Research & Facts

Evidence-based research, clinical studies, and scientific facts about Cannabinoid Hyperemesis Syndrome (CHS).

Research Timeline

Historical development and key milestones in CHS research

2004

First Medical Description

Allen et al. published the first case series in Gut journal, describing 9 patients with chronic cannabis use who developed cyclic vomiting relieved by hot showers.

Allen JH et al. (2004) - Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse

2009

Diagnostic Criteria Established

Sontineni et al. published diagnostic criteria in World Journal of Gastroenterology, providing the first standardized approach to CHS diagnosis.

Sontineni et al. (2009) - Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse

2021

HaVOC Trial

Landmark randomized controlled trial showing haloperidol superiority over ondansetron for CHS symptoms.

Ruberto et al. (2021) - Intravenous Haloperidol Versus Ondansetron for Cannabis Hyperemesis Syndrome (HaVOC): A Randomized, Controlled Trial

2024

AGA Clinical Practice Update

American Gastroenterological Association releases comprehensive clinical guidance for CHS management.

Rubio-Tapia et al. (2024) - AGA Clinical Practice Update on Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Commentary

Scientific Evidence

Key research findings and clinical evidence supporting CHS

Prevalence Studies

About 33% of frequent cannabis users report CHS symptoms, suggesting approximately 2.7 million affected Americans annually.

Habboushe et al. (2018) - The Prevalence of Cannabinoid Hyperemesis Syndrome Among Regular Marijuana Smokers in an Urban Public Hospital

Genetic Research

Studies identified mutations in genes related to TRPV1 receptor, dopamine signaling, and drug metabolism (CYP2C9) associated with CHS susceptibility.

Russo et al. (2024) - Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure

Treatment Efficacy

Clinical trials demonstrate haloperidol's effectiveness for acute episodes, with significant symptom reduction compared to standard antiemetics.

Ruberto et al. (2021) - Intravenous Haloperidol Versus Ondansetron for Cannabis Hyperemesis Syndrome (HaVOC): A Randomized, Controlled Trial

Pathophysiology

Understanding how CHS develops in the body

Receptor Desensitization

Chronic CB1 receptor stimulation leads to paradoxical effects on emetic pathways.

Long-term cannabis exposure may alter normal endocannabinoid system function.

Genetic Factors

Specific genetic variations affect individual susceptibility to CHS.

Mutations in TRPV1, dopamine pathways, and metabolism genes contribute to risk.

Hot Water Response

TRPV1 receptor activation explains temporary symptom relief from hot water.

Temperature-dependent activation modulates substance P and other nausea pathways.

Common Myths Debunked

Scientific examination of common misconceptions

Myth: CHS is caused by pesticides

Reality: Research shows pesticide levels are too low to cause CHS symptoms. Cases occur with tested and organic cannabis.

Evidence: Russo et al. (2024) - Cannabinoid hyperemesis syndrome: genetic susceptibility to toxic exposure

Myth: CHS is just Cyclic Vomiting Syndrome

Reality: CHS has distinct features including cannabis use history and hot shower relief.

Evidence: Levinthal et al. (2024) - AGA Clinical Practice Update on Diagnosis and Management of Cyclic Vomiting Syndrome: Commentary

Myth: Moderate use prevents CHS

Reality: Once CHS develops, any THC exposure typically triggers symptoms.

Evidence: Rubio-Tapia et al. (2024) - AGA Clinical Practice Update on Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Commentary