Cannabinoid hyperemesis syndrome, commonly abbreviated as CHS, is a condition associated with frequent cannabis use that causes recurrent episodes of severe nausea, vomiting, and abdominal pain.
Although CHS was initially described primarily in adults, pediatric and adolescent clinicians are increasingly recognizing the condition in younger patients. The University of Utah Health notes that CHS is now being seen in teenagers, while recent research has specifically examined emergency department encounters among adolescents and young adults.[1][5]
CHS is sometimes informally called “scromiting,” a term combining “screaming” and “vomiting.” The term describes extremely painful or forceful vomiting episodes, but cannabinoid hyperemesis syndrome is the medical term used for the condition.[6]
CHS is not simply a stomach virus or an isolated episode of vomiting. It is associated with a pattern of recurrent symptoms in the setting of cannabis use, and the diagnosis requires healthcare professionals to consider and rule out other possible causes.[3][4]
What Is Cannabinoid Hyperemesis Syndrome?
Cannabinoid hyperemesis syndrome (CHS) is a condition associated with regular cannabis use that causes repeated episodes of nausea, severe vomiting, and abdominal pain. It can occur in teenagers as well as adults.
CHS is different from an isolated episode of vomiting. The condition typically involves a recurring pattern of symptoms in someone who uses cannabis regularly. Some people with CHS also report temporary relief from nausea or abdominal discomfort after taking hot showers or baths.
The exact reason cannabis causes CHS in some people but not others is not fully understood. Researchers believe repeated exposure to cannabinoids may affect the body’s regulation of nausea, vomiting, and gastrointestinal function.
CHS can become serious when repeated vomiting causes dehydration, electrolyte abnormalities, weight loss, or other complications. Because its symptoms can resemble other medical conditions, healthcare professionals need to consider other possible causes before diagnosing CHS.
What Causes Cannabinoid Hyperemesis Syndrome in Teens?
The exact biological mechanism behind CHS is not fully understood.
Cannabis contains cannabinoids, including THC, that interact with cannabinoid receptors in the brain and gastrointestinal system. Researchers believe that repeated exposure to cannabinoids may eventually disrupt the body’s normal regulation of nausea, vomiting, gastrointestinal function, and other processes in susceptible individuals.[2][3]
Not every person who uses cannabis develops CHS. The Children’s Mercy clinical education material notes that individual differences in how people process cannabis and the strength of cannabis products may contribute to why some people develop CHS while others do not.[2]
Frequent or prolonged cannabis use is the strongest established association. However, newer evidence suggests that CHS may sometimes develop sooner than previously believed. Emerging evidence suggests that CHS may develop sooner in some people than previously recognized, although it remains most commonly associated with frequent cannabis use over time. [1]
Can CHS Happen After Using Cannabis for a Short Time?
Yes. Although CHS has traditionally been associated with long-term, frequent cannabis use, recent clinical evidence suggests that symptoms can develop earlier in some people.
The University of Utah Health reports that CHS can occur in teenagers after months of regular cannabis use, while the 2026 CDC review notes that emerging evidence suggests symptom onset can occur within the first year of use.[1]
This means a teenager should not assume that CHS is impossible simply because they have not used cannabis for many years.
What Are the Symptoms of CHS in Teens?
The main symptoms of cannabinoid hyperemesis syndrome in teens are recurrent nausea, severe vomiting, and abdominal pain.
Symptoms can become intense enough that a teenager cannot keep food or fluids down. Repeated vomiting can lead to dehydration, electrolyte abnormalities, weakness, weight loss, and hospitalization.[1][2][3]
| Symptom category | Common symptoms |
|---|---|
| Gastrointestinal | Severe nausea, repeated vomiting, abdominal pain |
| Dehydration-related | Dehydration, weakness, dizziness, reduced urination |
| General | Weight loss, fatigue, changes in body temperature |
| Behavioral | Repeatedly seeking hot showers or baths for temporary relief |
| Oral and dental | Tooth damage associated with repeated exposure to stomach acid |
The symptoms may occur in episodes rather than remaining constant. A teenager may appear relatively well between episodes and then develop another severe vomiting episode later.[3][6]
What Can Help Relieve CHS Symptoms?
During a CHS episode, the immediate goal is to relieve symptoms and prevent complications from repeated vomiting.
- Medical hydration: Severe vomiting can cause dehydration and electrolyte abnormalities. A healthcare professional may provide intravenous fluids when a teenager cannot maintain adequate hydration by mouth.
- Medical treatment for nausea and vomiting: Clinicians may use medications to manage severe nausea and vomiting. The appropriate medication depends on the teenager’s symptoms and medical history.
- Heat for temporary relief: Hot showers or baths may temporarily reduce nausea or abdominal discomfort in some people with CHS. However, they do not treat the underlying condition and should not be used as a substitute for medical care.
- Stopping cannabis: Sustained cessation of cannabis is the key intervention for resolving CHS and reducing the risk of recurrent episodes.
- Medical evaluation: Persistent or severe vomiting may require emergency or hospital care, particularly when the teenager cannot keep fluids down or develops significant dehydration, uncontrolled pain, or other concerning symptoms.
These measures can provide symptom relief or address complications, but there is no reliable home treatment that cures an active CHS episode. A healthcare professional should evaluate severe or persistent symptoms and rule out other causes of vomiting.
What Does “Scromiting” Mean?
“Scromiting” is an informal term used to describe episodes of extremely painful or forceful vomiting that may cause a person to scream.
The term has become associated with CHS in media and substance-use discussions. However, it is not a separate medical diagnosis. The clinical condition being discussed is cannabinoid hyperemesis syndrome.[6]
The severity of vomiting can be significant. Some adolescents with CHS require emergency treatment because they cannot maintain adequate hydration or develop complications from repeated vomiting.[1][2][3]
What Are the Stages of Cannabinoid Hyperemesis Syndrome?
CHS is commonly described as occurring in three phases: the prodromal phase, the hyperemetic phase, and the recovery phase.
Prodromal Phase
The prodromal phase may involve nausea, abdominal discomfort, and other early gastrointestinal symptoms. Some people continue or increase cannabis use because they believe it will relieve their nausea.
This can make the underlying problem harder to recognize.[2][6]
Hyperemetic Phase
During the hyperemetic phase, vomiting becomes severe and persistent. Abdominal pain and repeated attempts to obtain relief through hot showers or baths may occur.
This is often the stage when a teenager seeks emergency medical care. Severe vomiting can result in dehydration, electrolyte disturbances, weight loss, and other complications.[1][3]
Recovery Phase
The recovery phase begins after cannabis use is stopped and symptoms gradually resolve.
The time required for symptoms to improve varies. Some patients improve within days or weeks, while symptoms can last longer. Returning to cannabis use can cause symptoms to recur.[2][3]
When Does CHS Become a Medical Emergency?
Severe vomiting should not automatically be assumed to be CHS. A teenager with repeated vomiting may have another condition that requires urgent treatment.
Seek emergency medical care when a teenager has:
- Severe or persistent vomiting and cannot keep fluids down
- Signs of significant dehydration
- Severe or uncontrolled abdominal pain
- Blood in vomit
- Fainting, confusion, or significant changes in consciousness
- Severe weakness or inability to remain awake
- Another rapidly worsening or concerning symptom
The Johns Hopkins All Children’s clinical pathway identifies intractable vomiting, dehydration requiring intravenous fluids, inability to tolerate oral fluids, repeated emergency visits without resolution, and uncontrolled pain as reasons clinicians may consider hospital admission.[3]
Parents should not attempt to diagnose CHS at home based solely on vomiting or hot-shower behavior. Other gastrointestinal, neurological, metabolic, reproductive, and infectious conditions can produce similar symptoms.[3][4]
How Is Cannabinoid Hyperemesis Syndrome Diagnosed in Teens?
There is no single laboratory test that confirms CHS.
Healthcare professionals generally consider the teenager’s symptoms, cannabis-use history, physical examination, and clinical course while evaluating other possible causes of vomiting.[3][4]
The Johns Hopkins pathway describes CHS as a diagnosis of exclusion. Clinical criteria include recurrent vomiting resembling cyclic vomiting syndrome, a history of cannabis use, and improvement after sustained cannabis cessation. Hot showers or baths, weight loss, abdominal pain, and bowel changes can provide additional supporting information.[3]
Doctors may order tests to evaluate dehydration, electrolyte abnormalities, kidney function, infection, pancreatic or liver problems, pregnancy when relevant, urinary conditions, or other causes of vomiting. Depending on the symptoms, imaging or additional testing may also be needed.[3][4]
CHS vs. Cyclic Vomiting Syndrome
CHS can resemble cyclic vomiting syndrome (CVS), which also causes recurrent episodes of severe vomiting.
The important distinction is the relationship between symptoms and cannabis exposure. CHS is associated with regular cannabis use and improvement after sustained cessation, while cyclic vomiting syndrome can occur without cannabis exposure.[3]
Because the symptoms overlap, healthcare professionals should not assume that recurrent vomiting is caused by cannabis without considering other diagnoses.
What Are the Risks of CHS in Teens?
Repeated vomiting can cause complications beyond nausea and abdominal discomfort.
Potential complications include:
Dehydration
Repeated vomiting can cause substantial fluid loss. Severe dehydration may require intravenous fluids in an emergency department or hospital.[2][3]
Electrolyte Abnormalities
Loss of fluids through repeated vomiting can disturb electrolyte levels. Healthcare professionals may use blood testing to identify and treat these abnormalities.[3]
Kidney Problems
Significant dehydration can affect kidney function. Clinical pathways recommend assessing kidney function and metabolic abnormalities when evaluating adolescents with severe CHS symptoms.[3]
Weight Loss and Poor Nutrition
A teenager who cannot keep food down may experience weight loss and inadequate nutritional intake. Persistent vomiting can also interfere with normal daily activities and school attendance.[1]
Esophageal or Dental Complications
Repeated forceful vomiting exposes the mouth and esophagus to stomach acid. Recurrent vomiting has been associated with dental erosion, and severe vomiting can cause injuries to the upper gastrointestinal tract.[1][6]
These complications are one reason persistent or recurrent vomiting deserves medical evaluation rather than being treated as something a teenager simply needs to “wait out.”
What Should Parents Do If They Suspect CHS?
If suspect cannabinoid hyperemesis syndrome, arrange a medical evaluation, particularly if vomiting is recurrent or severe.
Tell the healthcare professional about the teenager’s cannabis use, including:
- How often cannabis is used
- How long the teen has been using it
- Whether use is daily or weekly
- The type of product used
- Whether cannabis is smoked, vaped, eaten, or consumed another way
- When the most recent use occurred
- Whether hot showers temporarily relieve symptoms
- Whether other substances or medications may also be involved
Being open about cannabis use can help clinicians distinguish CHS from other conditions and determine which tests or treatments are appropriate.[3][4]
Parents should also avoid assuming that cannabis is definitely responsible for the vomiting. CHS is a diagnosis of exclusion, and other medical conditions can produce similar symptoms.[3]
How Is Cannabinoid Hyperemesis Syndrome Treated?
Treatment has two parts: managing the acute symptoms and stopping cannabis exposure.
During a severe episode, medical treatment may include intravenous fluids for dehydration, medications for nausea or pain, monitoring of electrolytes and kidney function, and evaluation for other causes of vomiting.[2][3][4]
Some adolescents may require hospital observation or admission when vomiting cannot be controlled, dehydration requires IV fluids, oral hydration cannot be tolerated, pain remains uncontrolled, or symptoms continue despite emergency treatment.[3]
The Johns Hopkins pediatric clinical pathway also describes medications such as ondansetron and, when symptoms do not respond adequately, clinician-directed use of haloperidol. Medication decisions should be made by healthcare professionals because some treatments have important risks and contraindications.[3]
Hot showers may provide temporary symptom relief, but they do not treat the underlying condition.
Is There a Cure for CHS?
Stopping cannabis is the key intervention for resolving CHS and preventing recurrent episodes.
Continuing cannabis use can allow symptoms to persist or return. Clinical guidance identifies sustained cannabis cessation as a defining part of CHS management.[2][3]
Recovery is not necessarily immediate. Symptoms can continue for days or longer after cannabis cessation, particularly after severe episodes.[1][2]
If a teenager has difficulty stopping cannabis, the problem should be assessed separately from the acute vomiting episode. Cannabis use disorder can require its own clinical evaluation and treatment.
Can a Teenager Get CHS Again After Recovering?
Yes. Symptoms can recur if cannabis use is restarted.
This is one of the reasons complete cessation is important in the management of CHS. A teenager who has already experienced a CHS episode should discuss future cannabis exposure with a healthcare professional rather than assuming that using a different cannabis product or a smaller amount will necessarily prevent another episode.[3]
How Can Parents Tell CHS From a Stomach Bug?
The symptoms can overlap, so parents should not rely on symptoms alone to distinguish CHS from an infection or another medical condition.
A stomach infection may cause vomiting along with symptoms such as diarrhea, fever, or exposure to other people who are ill. CHS is more strongly associated with recurrent episodes, regular cannabis use, abdominal pain, and temporary relief from hot bathing.[3][4]
However, these features are not sufficient for a home diagnosis. Appendicitis, gastrointestinal obstruction, pancreatitis, pregnancy-related vomiting, urinary conditions, neurological disorders, eating disorders, and other illnesses can also cause vomiting and abdominal pain.[3]
If symptoms are severe, persistent, or unusual for the teenager, medical evaluation is appropriate.
How Clearfork Academy Can Help Teens With Cannabis Use
Cannabinoid hyperemesis syndrome (CHS) can return if a teenager continues using cannabis after an episode. Once the teen has received appropriate medical care for vomiting, dehydration, or other complications, addressing ongoing cannabis use may help reduce the risk of future episodes.
Clearfork Academy provides substance-use and mental-health treatment for adolescents struggling with cannabis and other substances. Depending on a teen’s individual needs, treatment may include residential care, partial hospitalization (PHP), intensive outpatient treatment (IOP), or virtual IOP, along with individual, group, and family therapy.
For teens who continue using cannabis despite experiencing problems such as recurrent vomiting, school difficulties, relationship problems, or difficulty stopping, an adolescent-focused substance-use assessment can help determine whether a structured treatment program is appropriate.
Insurance coverage may be available through participating insurance plans, but benefits vary by policy. Families can contact Clearfork Academy to verify insurance coverage and understand potential out-of-pocket costs before starting treatment.
Important: Clearfork Academy’s substance-use treatment is not a substitute for emergency medical care. A teen experiencing severe or persistent vomiting, dehydration, severe abdominal pain, confusion, fainting, or other concerning symptoms should receive appropriate medical evaluation first.
Frequently Asked Questions
What are the symptoms of CHS in teenagers?
Common symptoms include repeated severe vomiting, nausea, abdominal pain, dehydration, weakness, weight loss, and temporary relief from hot showers or baths. Symptoms can occur in recurring episodes.[2][3]
Can teenagers get CHS from vaping cannabis?
Yes. CHS is associated with cannabis exposure rather than one specific method of consumption. Cannabis can be smoked, vaped, or consumed in other forms, and clinicians should ask about the type and route of cannabis use when evaluating recurrent vomiting.[3][7]
How long does CHS last in teens?
There is no single duration that applies to every teenager. Symptoms may continue for days or longer after an episode, and recovery can vary. Continued cannabis use can cause symptoms to persist or recur.[1][2][3]
Do hot showers cure cannabinoid hyperemesis syndrome?
No. Hot showers or baths may temporarily relieve symptoms in some people, but they do not treat the underlying condition. Sustained cannabis cessation is the key treatment for preventing recurrent CHS.[2][3]
Can CHS be mistaken for another condition?
Yes. CHS can resemble cyclic vomiting syndrome, gastroenteritis, appendicitis, pancreatitis, gastrointestinal disorders, pregnancy-related vomiting, and other medical conditions. Healthcare professionals generally diagnose CHS after evaluating and excluding other possible causes.[3][4]
When should a teen with suspected CHS go to the emergency room?
Emergency evaluation is appropriate when a teenager cannot keep fluids down, has significant dehydration, severe or uncontrolled abdominal pain, blood in the vomit, confusion, fainting, altered consciousness, or another severe or rapidly worsening symptom.[3][4]
Medical Disclaimer: This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Suspected CHS in a teenager should be evaluated by a qualified healthcare professional, especially when vomiting is severe, persistent, or accompanied by dehydration or other concerning symptoms.
References:
- University of Utah Health. Cannabinoid Hyperemesis Syndrome in Teens: Symptoms, Causes, and Treatment. Updated March 10, 2026.
- Children’s Mercy. Cannabinoid Hyperemesis Syndrome: Information for Patients and Caregivers. Cannabinoid Hyperemesis Syndrome Clinical Pathway Committee, April 7, 2026.
- Johns Hopkins All Children’s Hospital. Cannabinoid Hyperemesis Syndrome Clinical Pathway. August 18, 2025.
- Cedars-Sinai. Cannabis Hyperemesis Syndrome (CHS).
- Emergency Department Visits for Cannabis Hyperemesis Syndrome Among Adolescents. JAMA Network Open. 2025.
- CDC. Trends in Emergency Department Visits Involving Cannabis Hyperemesis Syndrome Identified Using a New Diagnosis Code — United States, January 2023–May 2026. MMWR, August 6, 2026.
- Nguyen KN, Bravender T, Goldman PN. Management of Cannabinoid Hyperemesis Syndrome in Adolescents and Young Adults. The Journal of Pediatrics. 2026.
Shelby Hartman is a Licensed Master Social Worker with specialized training in EMDR (Eye Movement Desensitization and Reprocessing). She brings over a decade of experience in behavioral health, beginning her career as a Behavioral Health Technician at John Peter Smith Hospital’s Psychiatric Emergency Center, where she served for nine years supporting individuals in acute crisis.
She has also contributed to the community through volunteer work with Safe Haven in the Dallas–Fort Worth area, supporting survivors of domestic violence. She earned her Master of Social Work degree from Chamberlain University and went on to work as an inpatient program therapist for over two years, providing intensive therapeutic care to adolescents. Currently serving at Clearfork Academy, Shelby continues her work with teens navigating mental health challenges and substance use.
