ClearCHS Foundation — Emergency Resource

ER Guide: Cannabinoid Hyperemesis Syndrome

Print this page and bring it with you. Show it to your care team on arrival.

What to Tell Your Care Team

Say this when you arrive:

"I believe I have Cannabinoid Hyperemesis Syndrome (CHS). I am a long-term cannabis user. My vomiting and nausea are severe, and I get temporary relief from hot showers. I need treatment for dehydration and symptom management."

It is safe and important to be honest about your cannabis use. Your care team is not there to judge you — the more information they have, the faster they can help.

Treatments to Ask About

CHS does not always respond to standard anti-nausea medications. Ask your provider whether the following are appropriate for you:

Treatment	Purpose
IV Fluids & Electrolytes	Reverses dehydration caused by repeated vomiting
Topical Capsaicin (0.1%) Cream	Applied to the upper abdomen; shown to reduce nausea and pain in CHS
Haloperidol (antipsychotic)	Effective at reducing vomiting for many CHS patients in the ER
Benzodiazepines (e.g. lorazepam)	Short-term relief for acute symptoms and anxiety
Tricyclic Antidepressants (e.g. amitriptyline)	Recommended for longer-term symptom management post-discharge

Note: Standard anti-nausea medications like ondansetron (Zofran) are often ineffective for CHS. If one treatment isn't working, let your provider know.

Your CHS Symptoms — Check What Applies

Share this checklist with your care team:

Severe, repeated nausea and vomiting (may be up to 5 episodes per hour)
Intense abdominal cramping or pain
Temporary relief from hot showers or baths Hallmark Sign
Symptoms started within 24 hours of last cannabis use
Long-term, frequent cannabis use (daily or near-daily for 1+ years)
Prior episodes of the same type that resolved when cannabis was stopped
Weight loss or inability to eat during episodes

What Happens Next: Your Road to Recovery

There is no FDA-approved cure for CHS other than stopping cannabis use completely. Here is what the recovery path typically looks like:

In the ER

You will receive supportive care: IV fluids, medications for nausea and pain, and monitoring for complications such as electrolyte imbalances or kidney stress.

After Discharge

Symptoms typically begin to improve within 1–2 days of stopping cannabis use. Full recovery may take a few weeks to months.

Long-term

Counseling, cognitive behavioral therapy (CBT), and medications like tricyclic antidepressants can help manage withdrawal and prevent relapse.

Return to the ER Immediately If You Experience:

Signs of severe dehydration: very little or dark urine, dizziness, rapid heart rate, fainting
Confusion, delirium, or sudden change in mental state
Inability to keep any fluids down for more than 24 hours

Muscle spasms or seizures
Chest pain or abnormal heart rhythm
Severe weakness or difficulty standing

Resources & Support

Free · Confidential · 24/7

SAMHSA National Helpline

English and Spanish

1-800-662-4357

findtreatment.gov

Marijuana Anonymous

Peer support and recovery community

marijuana-anonymous.org

American College of Gastroenterology

Clinical resources and patient information

gi.org

This guide is for informational purposes and is not a substitute for professional medical advice.

Sources: JAMA Patient Page (2024), Cleveland Clinic, NIH StatPearls