Cannabis hyperemesis syndrome — with severe vomiting, abdominal pain and temporary relief through compulsive hot bathing — is increasingly affecting adolescents and young adults.

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:

  1. Prodromal phase: Nausea and early morning discomfort begin. Users increase cannabis consumption, thinking it will relieve symptoms.

  2. Hyperemetic phase: Intense vomiting, dehydration and abdominal pain follow. Hot showers or baths provide temporary relief — a hallmark of CHS.

  3. 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).

  • Showroom7561
    517·
    6 days ago

    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.

    • Victor Villas
      141·
      6 days ago

      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.

      • Showroom7561
        110·
        6 days ago

        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.

        • Victor Villas
          8·
          6 days ago

          Looks like we have different groups of experts in our respective informational sources

          • Showroom7561
            19·
            6 days ago

            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.

            • ILikeBoobies
              5·
              6 days ago

              Only marketing I’ve seen is anti-drug ads

              And per the above article, drinking until you puke seems to be worse

              • Showroom7561
                17·
                6 days ago

                Only marketing I’ve seen is anti-drug ads

                Recently, or around the time of legalization? Even pulling up Google Maps will highlight the cannabis shops, which is an insidious way to promote them.

                  • Showroom7561
                    17·
                    6 days ago

                    You’re lucky, I guess. Even just driving/riding around, I see cannabis shop signs everywhere. And I don’t want to see them, so I can only imagine how they stick out to an addict or vulnerable person.

    • brendansimms@lemmy.world
      9·
      6 days ago

      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)

      • Showroom7561
        35·
        6 days ago

        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).

    • FireRetardant@lemmy.world
      6·
      6 days ago

      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.

      • Showroom7561
        38·
        6 days ago

        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. 😆

        • BCsven
          32·
          6 days ago

          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.

          • Showroom7561
            21·
            4 days ago

            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.

              • Showroom7561
                1·
                4 days ago

                I’ve already corrected your misinterpretation of the studies on several occasions, so there’s no need to continue to belabour the point. If you want to argue about it to the authors of those studies, I’m sure they’d love to hear from you.

                This is not a “war on drugs”, but a public health concern. You’re free to harm yourself however you like. But the public, especially our youth, should be better informed of the risks, especially while the chatter about cannabis being “safe” is still being thrown about casually.

            • BCsven
              21·
              4 days ago

              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.