Cannabis and Cannabinoid Hyperemesis Syndrome: A Personal Journey
Jared Panks, like many others who use cannabis, turned to marijuana for relief. As a paramedic, he had witnessed the damaging consequences of various drugs and alcohol. After spending years working with the U.S. Forest Service, he began using marijuana to alleviate pain associated with scoliosis and his damaged knees.
The situation became even more personal for him when he observed family members struggling with cancer and opioid dependency. This prompted him and his wife to establish HomeGrown ORegonicX, a small medical cannabis farm in Oregon that caters to the deaf community. Panks started experimenting with different strains, using cannabis regularly to find relief.
In 2013, however, he experienced an alarming set of symptoms: persistent vomiting that would begin in the morning and last throughout the day, sometimes for several days. During these episodes, he was unable to eat or retain fluids. A hot shower was about the only thing that eased his discomfort. This condition would subside only to return every couple of months, often triggered by stress.
Panks lost 50 pounds during this ordeal, as his body seemed determined to rid itself of something. His abdomen and back were perpetually sore from constant dry heaving, and stomach acids damaged his throat. A dentist later informed him that his teeth were in terrible condition.
When a doctor finally diagnosed him, Panks struggled to accept it: cannabinoid hyperemesis syndrome, or CHS. Unlike others who might scream in agony during their episodes—earning the term “scromiting” for the combination of screaming and vomiting—Panks tried to manage it in silence.
“Sometimes it lasts for 14 days, and I end up in the ER for fluids,” Panks mentioned. “The experience is really harsh. You find yourself sliding down the stairs because you can’t muster the strength to stand.”
This condition is relatively rare, and its underlying causes remain unclear, which leads some cannabis supporters to dismiss it. Yet, Panks is far from alone. A study by the University of Illinois Chicago highlighted a significant surge in CHS diagnoses, showing a sevenfold increase from 2016 to 2022.
This uptick coincided with a rise in cannabis legalization and higher potency products, peaking at 33 cases per 100,000 ER visits during the COVID pandemic—when substance abuse saw a noticeable spike. Most affected individuals were long-term users, especially men aged 18 to 35.
Typically, those with CHS are daily users of high-potency cannabis or concentrates. Research indicates that 75% of CHS cases involved individuals who consumed cannabis each day.
Interestingly, while cannabis is often touted for its appetite-stimulating properties, the FDA has approved synthetic THC for managing nausea in patients undergoing chemotherapy. Yet, like many substances, what may be harmless in moderation can have adverse effects when consumed excessively.
James Swartz, the lead author of the UIC study, attributes rising cases to increased legalization and higher THC concentrations. He hopes the findings will prompt medical professionals to consider CHS in their evaluations.
“There’s still some disbelief out there,” Swartz expressed. “Some cannabis advocates think this is exaggerated, but it’s real and serious enough to warrant attention.”
He encouraged users to evaluate their consumption levels and approach high-potency products with caution.
Tim Blake, founder of The Emerald Cup, shares Swartz’s perspective. After experiencing his own issues with hyperemesis years ago, Blake had to significantly reduce his consumption. At 68, he has been a cannabis user since his teens, even relying on it during his battles with metastatic cancer.
However, he became severely ill from cyclic vomiting a little over a decade ago, which only subsided after several months of abstaining from cannabis to flush THC from his system. Now, he kicks off each year with a month or two of cannabis-free living to detox. He emphasizes moderation in cannabis use, drawing parallels to alcohol consumption.
“We don’t need to be downing shots of 151 every day,” he remarked. “Moderation, like opting for beer and wine, is what we should consider.”
Panks, collaborating with his wife through Deafining Cannabis, is focused on educating others about the importance of understanding cannabis terpenes—compounds that influence how cannabis affects individuals—rather than solely fixating on THC percentages.
“It’s essential to look beyond THC levels and focus on terpenes, which will help users understand their unique reactions,” he suggested. He hopes to contribute to research that clarifies the mechanisms behind CHS.
Though research into CHS is still in its early stages, recent federal movements to reclassify cannabis could enhance understanding. The World Health Organization has only recently acknowledged CHS as a medical condition, and those affected are eager for more investigations to explore its causes, potential treatments, and why it impacts certain individuals more than others.
At this moment, avoiding cannabis remains the only recognized solution for CHS.
Alice Moon, a notable cannabis advocate, expressed her desire for more studies so she might eventually reclaim her use of cannabis. “I promote something I can’t even use right now,” she noted. “It’s crucial to raise awareness because I wouldn’t want anyone else to suffer like I did.”
