I’ve incorporated medical findings, studies, terminology, symptoms, diagnostics, epidemiology, and current research to ensure it’s evidence‑based and informative. Where helpful, I’ve cited peer‑reviewed or reputable sources.
If you’re over a certain age, you’ll remember a time when cannabis was almost universally stigmatized — portrayed as a dangerous “gateway” drug, a moral corruptor, or something to be feared.
That reputation began to shift dramatically throughout the 2000s and early 2010s as scientific research, social attitudes, and public policy evolved.
Today, cannabis is legal for recreational use in many parts of the United States, with at least 24 states and territories having legalized adult‑use cannabis as of early 2026.
The cultural perception has shifted too: far fewer people view cannabis as the “devil’s drug” it was once portrayed to be, even among those who have never used it themselves.
Yet, this shift toward normalization and legal access hasn’t eliminated potential health risks — and one of the most shocking and least understood of these is a condition known as Cannabinoid Hyperemesis Syndrome (CHS), colloquially nicknamed “scromiting.”
What Is Cannabinoid Hyperemesis Syndrome (CHS)?
Cannabinoid Hyperemesis Syndrome (CHS) is a medical condition linked to long‑term, frequent cannabis use that causes sudden, severe, and repeated bouts of nausea, vomiting, and intense abdominal pain.
While cannabis often produces relaxation, pleasure, and appetite stimulation in many users, CHS represents a paradoxical effect — one in which chronic exposure to cannabinoid compounds ultimately leads to the opposite of what most people expect. Rather than easing nausea, it triggers uncontrollable vomiting and intense digestive distress.
The term “scromiting” isn’t clinical — it’s slang created by patients and media to describe the torment of screaming and vomiting simultaneously during a CHS episode. It captures both the physical intensity and emotional horror of the condition.
How CHS Develops: Theories and Mechanisms
Medical researchers still do not know exactly why CHS happens. What they do know is this:
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It appears almost exclusively among people who use cannabis daily or very frequently.
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Symptoms tend to develop only after months to years of heavy use — often 10+ years in many cases.
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Not every chronic cannabis user develops CHS — some people may never experience it, even after years of use.
The Most Widely Accepted Hypothesis
The most plausible scientific explanation involves the endocannabinoid system (ECS) — a complex network of receptors throughout the brain, gut, and nervous system that regulates mood, pain, nausea, and appetite.
Cannabis contains compounds like THC (tetrahydrocannabinol) that bind to ECS receptors. Over time, chronic overstimulation of these receptors may disrupt the body’s natural ability to regulate nausea and vomiting, paradoxically making nausea worse instead of better.
Researchers also suspect that high‑THC potency products — such as concentrates, vapes, and edibles with elevated levels of active cannabinoids — may increase risk, though definitive causal mechanisms are still under study.
Symptoms of CHS: What It Looks Like
CHS is generally described in three phases that many sufferers pass through:
1. Prodromal Phase
This early stage may last months or even years, and symptoms are often mild or misunderstood:
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Mild but persistent nausea
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Early‑morning queasiness
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Abdominal discomfort
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Fear of vomiting, but little or no vomiting initially
Because symptoms are subtle, many users don’t suspect CHS and may even use cannabis more to “treat” nausea, inadvertently worsening the course of the syndrome.
2. Hyperemetic (Active) Phase
This is the defining and most dramatic stage:
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Severe, relentless nausea
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Repeated vomiting (sometimes many times per hour)
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Intense abdominal pain
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Vomiting so extreme it can cause screaming — hence “scromiting”
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Relief often only transiently achieved through hot showers or baths (a curious and characteristic symptom)
The hyperemetic phase can last 24–72 hours or more and often leads patients to seek emergency medical care because nothing else provides relief.
3. Recovery Phase
If cannabis use is completely stopped, symptoms begin to fade over days, weeks, or months. However, if cannabis use resumes, symptoms often return quickly, which can trap people in a cycle of recurring episodes.
How Common Is CHS? A Growing Emergency Room Concern
Estimating how common CHS really is remains challenging for a number of reasons:
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Until recently, hospitals and clinicians lacked a specific diagnostic code for CHS, making it difficult to track nationally.
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Symptoms overlap with other conditions like cyclical vomiting syndrome, food poisoning, or stomach flu.
However, several studies strongly suggest that CHS cases have been rising over the past decade — likely tied to increased cannabis use, legalization, and higher THC potency in commercial products.
For example:
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Analysis of U.S. emergency department data from 2016 to 2022 showed that the number of visits coded for CHS climbed significantly, especially during the COVID‑19 pandemic years, and then remained elevated.
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Another study specifically examining adolescents (aged 13–21) found that the rate of CHS emergency visits increased dramatically from 2016 through 2023 — with overall volume rising nearly 50% per year by some measures, both in states with legalized recreational cannabis and those without.
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Surveys of CHS sufferers indicate that 85 % report at least one ER visit for their symptoms, and nearly half have been hospitalized as a result of their episodes.
These trends indicate that CHS is far from rare and may represent a significant and under‑recognized public health issue tied to changing patterns of cannabis use.
Who Is Most at Risk?
While CHS can technically happen to anyone who uses cannabis heavily over a long period, certain demographic and behavioral features are more common among diagnosed cases:
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Daily or near‑daily cannabis users
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People who started using cannabis at a young age; early initiation appears linked with higher lifetime risk of CHS symptoms and ER visits.
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Young adults (especially ages 18–35) constitute a large share of diagnosed cases, though adolescents are increasingly affected as well.
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Some studies suggest males may have a slightly higher risk profile, though CHS occurs across genders.
It’s important to note: not everyone who uses cannabis daily will develop CHS — the reason some people suffer it and others don’t remains a topic of ongoing clinical research.
Why CHS Is Often Misdiagnosed
One of the biggest challenges clinicians face is recognizing CHS. Because its symptoms mimic many other medical conditions — such as cyclic vomiting syndrome, gastrointestinal infections, migraines, pancreatitis, and others — CHS can easily be mistaken for a different illness.
This can lead to:
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Repeated ER visits before the correct diagnosis
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Unnecessary tests (e.g., CT scans, endoscopy, ultrasounds)
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Higher health care costs
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Delayed symptom relief
Many emergency departments have reported that patients are being treated for common vomiting illnesses before cannabis use history is fully explored — which may delay diagnosis.
How CHS Is Diagnosed
There is no single lab test for CHS. Instead, a clinical diagnosis is usually made based on a combination of symptoms and cannabis use history, commonly including:
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Repeated episodes of nausea and vomiting
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Chronic cannabis use (typically daily or near daily for a year or more)
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Symptoms that resolve with sustained cannabis cessation
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Behavioral clues like compulsive hot bathing for symptom relief
In October 2025, an official clinical diagnostic code was introduced — a major step forward for tracking and research — making it easier for clinicians to categorize and report CHS diagnoses accurately on medical records and insurance billing forms.
Treatment: Temporary Relief vs Permanent Recovery
One of the most frustrating aspects of CHS is that standard anti‑nausea medications often do not work during an episode. Many patients and physicians report that medications commonly used for nausea — such as ondansetron or promethazine — provide minimal benefit.
Symptom Support During an Episode
Doctors may offer:
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Intravenous (IV) fluids to prevent dehydration
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Electrolyte management (e.g., potassium replacement)
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Pain control, which in severe cases has included opioids like morphine for intense pain
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Hot showers or baths often provide temporary relief, a hallmark feature of CHS
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In some cases, medications like haloperidol (an antipsychotic drug) or capsaicin cream have been used off‑label with varying degrees of success in the ER setting.
The Only Known Permanent Cure
The only treatment demonstrated to stop CHS episodes in the long term is complete cessation of cannabis use. This includes all forms — smoked, vaped, edible, and other cannabinoid products.
Once cannabis use is stopped, symptoms gradually diminish and eventually disappear. Unfortunately, many individuals continue using cannabis despite repeated episodes, either due to misunderstanding the link between use and symptoms or because of dependence or addiction.
Potential Complications of CHS
Repeated vomiting from CHS is not just unpleasant — it can lead to serious complications, including:
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Dehydration
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Electrolyte imbalances
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Acute kidney injury
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Esophageal tears (in severe cases)
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Damage to dental enamel from chronic vomiting
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Hospitalizations and repeated ER visits
While deaths directly attributable to CHS are rare, severe dehydration and metabolic complications can have life‑threatening consequences if untreated.
Why “Scromiting” Is Gaining Attention in Public Health
As cannabis legalization has expanded, so has research into both its benefits and harms. CHS is now recognized by major medical authorities as a real and measurable clinical syndrome.
Several factors have likely contributed to the growing number of diagnosed CHS cases:
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Increased accessibility of cannabis products
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Higher THC concentrations in modern products
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Broader social acceptance — meaning patients are more willing to discuss cannabis use with health care providers
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Better awareness among clinicians
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Introduction of specific diagnostic codes for CHS
While debate continues about the true prevalence of CHS — and some clinicians warn against over‑diagnosis without careful clinical evaluation — most research supports the conclusion that CHS is not as rare as once thought and that its presence has risen with increased chronic use patterns.
Conclusion: Balancing Awareness With Caution
Cannabis undeniably plays a significant role in modern culture, medicine, and policy. Its therapeutic potential is real for many conditions, and its legal status continues to evolve.
But CHS is a prime example of why education and awareness are crucial. Even as stigma decreases and acceptance grows, patients and clinicians alike need to understand that chronic cannabis use can carry unexpected risks — including severe cyclical vomiting that can dramatically impact health and quality of life.
Knowing the signs, understanding risk factors, and recognizing that cessation of cannabis use is the only way to stop CHS episodes are the first steps toward improved outcomes.
If you or someone you know experiences recurrent vomiting associated with chronic cannabis use, it’s important to seek medical advice from a qualified health care provider — because early recognition can prevent repeated suffering and unnecessary interventions.
