If you’re old enough to remember the public conversations around cannabis in the 1980s and 1990s, you probably recall just how heavy the stigma once was. For many years, marijuana was framed almost exclusively as a gateway drug — dangerous, destabilizing, and socially corrosive.
While cannabis remains illegal in many parts of the world — and punishments in some countries are still severe — attitudes in the United States have shifted dramatically. Today, recreational cannabis is legal in 24 states, and medical marijuana is permitted in even more. Public opinion polls show that support for legalization has steadily climbed over the past two decades.
It’s not hard to imagine a future where cannabis is treated much like alcohol: regulated, normalized, and largely stripped of its taboo status.
But normalization doesn’t mean harmless.
The effects of THC — the psychoactive compound in cannabis — are well documented. Users often report relaxation, euphoria, altered perception, and increased appetite. Others experience anxiety, paranoia, or heightened heart rate. In rare cases, heavy use has been associated with psychosis, especially in individuals predisposed to certain mental health conditions.
Less widely understood, however, is a condition known as Cannabis Hyperemesis Syndrome (CHS) — a disorder that has been increasingly reported in emergency rooms across the U.S.
Over the past decade, hospitals have documented a surge in patients presenting with severe nausea, uncontrollable vomiting, and intense abdominal pain. The symptoms can be so extreme that medical staff coined a term to describe the phenomenon: “scromiting” — a combination of screaming and vomiting — because sufferers sometimes cry out from the pain.
CHS episodes typically occur within 24 hours of cannabis use and can last for several days. What makes the condition especially troubling is that traditional anti-nausea medications often fail to provide relief.
“There are currently no therapies approved by the Food and Drug Administration, and standard anti-nausea medications often don’t work,” said Dr. Chris Buresh, an emergency medicine specialist, describing the challenges clinicians face when treating CHS.
Patients frequently report cyclical episodes. One man was admitted to the emergency room four or five times within six months. He described a “burning” and “agonizing” pain centered in his abdomen, accompanied by relentless vomiting. Many CHS patients attempt to self-soothe with extremely hot showers — a behavior so common it’s considered a hallmark of the condition. In his case, the pain was so severe that he required morphine for relief.
Another individual compared the sensation to childbirth, calling it “some of the worst physical pain I’ve ever experienced in my life.” During episodes, she said she found herself pleading for the pain to stop.
Medical professionals emphasize that the only definitive treatment for CHS is cessation of cannabis use. Symptoms may subside temporarily, but if cannabis consumption continues, episodes often return — sometimes more severely.
“Because the syndrome strikes intermittently, some cannabis users assume a recent episode was unrelated and continue using — only to become severely ill again,” explained Dr. Beatriz Carlini, research associate professor at the University of Washington School of Medicine.
Research suggests that early and prolonged cannabis use may increase the likelihood of developing CHS. A study from George Washington University surveying more than 1,000 CHS patients found strong associations between heavy cannabis use and repeated emergency room visits for severe vomiting episodes.
Notably, adolescent cases have risen sharply. From 2016 to 2023, CHS-related cases among young people reportedly increased more than tenfold. Interestingly, while overall CHS cases tend to be more common in states where cannabis is legal — likely reflecting higher usage rates — the fastest growth in adolescent cases has occurred in states where recreational cannabis remains illegal.
This pattern has prompted ongoing discussion among researchers about access, regulation, product potency, and youth education. Modern cannabis products often contain far higher concentrations of THC than those available decades ago, which may also play a role in emerging health patterns.
As cannabis becomes more widely accepted and commercialized, public health experts argue that education must keep pace with legalization. While many people use cannabis without severe complications, conditions like CHS serve as a reminder that no substance — even one increasingly normalized — is entirely without risk.
The broader cultural shift surrounding cannabis is undeniable. But as with alcohol, tobacco, or prescription medications, understanding both the benefits and potential harms remains essential for informed decision-making.
