If someone told you that smoking a lot of weed could one day make you hate weed because of relentless nausea and vomiting, you might think they were exaggerating.
But that’s exactly what happens in a condition called cannabinoid hyperemesis syndrome (CHS) – a rare but very real disorder linked to long-term, heavy cannabis use.
People with CHS often end up in the emergency room with severe vomiting and stomach pain, clutching their belly with one hand and begging for a hot shower with the other.
That “hot shower obsession” is oddly classic for this condition and can be a major clue for doctors.
In this in-depth guide, we’ll break down what CHS is, what causes it, how to recognize the symptoms, and which treatments (and lifestyle changes) actually work.
We’ll also walk through real-world challenges and experiences people face when living with or recovering from CHS.
What Is Cannabinoid Hyperemesis Syndrome?
Cannabinoid hyperemesis syndrome (CHS) is a condition in which people who use cannabis regularly over a long period develop
recurrent episodes of severe nausea, vomiting, and abdominal pain.
A few key features tend to show up over and over:
- Long-term, frequent cannabis use (often daily or near-daily for months or years)
- Cycles of intense nausea and vomiting that come and go
- Cramping or burning abdominal pain
- Compulsive hot showers or baths that temporarily relieve symptoms
- Symptoms that improve – or completely disappear – after cannabis is stopped for a while
CHS is considered uncommon, but it’s being recognized more often as cannabis products become stronger and more widely used.
Many people bounce between clinics and emergency departments for years before someone finally connects the dots between cannabis use and vomiting.
Causes: Why Does CHS Happen?
Here’s the twist: cannabis is famously used to help with nausea – especially in conditions like chemotherapy-related nausea.
So how can it also cause vomiting in some people? The short answer: we don’t fully know yet, but we have some solid theories.
Long-Term, Heavy Cannabis Use
Almost every description of CHS points to the same trigger: frequent, long-term cannabis use.
Many people with CHS have used cannabis at least weekly (often daily) for years before symptoms started.
Risk factors may include:
- Using high-THC products (like concentrates, dabs, or potent edibles)
- Using cannabis multiple times per day
- Starting heavy use at a young age
- Using cannabis for many years without breaks
Possible Mechanisms Behind CHS
Researchers are still figuring out exactly why CHS develops in some people and not others, but several ideas are on the table:
-
Overstimulation of cannabinoid receptors.
THC acts on CB1 receptors in the brain and gut. Over time, chronic activation may disrupt normal gut motility and nausea pathways,
flipping cannabis from “anti-nausea helper” to “vomiting trigger.” -
Effect on the gut–brain axis.
CHS is now grouped with functional gut–brain interaction disorders (like cyclic vomiting syndrome), which involve complex communication between the brain and digestive system. -
TRPV1 (capsaicin) receptors and heat.
The same receptors activated by heat and chili peppers may help explain why hot showers and topical capsaicin creams can temporarily relieve symptoms.
Bottom line: CHS isn’t about “bad weed” or a random stomach bug. It’s a pattern that develops in a subset of chronic cannabis users whose systems seem to hit their limit.
Phases and Symptoms of CHS
CHS doesn’t usually appear out of nowhere. Symptoms tend to unfold in three phases: prodromal, hyperemetic, and recovery.
1. Prodromal Phase: The “Warning” Stage
This phase can last for months or even years and is easy to miss. Symptoms may include:
- Mild to moderate morning nausea
- Occasional belly discomfort
- Fear or worry about vomiting
- Still eating fairly normally
Many people increase their cannabis use in this phase, thinking it will help calm their nausea – which unfortunately can make CHS more likely over time.
2. Hyperemetic Phase: The “Everything Is Coming Up” Stage
This is the phase that often sends people to the emergency room. Symptoms can include:
- Relentless nausea
- Repeated vomiting (sometimes dozens of times a day)
- Inability to keep down food – or even water
- Crampy or burning abdominal pain
- Dehydration (dark urine, dizziness, fast heart rate)
- Weight loss if episodes happen often
A hallmark sign in this phase is compulsive hot bathing. People may take multiple long showers or baths a day or stand under hot water in the emergency department because it’s the only thing that eases their nausea for a short time.
3. Recovery Phase: When Cannabis Stops
Once cannabis use stops and the worst of the vomiting passes, people enter a recovery period:
- Appetite slowly returns
- Nausea fades
- Weight may stabilize or improve
- Hot shower “addiction” disappears because it’s no longer needed
Recovery can take weeks to months, and in some cases, full resolution may require several months of cannabis abstinence or at least three vomiting cycles.
Complications: Why CHS Is More Than “Just Vomiting”
Untreated CHS can lead to serious medical issues. Persistent vomiting and reduced fluid intake can cause:
- Severe dehydration
- Electrolyte imbalances (low potassium, sodium, etc.)
- Acute kidney injury or “cannabinoid hyperemesis acute renal failure” from dehydration and constant hot showers
- Low blood pressure and fainting
- Esophageal tears (like Mallory–Weiss tear), bleeding, or chest pain
- Tooth enamel damage from recurrent stomach acid exposure
- Rare but serious events like abnormal heart rhythms, seizures, or life-threatening complications in extreme cases
If you or someone you know with CHS symptoms can’t keep fluids down, is confused, extremely weak, or has chest pain or blood in vomit, it’s time for emergency care.
How Is Cannabinoid Hyperemesis Syndrome Diagnosed?
There’s no single blood test or scan that “proves” CHS. Instead, doctors use:
- A detailed history of symptoms
- Questions about cannabis use (how much, how often, how long)
- Physical exam
- Lab tests and imaging to rule out other causes of vomiting
Rome IV Criteria and CHS
The Rome IV criteria for CHS help standardize the diagnosis. In general, they include:
- Stereotypical episodes of vomiting, similar in pattern to cyclic vomiting syndrome
- Episodes occurring after prolonged, heavy cannabis use
- Improvement of symptoms after sustained abstinence from cannabis
- Symptoms present for at least 3 months, with onset at least 6 months before diagnosis
Doctors may also ask specifically about:
- Compulsive hot bathing or showering
- How often vomiting episodes occur and how long they last
- Other medical conditions, medications, and mental health history
Because nausea and vomiting are such nonspecific symptoms, many people are first tested for gallbladder disease, ulcers, pancreatitis, infections, or even heart problems before CHS is considered.
Treatment: What Actually Helps with CHS?
CHS treatment has two parts:
- Managing the acute (right now) episode
- Preventing symptoms in the future – which basically means tackling cannabis use
Acute Treatment in the Emergency Department or Clinic
During the hyperemetic phase, people often need hospital care for:
- Intravenous (IV) fluids to treat dehydration
- Lab tests to monitor electrolytes, kidney function, and blood sugar
- Anti-nausea and anti-vomiting medications
The tricky part: standard antiemetics like ondansetron don’t always work well in CHS. Other options that may be used in the emergency setting include:
- Haloperidol or droperidol (dopamine-blocking medications shown in some studies to reduce vomiting)
- Topical capsaicin cream applied to the abdomen or arms – activating the same receptors as heat and possibly providing relief
- Occasionally, benzodiazepines or other medications for anxiety or severe distress (not usually first-line)
While hot showers might help for a bit, they are not a substitute for medical care. In fact, long, very hot showers combined with dehydration can worsen kidney injury.
The Only Definitive Treatment: Stopping Cannabis
This is the part no heavy cannabis user wants to hear – but it’s the core truth:
the only proven long-term “cure” for CHS is complete cessation of cannabis use.
When cannabis is stopped and stayed off, most people:
- Stop having severe vomiting episodes over time
- Can eat and drink normally again
- Gain weight back if they were losing it
- No longer need hot showers to feel human
However, it may take several weeks to months – or multiple vomiting cycles – before symptoms fully resolve. If cannabis use resumes, CHS often returns.
Support for Quitting Cannabis
Quitting cannabis can be emotionally and physically challenging, especially if you’ve used it to cope with anxiety, pain, or sleep issues.
Support can make the process far easier:
- Primary care or addiction medicine providers for structured plans
- Therapists or counselors experienced in substance use or mental health
- Support groups (in-person or online) for people cutting down or quitting cannabis
- Cognitive behavioral therapy and other approaches to manage triggers and stress
Some people also need help tackling underlying conditions (like anxiety, depression, or chronic pain) in healthier, evidence-based ways that don’t involve heavy cannabis use.
Living with CHS: Practical Tips
While you’re working toward full recovery, these strategies can help reduce risk and manage milder nausea:
- Stay as hydrated as possible between flare-ups (water, oral rehydration solutions)
- Eat small, bland meals (toast, rice, bananas, broth) when able
- Limit caffeine and alcohol, which can worsen dehydration
- Keep a symptom diary (what you used, when you felt sick, how hot showers helped) to share with your doctor
- Build a support system that understands CHS is real – not “in your head” and not just “a bad high”
And remember: if vomiting becomes non-stop, you can’t keep fluids down, or you feel faint, confused, or very weak, it’s not the time to “tough it out.”
It’s time for urgent medical evaluation.
Personal and Clinical Experiences with CHS
Reading about CHS in a textbook is one thing; running into it in real life is another. The condition can be frustrating, confusing, and – once you recognize it – oddly eye-opening.
How It Often Feels from the Patient’s Side
Many people with CHS describe their journey as a kind of medical merry-go-round. At first, the pattern doesn’t make sense:
“I’ve always used weed to chill out and help my stomach – so why am I suddenly living in my bathroom?”
Early on, symptoms may show up as “just nausea” in the morning or occasional vomiting that seems random. People blame bad takeout, stress, or stomach flu.
Because cannabis used to relieve nausea, it’s natural to reach for more when the stomach acts up. For a while, that might even feel helpful – until it doesn’t.
As CHS progresses, the hyperemetic episodes can get brutal. Some people end up lying on the shower floor in the middle of the night under very hot water,
not because it’s relaxing, but because it’s the only thing that briefly dials down the nausea. They may cycle through multiple ER visits with different diagnoses –
food poisoning, gastritis, anxiety – and leave with a handful of anti-nausea prescriptions that don’t touch the symptoms.
Emotionally, this can be draining. It’s common to feel:
- Embarrassed about how much time is spent in the bathroom or shower
- Worried that something “serious and unknown” is being missed
- Defensive when someone suggests cannabis might be part of the problem
- Conflicted – because cannabis may feel tied to identity, social life, or coping
When a clinician finally explains CHS and connects the dots between heavy cannabis use, hot showers, and cyclic vomiting, the reaction is often a mix of skepticism and relief.
It can sound almost too convenient – “blame the weed” – yet for many, the story fits eerily well.
People who try full abstinence and then notice that their symptoms fade over weeks to months often describe the experience as surreal and, in some ways, empowering:
a switch they didn’t know existed has been flipped.
How It Looks from the Clinician’s Side
From the clinician perspective, CHS is both a diagnostic challenge and an important opportunity.
A patient shows up in the emergency department hunched over, dehydrated, and vomiting nonstop. The first job is to stabilize: fluids, labs, pain and nausea control,
and ruling out immediately dangerous conditions.
As more cases of CHS are recognized, providers are getting better at spotting patterns:
- The age group is often teens to middle-aged adults
- There’s usually a history of daily or near-daily cannabis use
- CT scans, ultrasounds, and endoscopies may all come back normal
- The patient may casually mention frequent hot showers or show up freshly showered from the hospital bathroom
When clinicians gently explore cannabis use – not with judgment, but with curiosity – the story often unfolds quickly.
Some patients are surprised to hear that cannabis could be the culprit; others have already Googled CHS and are hoping someone will take the possibility seriously.
The hardest part of management is not the IV fluids or the medication orders; it’s the conversation about stopping cannabis.
For some, cannabis is a daily ritual. For others, it’s a way to manage trauma, anxiety, or chronic pain. Asking them to quit can feel like asking them to give up their main coping tool.
Good clinicians focus on partnership: explaining the evidence, validating how miserable the patient feels, and offering concrete support for quitting.
That might mean connecting them with addiction medicine, counseling, or community resources. It also means acknowledging that relapse is common – and that coming back for help
is not a failure, but part of the process.
Recovery and Life After CHS
People who successfully stop cannabis after CHS often describe the first few weeks as bumpy. Sleep may be off, appetite may feel strange, and cravings can show up at awkward times.
But as the months pass and vomiting episodes don’t return, the benefits become clearer:
- Less time spent in hospitals and clinics
- More predictable mornings (no more daily nausea roulette)
- Improved energy and hydration
- Freedom from the “hot shower trap”
Some people discover new coping tools – therapy, movement, creative outlets, or healthier medical treatments – that were overshadowed by heavy cannabis use.
Others become informal “CHS ambassadors” in their friend group, gently warning people who think cannabis has no downside at all.
The big takeaway from lived experience on both sides – patient and clinician – is this: CHS is real, it’s treatable, and recognizing it early can spare a lot of suffering.
It doesn’t mean cannabis is “evil” or that people who develop CHS are weak. It just means that, for some bodies, long-term heavy cannabis use eventually crosses a threshold,
and the stomach decides it has had enough.
Conclusion
Cannabinoid hyperemesis syndrome sits at the strange intersection of a plant known for calming nausea and a body that suddenly rebels.
If you’re seeing the pattern – long-term heavy cannabis use, repeated vomiting, abdominal pain, hot showers that help – it’s worth taking CHS seriously.
Diagnosis often requires ruling out other causes and being honest about cannabis habits.
Treatment focuses first on stabilizing dehydration and vomiting, and then on the tough but powerful step of quitting cannabis completely.
The process isn’t always easy, but the payoff – fewer ER trips, a calmer stomach, and a healthier relationship with your body – can be huge.
If CHS sounds uncomfortably familiar, talk with a healthcare professional.
You deserve care that sees the full picture, not just another round of “it’s probably a virus.”
SEO Summary
meta_title: Cannabinoid Hyperemesis Syndrome: Causes & Treatment
meta_description: Learn what cannabinoid hyperemesis syndrome (CHS) is, why heavy cannabis use can cause severe vomiting, and how to treat and prevent it.
sapo: Cannabinoid hyperemesis syndrome (CHS) turns the “anti-nausea” reputation of cannabis upside down.
In some long-term, heavy users, weed can trigger cycles of severe vomiting, stomach pain, and an unusual craving for hot showers.
This in-depth guide explains what CHS is, why it happens, how doctors diagnose it, and which treatments actually work – from emergency care and capsaicin cream to the one proven long-term solution: stopping cannabis.
You’ll also find real-world experiences and practical tips to help you navigate recovery and protect your health moving forward.
keywords: cannabinoid hyperemesis syndrome, CHS symptoms, CHS treatment, cannabis vomiting, hot shower relief CHS, cannabis withdrawal nausea, chronic marijuana use complications