temporary relief — a hallmark of CHS.
Recovery phase: Symptoms resolve after stopping cannabis entirely.
Diagnosis is often delayed. One reason is because CHS mimics conditions like gastroenteritis or eating disorders, leading to costly CT scans, MRIs and gastric emptying tests. One telltale sign — compulsive hot bathing — is frequently overlooked, despite its strong diagnostic value.
Youth face unique risks. The brain continues to develop until about age 25, and THC exposure during this critical window can impair cognitive functions like memory, learning and emotional regulation. Heavy cannabis use is associated with heightened risks of anxiety, depression, psychosis and self-harm.
Edit, the link in the article goes to this study:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796355
Results There were 12 866 ED visits for CHS from 8140 individuals during the study. Overall, the mean (SD) age was 27.4 (10.5) years, with 2834 individuals (34.8%) aged 19 to 24 years, 4163 (51.5%) females, and 1353 individuals (16.6%) with a mental health ED visit or hospitalization in the 2 years before their first CHS ED visit. Nearly 10% of visits (1135 visits [8.8%]) led to hospital admissions. Monthly rates of CHS ED visits increased 13-fold during the 7.5-year study period, from 0.26 visits per 100 000 population in January 2014 to 3.43 visits per 100 000 population in June 2021. Legalization was not associated with an immediate or gradual change in rates of ED visits for CHS; however, commercialization during the COVID-19 pandemic period was associated with an immediate increase in rates of CHS ED visits (incidence rate ratio [IRR], 1.49; 95% CI, 1.31-1.70). During commercialization, rates of CHS ED visits increased more in women (IRR, 1.49; 95% CI, 1.16-1.92) and individuals older than the legal age of cannabis purchase (eg, age 19-24 years: IRR, 1.60; 95% CI, 1.19-2.16) than men (IRR, 1.08; 95% CI, 0.85-1.37) and individuals younger than the legal age of purchase (IRR, 0.78; 95% CI, 0.42-1.45).
Why is everyone so combative as if this has not been well known for decades?
Cannabis is a drug just like every other. It’s not safe unregulated. This is evidence that we should regulate and provide safe guidelines on usage.
But I know so many people that spread that you can’t eat or smoke to much cannabis. That level of ignorance is no better.
I wouldn’t say “combative”. Critical, maybe.
It is a syndrome they’re describing, with rather vague symptoms and a very large userbase.
I’m not one to deny the risks of anything, but since cannabis has been subjected to biased research and journalism for 100 years, it’s not really surprising some people are somewhat critical of something this vague.
Like what’s your suggestion on “regulation”? Because I think an appropriate age limit is fine, just like with alcohol. Actual proper legalisation would allow people to actually know how much theyre consuming. Now it’s just random strength weed for random amount of inhale. If you knew x mg per puff or edible, like you can do in some places, but not most of the world, then it becomes easier knowing how much you’re actually consuming. So yeah, better regulation. Which requires legalisation.
Agreed. Proper legislation. I hope the political conversation becomes more about how rather than this bad/good argument.
And then they go all satanic and do murder.
When I had a gallstone induced pancreatitis they tried to tell me this is what I had. Luckly they still ran some blood work and got me scheduled for emergency surgery.
It was pretty annoying having the doctor trying to blame my severe pain on cannabis use though :/
The interesting part is that CHS shares the bathing thing with the Cyclic Vomitting Syndrome. There’s something similar that must be causing both
I like how “used it in the past year” in one paragraph mysteriously becomes “regular, heavy use” in the next.
Emesis doesn’t happen except in extreme cases with long term multiple times a day use
Heavy cannabis use is associated with heightened risks of anxiety, depression, psychosis and self-harm.
So is antidepressant use.
That’s correlation though. The reason you get prescribed antidepressants is a bias pick for already being a risk to self.
You have accurately explained my criticism.
Yeah just could let it sit with people believing its causation
Do this report have actual numbers of youth “landing in the ER with vomiting from cannabis use”, or is this just percentages, none which seem directly related?
Of course not, if they did that it would be too obvious that this is alarmist drug war horseshit
I’m a daily user for years and I’ve never heard of this. I wonder if it has to do with the way they’re consuming it. Shady vapes from the internet could be causing trouble, not the thc itself.
I’m a long time daily user as well, and my suspicion would be the ever increasing potency. I have a quite high tolerance, yet a high THC strain (iirc advertised were 26-27%) i bought some months ago seriously fucked me up.
Loss of motor control, balance, intense nausea and sweating, I had to literally sit on the toilet and lean my head and upper body against the wall for 45 minutes, because that was somehow the only bearable position with the option to puke if needed. Topped off with a racing mind going to unhappy places.
I then sort of cut the stuff with “normal” ~20% weed to tone it down and make it tolerable. I can definitely see these potent strains having unexpected and perhaps so far undocumented effects on the body. A little like beer versus liquor.
It really is just the THC, but it requires absurd dosages consistently for an extended period. First I ever heard of hyperemesis syndrome was when a friend from high school managed to inflict it on himself during his first year in college, he was selling at the time so he had an endless supply of the strongest flower I’d ever encountered at that point and was constantly smoking as much as physically possible, but he’s the only person I’ve ever met who did. I spent most of the past 5 years doing dabs several times a day and haven’t even come close, it’s not easy.
It’s the THC itself you just need a stupidly large amount consistently over a long time to get emesis
And people like you throwing shade on the vape industry isn’t helping,
Any comparison to alcohol?
Cause I’m hearing that youth are suffering from nausea, which sounds a lot better than dying of alcohol poisoning.
Maybe if the world wasn’t burning these youth’s future in plain sight they’d be less stressed and depressed?
Substance abuse is a symptom of, not a cause of, mental health problems.
When I was a kid it was alcohol poisoning and lots of kids even in my rural community died in ditches and at bush parties. There were 300 kids in my high school. Grades 9-12. We had 6 deaths from alcohol. Either consumption or drunk driving. I’d be interested to know how many kids are dying from cannabis ingestion or accidents related to.
Idk about accidents but for ingestion it’s definitely still zero
Gonna be really close to zero.
I don’t have skin in the fame either way, but this is interesting https://poppot.org/2023/04/17/child-abuse-deaths-linked-to-thc-top-300/
I suppose you could describe attributing child neglect deaths to marijuana use as interesting, in a “wow I wonder what batshit nonsense they’ll blame the safest recreational drug in existence for next” sort of way
I think alcohol abuse destroys lives, but so does Marijuana abuse. One isn’t better than the other.
If you think marijuana and alcohol are equally harmful then you aren’t qualified to walk and chew at the same time
As abuse. Like if somebody tokes on the weekend or has a single beer neither is a problem.
As I mentioned prior I know people that have abused it to point of psychosis hospitalization, and completely destroying their job/education. You just have to define the amounts for abuse, and those will be different per drug.
They’re not even close to the same
I am an old fellow who has been using cannabis almost daily since 1966. I have never heard of these symptoms. I hang out with many other old people with similar profiles. I have asked around nobody has heard of these symptoms. This article reads like bad AI.
Fair, I’ve been smoking pretty close to daily for over 20 years now and only met one person who managed to smoke/eat enough weed to trigger hyperemesis. It requires absurd dosages constantly for weeks without stopping, not impossible but definitely nowhere near as big a problem as this article or some commenters are suggesting.
And I am an old fellow that has been using cannabis daily since 1993 and I can tell you first hand cannabis emesis is absolutely a thing and is exactly as described, AND is relieved by hot showers.
It comes from CHRONIC high dosages such as vaping, concentrates, and those who smoke joints like cigarettes.
I have had these symptoms in my 30s when I used to grow and make tinctures, but I didn’t need a doctor I just stopped smoking for a few days and then kept it light.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11597608/
It’s pretty disgusting that people just upvote whatever
It’s real, a person I know went through it. They basically just smoked a bong all day, every day. Creates a paralysis like effect on your intestines.
yuppers, I got it through overusing tincture
It’s been the go-to opinion of the (pharmaceutical) medical community right about since… immediately after some states decriminalized.
This is just the symptom of a much bigger underlying issue. We can talk about regulation all we want or even banning it, but it won’t solve the big problem of what young adults have to face today in society at large. They are ill prepared for the real world, bombarded by social media influences 24/7, this is just another coping mechanism they’ve turned to.
Excessive use of alcohol, vapes, sugar etc. are all just as bad. But hey, the stats are saying 16-19 year olds at 43 percent - last I checked the legal age to purchase cannabis was 19 in Canada. So, anything under that would be considered illegal and I’d solely place the blame on the parents - just like any other substance abuse. Alas, that still doesn’t solve the mental pressures that these young adults will need to face (housing, employment opportunities, global factors - climate change etc.). We can educate all that we can, but it won’t change the reality. The reality is that it takes real political will and a strong mandate from voters (we all know our federal government is like a bunch of companies in a trench coat and that needs to change) to actually FIX the money side of problems. I am not surprised that the 20-24 year old’s use cannabis (48% claimed by the article) - record inflation anyone? high groceries? lack of good livable wage employment? housing?
Here’s my hot take, cannabis gets more bad rep than alcohol when alcohol, IMO, is worse.
Can’t provide employment or affordable housing to our youth, but we can shame their for their totally unexplainable drug use.
I don’t buy this “increased potency” argument as it sounds like the same anti-weed shit they’ve been saying since the 90s. We had concentrates and hash and vaporizers in the 2000s. Potency of the flower doesn’t matter much when you can rip volcano vapes from dawn till dusk. All these “CHS” stories also always mention the dumb “hurr Cannabis psychosis” shit which is the other Hallmark of old anti weed propaganda that makes me skeptical.
Idk, it kind of feels like hysteria or some related comorbidity with munchies. I’ve definitely known people who make themselves sick over and over again from eating too many Doritos
It’s real, a person I know went through it. They basically just smoked a bong all day, every day. Creates a paralysis like effect on your intestines, so stuff doesn’t go down has to come out
I’ve worked in a parc, we were not security but prevention guy that walk the parc talking to teen getting high, and kids were always saying « the weed now is way more potent that it your time ». Bullshit !
I’ve read a little about it once in a while. Apparently one of the ways to treat this is to administer haloperidol, an antipsychotic, to relieve the symptoms. It’s not a very long lasting condition either, especially if the user can recognize that weed’s causing it and just stops for a little while.
yeah my symptoms went away in less than 3 days and did not recur as long as I kept my intake reasonable
