Overview
CHS is a condition in chronic cannabis users where they develop cyclic episodes of severe vomiting — strikingly similar to Cyclic Vomiting Syndrome but caused by cannabis itself. Almost universal feature: relief from prolonged hot showers/baths. The only definitive treatment is stopping cannabis.
Symptoms
Episodes of severe nausea and vomiting (usually morning), separated by symptom-free periods
Diffuse abdominal pain
Compulsive hot showers or baths — provides striking relief
Weight loss, dehydration
Episodes worsen over time without cannabis cessation
Self-Care Tips
Stop ALL forms of cannabis (smoked, edibles, vapes, oils, CBD products with THC).
Seek addiction support — cannabis dependence is real.
Hot showers help during attacks.
Stay hydrated; small frequent fluids.
When to See a Doctor
Seek medical care promptly if you notice: Severe dehydration; Vomiting blood.
Why it happens
Long-term high-dose cannabinoid receptor stimulation in the gut and brain alters thermoregulation and digestive control. Why some chronic users develop CHS and others don't isn't fully understood.
How common it is
Increasing as cannabis use rises globally. Affects daily/near-daily users for 2+ years. In Saudi Arabia, cannabis use is illegal but does occur — patients may be reluctant to disclose.
Cannabis use is illegal in Saudi Arabia. Patients may be reluctant to disclose use. Confidentiality between patient and physician is preserved by law for medical assessment. Open conversation is essential for diagnosis and recovery.
How it is diagnosed
Diagnosis is clinical. Pattern of cyclic vomiting + chronic cannabis use + relief with hot bathing = CHS until proven otherwise. Tests rule out other causes (CBC, lipase, electrolytes, abdominal imaging). Definitive proof: symptoms resolve completely after 4-8 weeks of cannabis cessation.
Lifestyle and daily habits
Stop cannabis. There is no other path to lasting relief.
• Stop ALL forms of cannabis (smoked, edibles, vapes, oils, CBD products with THC).
• Seek addiction support — cannabis dependence is real.
• Hot showers help during attacks.
• Stay hydrated; small frequent fluids.
Diet
Standard healthy diet.
• No specific diet, but small frequent meals during recovery.
Medicines
Acute treatment is similar to CVS.
• IV fluids during attacks.
• Topical capsaicin cream on the abdomen often helps.
• Haloperidol or droperidol — surprisingly effective.
• Standard antiemetics (ondansetron) often don't work well.
Procedures and surgery
No procedures needed.
• Counseling for cannabis cessation.
Outlook
Excellent if cannabis is stopped — usually full resolution within weeks. Continued cannabis use leads to ongoing cycles of vomiting, weight loss, and ED visits. Relapse is common if cannabis resumed.
Questions to ask your doctor
• Could my cyclic vomiting be from cannabis use?
• How long until I feel better after stopping?
Source and review
This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the SGA Patient Education Panel. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.
Frequently Asked Questions
What is Cannabinoid Hyperemesis Syndrome (CHS)?
How is Cannabinoid Hyperemesis Syndrome (CHS) diagnosed?
What is the outlook for Cannabinoid Hyperemesis Syndrome (CHS)?
When should I see a doctor about Cannabinoid Hyperemesis Syndrome (CHS)?
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