After more than two decades of mounting evidence and healthcare system strain, the World Health Organisation has formally recognised cannabis hyperemesis syndrome (CHS) in its International Classification of Diseases, marking a watershed moment in the acknowledgement of marijuana-related harms that industry propaganda has deliberately obscured.
The WHO published guidance in October 2025 establishing dedicated diagnostic codes that took effect on 1 October, which the US Centers for Disease Control and Prevention has adopted. The classification assigns CHS the code ICD-10-CM R11.16 and lists it as a synonym under ICD-11 code DD90.4. This formal classification enables physicians worldwide to properly identify, track, and study a condition that has plagued healthcare systems whilst being systematically downplayed by cannabis advocates.
The Smokescreen of Denial
Researchers first described the syndrome in a published case series in 2004, yet its formal recognition comes only now, over two decades later. Health experts argue this delay reflects a broader pattern of denial that pro-cannabis lobbying efforts have fuelled, consistently deflecting attention from emerging harms that marijuana use causes.
“This just one individual and health care system crippling outcome of cannabis use is unsustainable for any healthcare system, free or paid for,” noted one public health commentary in 2023. “The cannabis lobby and industry continue to deflect, as does the cannabis user, at this growing endemic and the outrageous expense it is incurring on non-drug using taxpayers.”
Medical literature first documented the paradoxical hyperemetic effects of marijuana in 2004, despite its well-known antiemetic properties. Even in subsequent years, experts emphasised that understanding the diagnostic criteria could reduce unnecessary investigations and inappropriate treatments. Yet formal recognition comes only now, with many attributing the delay to relentless cannabis propaganda that has bogged down fact and science in denial.
The Horror of ‘Scromiting’
Cannabis hyperemesis syndrome manifests as a dangerous condition affecting chronic cannabis users with severe nausea, repeated vomiting, abdominal pain, dehydration, weight loss, and in rare cases, heart rhythm problems, seizures, kidney failure, and death.
Patients suffer from what emergency room staff have termed “scromiting” (screaming and vomiting simultaneously due to extreme pain). The condition’s severity cannot be overstated: in 2024, a 22-year-old woman who had used cannabis since age 14 died after suffering from CHS for over three years. Her repeated vomiting episodes led to dangerously low potassium levels, ultimately triggering torsades de pointes, a fatal heart arrhythmia. Despite doctors restarting her heart, she had gone without oxygenated blood flow to her brain for over 30 minutes, resulting in irreversible damage. Doctors declared her brain dead four days later.
Emergency Departments Overwhelmed by Cannabis Hyperemesis Syndrome
A study published in JAMA Network Open in November 2025 revealed that CHS-related emergency room visits spiked approximately 650% from 2016 to their peak during the COVID-19 pandemic, particularly amongst those aged 18 to 35. The surge has remained elevated ever since.
Beatriz Carlini, a research associate professor at the University of Washington School of Medicine, emphasised the importance of the new diagnostic code: “It helps us count and monitor these cases. A new code for cannabis hyperemesis syndrome will supply important hard evidence on cannabis-adverse events, which physicians tell us is a growing problem.”
The dramatic increase in THC potency has likely contributed to rising rates. Today’s cannabis products often exceed 20% THC (some reaching over 90%) compared to just 5% in the 1990s. Researchers suggest isolation, stress, and increased access to these high-potency products during the pandemic accelerated the trend.
John Puls, a Florida-based psychotherapist and nationally certified addiction specialist, stated he has witnessed an “alarming” increase in marijuana hyperemesis, particularly amongst adolescents and young adults. “In my opinion, and the research also supports this, the increased rates of CHS are absolutely linked to high-potency cannabis,” he told media outlets.
Puls noted that the most common misconception claims the condition isn’t real, precisely the narrative cannabis advocates have promoted. “I believe the new diagnosis code is a significant step in the right direction,” he said.
Misdiagnosis and Patient Suffering
Until now, doctors struggled to diagnose cannabis hyperemesis syndrome because symptoms mimic food poisoning, stomach flu, and other gastrointestinal conditions. Some patients have gone months or years without answers, enduring repeated emergency room visits and expensive, unnecessary investigations.
A telltale sign is that sufferers often find relief only through long, hot showers (a temporary fix that scientists still don’t fully understand). However, the syndrome’s intermittent nature leads many users to believe episodes are flukes, continuing cannabis use only to become violently sick again.
Dr Chris Buresh, an emergency medicine specialist with UW Medicine, noted the paradox: “Some people say they’ve used cannabis without a problem for decades. But even small amounts can make these people start throwing up.”
Stopping cannabis use appears to be the only reliable cure. Typical nausea medications rarely help, forcing doctors to turn to stronger drugs or capsaicin cream. Yet many patients resist the diagnosis, and even those who accept it struggle to quit due to addiction.
One theory suggests heavy, long-term cannabis use overstimulates the body’s cannabinoid system, triggering the opposite of marijuana’s usual anti-nausea effect. Whilst cannabis can treat nausea in low doses (typically under 5% THC), the high-potency products now dominating the market appear to produce devastating consequences.
Financial Burden on Healthcare Systems
The healthcare costs that marijuana hyperemesis generates are staggering. Repeated emergency room visits, extensive diagnostic testing, hospital admissions, and futile treatment attempts place enormous strain on medical systems, with non-drug-using taxpayers ultimately bearing these costs.
Health commentators have described this burden as “unsustainable,” yet the cannabis industry continues to deflect responsibility whilst profiting from increasingly potent products.
As cannabis legalisation spreads and high-potency products proliferate, health experts expect cases to continue rising. The WHO’s formal recognition is anticipated to dramatically improve surveillance and help physicians spot trends earlier.
“My hope would be that with this new diagnosis code that CHS is more accurately diagnosed in an emergency room setting,” Puls said, adding that once someone experiences cannabis hyperemesis syndrome, they’re more likely to suffer it again.
Breaking Through the Propaganda
The two-decade delay in formal recognition highlights how effectively cannabis industry propaganda has obscured emerging harms. Whilst marijuana advocates have promoted the plant as harmless medicine, emergency departments have quietly dealt with the growing reality of “scromiting” patients and, in tragic cases, preventable deaths.
The WHO’s decision to add the condition to its diagnostic manual represents not just a medical milestone, but a public acknowledgement that the “smokescreen of denial” surrounding cannabis harms can no longer be sustained.
Understanding and acknowledging this syndrome is essential. Pursuing abstinence from cannabis leads to resolution of symptoms in the majority of patients, a simple truth that doctors may have recognised years earlier had relentless industry denial not bogged down science.
(Source: WRD News)
