Cannabinoid Hyperemesis Syndrome (CHS): Signs, Symptoms, and the Connection to Gallbladder Issues and High-Potency THC Products

Cannabinoid Hyperemesis Syndrome (CHS) is a bizarre and very real syndrome that has become increasingly apparent, particularly since the expansion of cannabis legalization. It is characterized by intractable vomiting in heavy cannabis users.

• Symptoms: CHS involves chronic, uncontrollable vomiting ("puking") that patients cannot stop. It often leads to ER visits. The symptoms can be so severe that one user reported losing almost 3kg in weight and requiring two nights in the hospital with IV anti-sickness medication.
• User Profile: CHS usually affects excess cannabis users.
• Paradoxical Nature: The syndrome is highly counterintuitive because cannabis is known as an antinauseant, especially in chemotherapy. For something with anti-nausea qualities to trigger a vomiting syndrome is paradoxical.
• Hypothesized Mechanism: Experts believe that after chronic use, CB1 receptors mediating anti-nausea effects (involving the insular cortex) become overwhelmed, burned out, or flipped. The system stops working or becomes sensitized, leading to uncontrollable vomiting.
• Emergence: The phenomenon is frequent enough that it is now documented at the federal data level as a health issue requiring emergency attention.

The audience is deeply concerned because CHS represents a severe, life-threatening negative effect associated with cannabis use. The distress stems from its paradoxical nature — vomiting caused by a known anti-nausea agent — and the terrifying physical experience of intractable vomiting. There is a specific concern about gallbladder issues and whether CHS necessitates removal, and whether it is tied to high-potency THC or cannabinoid overload. Patients and families fear that toxic cannabis levels may lead to organ failure and death.

For individuals experiencing CHS symptoms, the most bizarre but clinically reported palliative measure is a hot shower. For long-term prevention, cessation or drastic reduction in chronic, excessive use is required to allow the endocannabinoid system (ECS) to reset and prevent physiological overload.

• Dr. Matthew Hill: Described CHS as a "bizarre cyclic vomiting syndrome" increasingly seen in ERs post-legalization, especially in Canada. He explained its paradox — a drug known for anti-nausea now causing vomiting — and noted that heat exposure (hot showers) can relieve symptoms. He suggested the mechanism might involve burnout or sensitization of the insular cortex circuit. Hill listed CHS among the few “genuine bonafide health issues” tied to cannabis.
• Andrew Huberman: Introduced CHS as a "bizarre cyclic vomiting syndrome," highlighting the gap in scientific understanding. He acknowledged links between industrialized, high-potency THC products and CHS, echoing the paradoxical and poorly understood nature of the syndrome.

If you use cannabis daily and experience severe, cyclical vomiting and nausea, discontinue all cannabis use immediately and apply a hot shower for symptom relief.

• Mistake: Assuming the nausea and vomiting must be from another cause since cannabis is anti-nauseant.
  Fix: CHS is a paradoxical condition where chronic use overloads or flips the anti-nausea mechanism.
• Mistake: Using more cannabis to stop the nausea.
  Fix: Continued use perpetuates the overload state. Abstinence is required for recovery.
• Mistake: Believing the symptoms come from dirty sources or additives.
  Fix: CHS stems from over-stimulation of cannabinoid receptors themselves from chronic heavy use, not product contamination.

Cannabinoid Hyperemesis Syndrome (CHS) is a genuine and serious health risk tied to chronic, excessive cannabis use, manifesting as uncontrollable vomiting. Its paradox lies in the systemic overload of CB1 receptors that reverses cannabis’s usual anti-nausea effects. Though hot showers can bring temporary relief, the only reliable long-term solution is complete cessation of heavy cannabis use.