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).
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 :/
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
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.
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It’s genuinely more or less just more “reefer madness”.
If you actually read my comment and the study carefully, you might notice that.
For example:
Because there is no diagnostic code for CHS, we followed the previous literature identifying CHS ED visits as those in which vomiting (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada [ICD-10-CA] code R11) was the primary diagnosis and a cannabis harm (ICD-10-CA code F12 or T40.7) was an additional diagnosis.19,20 Since CHS is not widely recognized, we developed a secondary outcome measure termed sensitive CHS ED visits, which includes the primary outcome definition and an ED visit with a primary diagnosis of vomiting (ICD-10-CA code R11) plus an ED visit owing to a cannabis harm in the 6 months preceding or following the incident vomiting visit.
So, anyone who’s been labeled to have any sort of harm from cannabis, which a lot of people take to just be use of cannabis. I can show you a recording of a psychiatrist supposedly specialising in drugs and addiction, who told me “there is no safe amount of cannabis you can use”.
And then, when any of those roughly just users, report with vomiting to an ER even 6 months after someone has written down something about cannabis use, it get counted as “cannabis hyperemesis syndrome”.
So because legalisation has made doctors more aware they’re questioning youth more about cannabis use. And since it’s legal, the youths aren’t lying as much as they used to. But they still have the same amount of alcohol overdoses (ie getting so drunk you start vomiting) and if you then visit the ER even just for being too drunk or having a fever with vomiting, you’ll be counted as a “ER CHS patient”.
So you know. You really do need to go and read the things they claim, all the way down to the source. For one most of the things they source in those studies are studies which aren’t exclusively Canadian, making your “well the study is Canadian” argument a bit frail, since the study references other non-Canadian studies.
I’m not against regulation, and I think a boozecard model would be fantastic. For things that actually require it. We had the same in Finland, up until the 70’s, really.
It was from ‘44-’ 70 yeah.
https://en.m.wikipedia.org/wiki/Bratt_System
But see that was for booze, not beer. Since growing your own is also legal and east af, trying to control the amount of cannabis wouldn’t work in practice, and as someone who’s known daily users for years, I don’t think there is any inherent factor in cannabis which would cause this syndrome (“syndrome” = a collection of symptoms, not a disease in itself). It’s more bad reporting and bad understanding of the subject.
For one when you’re totally drunk, never smoked weed, you take a large hit of something strong, you can easily start to feel spinning such that you literally vomit like there’s no tomorrow. To the point people who haven’t seen it will genuinely consider taking them to the ER. And during something like that, it does help to be in a hot shower.
However as the drunkenness wears off, the person becomes even more nauseous, as they’re still plenty high without being used to it, and the hangover is creeping in.
But never have I ever seen anyone vomit from cannabis who hasn’t been drinking. I’m not saying they don’t exist or that this syndrome isn’t real. I’m just saying I don’t see a well-explained causal relationship. I just see a bunch of poor correlation, as always.
Anyways, yeah, register and limit. For actual drugs. That’s why booze was on the card but beer wasn’t. You can make that at home and it’s not strong enough to mess you up line vodka will do.
Just the same, cannabis should be legal and ecstasy and others legalised with the Bratt system. People don’t cook mdma at home if there’s some available to purchase legally.
Government is leaving out billions in drug money because there’s a huge market for illegal drugs just going completely unregulated and untaxed.
Agreed. Proper legislation. I hope the political conversation becomes more about how rather than this bad/good argument.
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
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.
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
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.
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.
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.
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
Idk about accidents but for ingestion it’s definitely still zero
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.
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.
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’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,
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?
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The interesting part is that CHS shares the bathing thing with the Cyclic Vomitting Syndrome. There’s something similar that must be causing both
Can’t provide employment or affordable housing to our youth, but we can shame their for their totally unexplainable drug use.
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.
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 !
And then they go all satanic and do murder.
Cannabis, totally safe, they said. Nobody ever gets hurt, they said. It’s not habit-forming, they said. 🫤
It’s still the safest recreational substance in existence by a fantastically wide margin
Safe in the sense that it won’t kill you outright like fentanyl.
But it’s not safe.
It doesn’t have to be as bad as other drugs to be a cause for concern.
Safe in the sense that it won’t kill you at all, yes, in a literal sense, in a “you’re either stupid or lying if you pretend otherwise” sense. This is the most alarmist article anyone could come up with and it describes vomiting and moderate discomfort that goes away again forever as soon as you take a tolerance break. You are a joke.
I’m assuming then, that you aren’t aware of the decades of research on cannabis, especially when smoked, showing harm in other areas of human health?
Nothing in your link proves me wrong, if you’d bothered to read it you’d know that, you’re either illiterate or lying
Oh, come on now. You are arguing in bath faith if you couldn’t find one thing that “proves you wrong”.
Here are just a few from that link, and each topic is explored in depth if you click through the supporting links on that page:
“Hospitalizations for psychotic disorder related to cannabis use accounted for one-third of mental or behavioural disorders between 2006–2015, increasing more than 25 per cent during this time.”
“Cannabis smoke contains chemicals (toxins, carcinogens and irritants) that are known to negatively affect lung health.”
“Smoking cannabis may suppress the immune system, which can make you more prone to infection from viruses.”
“Regular cannabis use can increase the risk of developing psychosis and schizophrenia…”
“Cannabis impairs the cognitive and motor abilities necessary to operate a motor vehicle and doubles the risk of being involved in a collision.”
“Cannabis, when inhaled, can potentially trigger stroke, heart attack or inflammation of arteries, especially in those who use cannabis heavily.”
“Regular use of these products [edibles] has been associated with problematic cannabis use, cannabis use disorder and mental health disorders.”
“Based on existing research and because of the associated risks of harms, cannabis use should only be considered for people who do not respond to first- and second-line treatments.”
“Most of the cases of emerging lung and respiratory disorders have been linked to vaping products containing THC from cannabis extracts.”
“Regular cannabis use is associated with changes in brain structure and function, including changes to the brain’s natural reward pathways.”
“Regular cannabis use is generally associated with more harmful rather than beneficial effects among people with mental health conditions.”
“Frequent cannabis use during pregnancy is associated with … Altered neurodevelopment and cognition, and academic under-achievement; and behavioural disturbances among children and young adults, including attention deficits, increased hyperactivity and impulsivity, and increased likelihood of delinquency and substance use.”
No proof whatsoever that the referenced psychotic disorders were caused by cannabis use, correlative misrepresentation is nothing new for anti-marijuana propaganda.
Smoking anything is bad for lung health, does nothing to change the fact that marijuana is the safest recreational substance in existence, especially when ingested in any other way.
“May supress the immune sustem” no evidence provided lol, unsubstantiated speculation, embarassingly weak
“Can increase risk of developing schizophrenia” also well documented that it has no chance whatsoever of causing schizophrenia in individuals that aren’t already hereditarily prone to developing it, at most it can accelerate onset
I’m not going to waste my time individually addressing the many unsubstantiated claims you’ve copypasted here, it’s clear you don’t actually give a shit about what’s true and are just here to push an agenda. Get a job.
Not really what serious advocates ever said. Maybe what random people on the Internet sometimes said?
Before legalization, pretty much every cannabis magazine and website was being cited as saying it was totally safe. Even mocked people for thinking otherwise.
That changed public opinion, and experts were ignored. These risks were known many years ago, so why has the industry been allowed to keep selling stronger strains, marketing to young people, and making these drugs available everywhere?
Now that the consequences are being seen, what are we going to do about it? This shit is being sold at every street corner, sometimes multiple cannabis shops at the same intersection. It’s nuts.
Ah ok, “they” meant cannabis magazines.
experts were ignored
The experts were on the side of legalization, so they weren’t really ignored. If by experts you mean people who study public health policy and narcotrafficking.
Now that the consequences are being seen, what are we going to do about it?
What are these experts saying nowadays? What I see is a consensus that legalization was a pretty good move. There’s probably more we should do, but it’s stuff that builds on top of legalization.
Ah ok, “they” meant cannabis magazines.
Before legalization, there really weren’t many other places promoting cannabis (maybe there was, but marketing back then was very different from now), so the promotion of their safety came from those sources (unfortunately).
Worse yet, as the plans to legalize were getting closer, I remember a massive push on social media by people promoting cannabis as a cure-all for just about anything: mental health, cancer, anxiety, bowel problems, etc. They used the Trojan horse of “medicinal use” to bring it into everyone’s life.
I’m sure there was industry influence, because it was extremely rare to see people pointing out the harms of cannabis back then.
The experts were on the side of legalization, so they weren’t really ignored. If by experts you mean people who study public health policy and narcotrafficking.
Decriminalization is one thing, and experts were certainly in support of decriminalization.
But legalization, as in “allow stores to sell these everywhere and to everyone”, just like alcohol and cigarettes, became a fucking disaster, and now we are seeing the result of what the experts warned us about.
What are these experts saying nowadays? What I see is a consensus that it has a pretty good move.
Again, they still agree that decriminalization was the right move. But experts, doctors, law enforcement, educators… all see what a disaster this has become.
We knew that normalizing cannabis and selling it everywhere would lead to more DUI, more hospitalizations, more poisoning of small children, lower academic performance in teens… just wait until the wave of long-term harm begins to surface. How will our healthcare system even handle that burden? Experts have warned us for decades, and still do.
Looks like we have different groups of experts in our respective informational sources
The “experts” looked a lot different on 2016 Social Media… and that’s what drove much of the public support.
The real experts would have never wanted cannabis to be sold and promoted the way it has been.
Only marketing I’ve seen is anti-drug ads
And per the above article, drinking until you puke seems to be worse
A disaster? Be serious
Education! Real, honest education to school age kids. Prohibition just creates a more dangerous black market, and lying (by hyperbole) about drug effects makes kids not believe the warnings which is just as bad (see: US’s failed D.A.R.E. Program in the 90s where they said marijuana is as bad as heroin)
Prohibition
I don’t think prohibition is the way to go. But we (society) should treat these drugs like we treat cigarettes: keep them out of view (i.e. “behind the counter”) and stop allowing them to be marketed at every street corner.
I view it from the perspective of someone who might never want to get into drugs, or may have recently become sober: they see cannabis shops at every turn, they are being primed to fail, and that’s not right.
We were able to get sensible people to stop smoking once we stopped allowing cigarettes to be displayed and marketed everywhere. I feel we need to do the same for cannabis (and alcohol) because of the harm we are causing to the most vulnerable in our society (youth and the poor).
One could argue it is safe in reasonable moderation. CHS devlops due to extreme and excessive daily use of cannabis. Enjoying a joint every now and then is far safer than toking every 30 minutes.
If i ate 30 chocolate bars everyday for weeks on end, I’d have some serious health issues, but one every weekend would be nearly unnoticeable from a health perspective.
Enjoying a joint every now and then is far safer than toking every 30 minutes.
The problem is, what Health Canada once labelled as “heavy use” is pretty much normal use these days. Daily use, or using multiple times a day, is very common.
If people (and teens) were only consuming once in a while, I doubt we’d be in this mess.
They consume often, partly because they’ve been told “it helps with XYZ”, so they self-medicate, which leads to greater problems. But also because they believe it’s “safe”.
Single cannabis use can also lead to acute impairment and puts stresses on the body. I’ve never heard of someone getting in a car and killing someone because they were impaired on having chocolate that afternoon. 😆
You are being down voted but this exact thing happened to somebody I know. The repeal of criminalization, without a better education plan, gave them the idea that “Oh its fine now”. They became addicted to smoking it, spent all day every day just hitting a bong. Stopped working, had to repeat a year at uni to get courses on track. They’ve had to completely abstain, or they fall back into the spiral. Some people get addicted to alcohol, some its another drug entirely.
I’m being downvoted because addicts have to defend and justify their addiction, unfortunately.
I had a family member who also went through the same. They developed psychosis (Cannabis-induced depersonalization-derealization disorder) through daily use of cannabis, and ended up needing to get treatment after their life went downhill.
Stopped once the weed stopped, but it was an alarming transition, and not an easy addiction to break.
They only became hooked once legalization came into effect, since it was accessible from anywhere.
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I had to check if we were in the same family/circle. Besides the one situation I mentioned, what you described happened happened to a family friend also. Quite a scary time for those around the person that didn’t know what was happening to them (because isolation had led to less interaction), but luckily the ones that got hints took them in to make sure they were OK. And turned out it was bad psychosis and required a few weeks hospitalization.
I’m a let people do what they want guy, but claiming marijuana is harmless is dangerous.
