Rising Cases of Cannabis-Induced ‘Scromiting’ Raise Concerns

Emerging research highlights an alarming increase in cases of Cannabinoid Hyperemesis Syndrome (CHS), commonly referred to as “scromiting,” among cannabis users in the United States. A recent study conducted by researchers at the University of Illinois Chicago indicates that emergency department visits related to this painful condition have surged significantly over the past several years, particularly among younger adults.

The study, published in JAMA Network Open, analyzed a nationwide sample of emergency room visits from 2016 to 2022. It revealed that approximately 100,000 cases of suspected CHS were documented during this period. Prior to the COVID-19 pandemic, the annual rates of CHS remained stable. However, a noticeable increase in suspected cases began in 2020, coinciding with rising cannabis use due to the pandemic’s stress and isolation effects.

CHS is characterized by cyclical episodes of severe nausea, vomiting, and abdominal pain. These episodes can last from one to two days and are often so excruciating that individuals may scream in agony while experiencing intense bouts of vomiting—a phenomenon dubbed “scromiting.” While the exact causes of CHS remain unclear, it is believed to stem from overstimulation of cannabinoid receptors in the gastrointestinal tract. This condition typically affects individuals who have been chronic cannabis users for several years.

Researchers found that although there was a decline in CHS cases in 2022, the rates remained above pre-pandemic levels. Importantly, while cannabis-related health issues rose during this time, cases of cyclical vomiting syndrome without cannabis involvement did not increase, reinforcing the notion that CHS is indeed on the rise.

In light of these findings, James Swartz, lead author of the study and professor at UIC’s Jane Addams College of Social Work, emphasized the necessity for greater awareness among healthcare providers. “Cannabinoid hyperemesis syndrome is real, and it’s becoming a more routine part of emergency medicine in the U.S.,” Swartz remarked.

Impact of the COVID-19 Pandemic

The researchers speculate that the COVID-19 pandemic played a significant role in the uptick of CHS cases. Increased stress, isolation, and higher cannabis consumption during the pandemic likely contributed to the surge. “The COVID-19 pandemic likely catalyzed the rise in CHS through stress, isolation, and increased cannabis use,” the authors noted.

As cannabis legalization expands across the U.S., the researchers also suggest that the higher concentrations of THC in contemporary cannabis products may be linked to the increasing prevalence of CHS. While the condition remains relatively rare, it poses serious health risks for long-term users.

Management and Awareness of CHS

Although CHS can be a distressing experience, effective management strategies exist. Interestingly, many patients report that hot baths or showers may provide temporary relief during acute episodes. The only definitive way to prevent CHS is to cease cannabis use entirely, a process that may take weeks for symptoms to subside.

The study also highlights the importance of accurate diagnosis. Earlier this year, CHS was officially included in the latest edition of the International Classification of Diseases (ICD), which facilitates better tracking and reporting of the condition. However, awareness among medical professionals remains crucial, as misdiagnosis can lead to unnecessary testing and treatment.

“Our findings shouldn’t be interpreted as a reason to panic, but they do reinforce that cannabis is not risk-free, especially at higher doses and with long-term, heavy use,” Swartz cautioned. The authors advocate for more research to uncover the precise causes of CHS and to understand why it affects only a subset of long-term cannabis users.

As cannabis continues to gain acceptance and legalization expands, ongoing education and research will play pivotal roles in managing its potential health impacts.