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The findings of a group of researchers at the University of California suggest that the use of vape cartridges containing THC may play a key role in the development of Cannabinoid Hyperemesis Syndrome symptoms.
California researchers, in a study published in Cannabis & Cannabinoid Research this month, took a closer look at this little-known condition that triggers repeated bouts of nausea and vomiting in people who use cannabis to get a clearer picture of how it develops, exploring several cannabis habits and types of products.
Though research on Cannabinoid Hyperemesis Syndrome (CHS) remains limited, its growing impact is clear. Cases in U.S. emergency departments have surged from 4.4 per 100,000 visits in 2016 to 33.1 by mid-2020, and remained elevated at 22.3 per 100,000 in 2022, according to a study published last year.
Therefore, to better understand this condition, California researchers surveyed 1,134 people who had been diagnosed with, or suspected they had, CHS in late 2024.
To gather their data, the researchers ran an anonymous online survey asking participants, found in CHS-focused social media communities, about their cannabis use and CHS symptoms.
The findings show a very frequent use of cannabis among people with CHS. Over 96% of participants used cannabis at least once per day, and nearly half said they used the substance six or more times per day before symptoms appeared.
The researchers, however, found no link between where participants obtained their cannabis and CHS symptoms. Most purchased it from licensed dispensaries, while others used unlicensed sources or home-grown cannabis.
Most of the cannabis products used were flowers and vape cartridges, with participants reporting using about 10.3 grams of flower per week or two vape cartridges per week.
When it comes to the use of vape cartridges, researchers found that vaping may be linked to a quicker onset of CHS compared to smoking cannabis flower. While the reason for this difference is not yet clear, they pointed to several possible factors, including higher THC concentrations in vape products, faster absorption into the bloodstream, and stronger peak effects. The study also noted that people who exclusively used vape cartridges tended to consume cannabis more frequently. This suggests that both biological effects and patterns of use could play a role. However, while the survey-based study shows an association, it doesn’t prove that vaping directly causes earlier onset of the condition.
The research also points to a strong association between CHS and ongoing, heavy use of inhaled cannabis high in THC, particularly when smoked or vaped. Early warning signs, such as morning nausea, may appear well before severe vomiting episodes begin.
But even with these results, the study has some limitations. It relied on self-reported data without independent medical confirmation, and participants were recruited from CHS-focused online groups, which may introduce bias. Researchers also didn’t collect detailed information on THC potency, which leaves uncertainty about its role in the condition.
CHS was reportedly first described by Australian researchers in 2004, who identified a pattern of recurrent vomiting in long-term cannabis users that was often relieved by hot showers, a feature still considered characteristic.
Early clinical studies, including a study from researchers at Mayo Clinic published in 2012, helped define those conditions after years of frequent cannabis use, with symptoms often poorly responsive to standard anti-nausea treatments and improving after stopping the use of cannabis.
Diagnostic criteria were later standardized in 2016 with the introduction of the Rome IV guidelines.
A more recent research also highlighted heavy use of high-THC cannabis among affected cannabis users and explored possible genetic factors such as TRPV1 receptor involvement, though these remain under investigation.
In California, there was a reported 134–175% increase in CHS-related cases from 2009 to 2019.
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