In the 1980s and 1990s, cannabis was heavily stigmatized, often framed as a dangerous “gateway drug” that led to addiction and social instability. For many years, public discourse painted marijuana as a substance to be avoided at all costs, and its users were marginalized. Fast forward to today, and attitudes toward cannabis in the United States have changed dramatically. Recreational cannabis is legal in 24 states, and medical marijuana is permitted in even more. Public opinion has shifted as well, with support for legalization steadily rising over the past two decades. This cultural shift suggests a future where cannabis may be treated much like alcohol—regulated, normalized, and stripped of its taboo status.
However, just because cannabis is becoming more socially acceptable doesn’t mean it’s without risks. While many people use cannabis without severe consequences, its psychoactive compound, THC, has well-documented effects. Common experiences include relaxation, euphoria, altered perception, and increased appetite. Yet, others may experience negative side effects such as anxiety, paranoia, or an elevated heart rate. In rare cases, heavy use of cannabis has been linked to psychosis, especially in those with a predisposition to certain mental health conditions. One lesser-known but increasingly reported consequence of cannabis use is Cannabis Hyperemesis Syndrome (CHS), a disorder that has been gaining attention in emergency rooms across the U.S.
CHS is characterized by severe nausea, uncontrollable vomiting, and intense abdominal pain, which can last for several days. This condition is troubling not just because of the intensity of the symptoms, but also because traditional anti-nausea medications are often ineffective in treating it. Medical professionals have coined the term “scromiting” (a combination of screaming and vomiting) to describe the distress that many patients experience during CHS episodes. The condition typically manifests within 24 hours of cannabis use and can be incredibly debilitating. In some cases, patients report experiencing such extreme pain that they require narcotics like morphine for relief, and hot showers, which temporarily alleviate symptoms, are often used as a coping mechanism.
Despite its severe symptoms, there is no approved medical treatment for CHS. The only definitive way to alleviate the condition is to stop using cannabis. Unfortunately, because CHS symptoms often appear intermittently, many cannabis users fail to recognize the connection between their symptoms and their cannabis use. As a result, they may continue to use cannabis, leading to repeated and sometimes more severe episodes. Research shows that prolonged and heavy cannabis use increases the likelihood of developing CHS. A study from George Washington University found strong links between excessive cannabis consumption and frequent emergency room visits due to severe vomiting episodes, which were a hallmark of the syndrome.
Alarmingly, cases of CHS are on the rise among adolescents. Between 2016 and 2023, the number of CHS-related cases in young people increased more than tenfold. Interestingly, this rise has been most pronounced in states where recreational cannabis remains illegal, suggesting that even in places where cannabis use isn’t legally sanctioned, young people may still be accessing and using potent products. This trend highlights the need for a more nuanced conversation about cannabis use, especially among adolescents. Modern cannabis products often contain much higher concentrations of THC than those available in the past, and researchers are questioning whether the increased potency of cannabis products could be contributing to the rise in CHS cases.
The surge in CHS cases and the changing landscape of cannabis legalization underscore the importance of public education about cannabis use. As cannabis becomes more widely accepted and commercialized, public health experts argue that education should evolve to keep pace. While the vast majority of cannabis users experience no severe side effects, the emergence of conditions like CHS serves as a reminder that all substances—no matter how normalized—carry risks. It is essential that as the cultural shift around cannabis continues, we also focus on understanding both its potential benefits and its risks, just as we do with other substances like alcohol, tobacco, and prescription medications.
In conclusion, the normalization of cannabis presents both opportunities and challenges. As public opinion shifts and more states legalize cannabis, there is a growing need for informed decision-making and public health education. While cannabis may become more widely accepted, it is crucial to recognize that its use is not without risk, and conditions like CHS remind us that even widely accepted substances can have serious health consequences. Just as with any other substance, understanding both the benefits and potential harm
