Weekly cannabis use is generally required for the syndrome to occur; synthetic cannabinoids can also cause CHS.[6][5] The underlying mechanism is unclear, with several possibilities proposed.[2][5] Diagnosis is based on the symptoms, as well as the history of cannabis use (including a urine screen test if necessary).[6] The condition is typically present for some time before the diagnosis is made.[6]
The only known curative treatment for CHS is to stop using cannabis.[7][2] Symptoms usually remit after two weeks of complete abstinence, although some patients continue to experience nausea, cyclic vomiting, or abdominal pain for several weeks.[6][8] Treatments during an episode of vomiting are generally supportive in nature (e.g., hydration). There is tentative evidence for the use of capsaicin cream on the abdomen during an acute episode.[2]
Of note, frequent hot showers or baths are both a possible sign (diagnostic indicator) of CHS and a short-term palliative treatment (often called hot water hydrotherapy in the medical literature).[9][10]
Another condition that presents similarly is cyclic vomiting syndrome (CVS).[3] The primary differentiation between CHS and CVS is that cessation of cannabis use only resolves CHS. CVS does not resolve with the cessation of cannabis use.[5] Another key difference is that CVS symptoms typically begin during the early morning; predominant morning symptoms are not characteristic of CHS.[11][12] Distinguishing the two can be difficult since many people with CVS use cannabis, possibly to relieve their symptoms.[5]
The syndrome was first described in 2004, and simplified diagnostic criteria were published in 2009.[13][14]
^Richards JR, Lapoint JM, Burillo-Putze G (January 2018). "Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment". Clinical Toxicology. 56 (1): 15–24. doi:10.1080/15563650.2017.1349910. PMID28730896.