A University of Illinois study looking at cannabinoid hyperemesis syndrome (CHS) presentations in US emergency departments has revealed some interesting/disturbing results.
Cannabinoid hyperemesis syndrome, also known as ‘scromiting‘ is a condition in some chronic and heavy users characterised by recurrent nausea, vomiting and abdominal pain. It may also be accompanied by loud vocalisations during vomiting; hence the term scromiting — screaming + vomiting.
With legal cannabis in some form accessible in most US states — nearly half of all US residents lived in states with legalized recreational cannabis in June 2025, and approximately three-quarters of the population live in a state with a medical cannabis program — it would be fair to assuming prevalence CHS is increasing too.
But is it?
The new study assessing trends from 2016 to 2022 in hospital emergency departments found CHS increased from 4.4 per 100 000 visits, peaked at 33.1 in quarter 2 2020, and remained elevated at 22.3 in 2022. The analytic sample included 188,610,906 unweighted visits (806 million weighted).
As for the peak in 2020, the authors say:
“The COVID-19 pandemic likely catalyzed the rise in CHS through stress, isolation, and increased cannabis use. After peaking in 2021, CHS incidence declined but plateaued above prepandemic levels, suggesting sustained structural or clinical drivers.”
Age categorization found CHS patients were disproportionately represented in the 18 to 25 years (35.7%) and 26 to 35 years (31.5%) age groups.
In their conclusion, the authors state:
“The findings highlight the need for continued vigilance and refinements to the clinical recognition of CHS.”
The study paper has been published in Jama Network Open: Emergency Medicine.
Among the limitations of the study, CHS was not directly coded in ICD-10* during the study period, so proxy definitions were used that raised misclassification risk. While some cases may have been missed due to cannabis use underreporting, others may have been misclassified due to overlapping symptoms.
And just on that, in July this year an instructor of medicine in the US expressed concerns CHS is being improperly diagnosed too often without a proper diagnostic work-up.
Trivia: Cannabinoid hyperemesis syndrome was first identified in 2004 in Australia.
*The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) is a system developed by the World Health Organization (WHO) for coding diseases, symptoms, injuries, and other health conditions.
