The Truth About Marijuana Hyperemesis

January 6th, 2025

By P. Casey Arrillaga, LCSW, LCDC

As marijuana is increasingly legalized and accepted in the
United States, many people think of it as harmless and even beneficial. While
there are many people for whom that may be true, there are also dangers
associated with marijuana use that are becoming more threatening as THC levels
in commercially-grown marijuana are growing stronger. One such danger,
marijuana hyperemesis, will be the focus of this post.

What We Know So Far

Marijuana hyperemesis (AKA cannabinoid hyperemesis or cannabinoid
vomiting syndrome) is a condition in which someone using marijuana regularly
and seemingly safely suddenly finds themselves vomiting over and over. This can
go on for hours or even days, to the point that the person becomes dehydrated
and in medical danger. Unsurprisingly, there is often abdominal pain. Once an
episode of repeatedly vomiting is over, the symptoms may go away for weeks or
months, only to return again without warning.

To make matters worse, when a person is in this state,
typical medications that bring nausea and vomiting under control don’t work. It
may seem ironic that marijuana is often prescribed as an anti-nausea drug, but
it is known in the medical community to induce vomiting as well as keep it
under control. Unfortunately, given that people often associate marijuana with
nausea control, and many people are unaware of marijuana hyperemesis, they may
try to use more of the drug to control the vomiting, thus increasing the
problem and putting themselves in greater danger.

When someone is experiencing marijuana hyperemesis, the most
effective way to get the nausea and vomiting under control is to stop using
marijuana and take very hot baths until the nausea subsides. Notably, while
stopping marijuana use seems to be essential to getting symptoms under control,
this still takes hours or days to work. Because marijuana hyperemesis is not
known to a lot of users, they may have no idea that marijuana is the cause, so
unless they get medical help from someone who is aware of the risks and asks
appropriate screening questions, they may go through a lot of distress and
danger without finding a solution.

Reports of marijuana hyperemesis have been increasing at a
rate of about 8% per year, and cases have been reported all over the world. One
of the most likely causes of this is the increase in in acceptance and
legalization of marijuana use. While some of this is ostensibly being done for
medical purposes, it is clear that recreational use is a primary motivation for
many people who support this change.

Often, an argument is made that marijuana is “all natural”
and thus safe, even good for you. This line of reasoning overlooks the fact
that as legalization has increased, so have marijuana breeding techniques and
thus levels of THC, the active ingredient that makes marijuana use so popular. The
THC concentration in marijuana and related products has more than doubled over
the past 20 years. With increased potency comes increased risk, risk that is
often glossed over or simply never known until it is too late. In some ways,
the world of marijuana use is undergoing a change similar to what the world of
alcohol experienced when distilled liquor became easily available: individuals
and society are seeing the effects of greatly increased potency in something
that had already been around and accepted for a long time.

It is currently thought that marijuana hyperemesis may occur
primarily or even exclusively in people who were already susceptible to cyclic
vomiting disorders, and high levels of cannabinoid use brings a dormant
condition out in them. This is not known for certain, but more importantly,
there is currently no way to know who is at risk and who is not, let alone how
great that risk is for a given person. Thus, anyone ingesting high levels of
THC is rolling the dice. The longer they use marijuana and related products,
the greater the chances that marijuana hyperemesis will happen.

People who have mental heath issues are at additional risk
if they experience marijuana hyperemesis, because vomiting and the resultant
dehydration will often reduce the levels of any psychiatric medication they are
taking, leaving them at risk for increased mental heath symptoms.
Unfortunately, they may use more marijuana to deal with those symptoms, and
they can get into a downwards spiral without realizing that what seems like a
potential help is actually the source of the problem.

How Do We Use This Knowledge to Help People?

First and foremost, if you or someone you love seems like
they may be experiencing these symptoms, seek medical help immediately. The
dangers of dehydration and related issues is very real. Tell your medical
providers in detail about any use marijuana and related products. Make sure
they are familiar with marijuana hyperemesis so that accurate diagnosis and
proper care can be given.

At Windmill, we make it our business to stay on top of the
latest research and care protocols for anything related to addiction and other
mental health issues. While we are unlikely to have someone enter treatment
solely because of marijuana hyperemesis, we help many clients to see the
unknown dangers of chemical use and how to move away from it. As marijuana has
become more accessible and accepted, we have seen more people come into
treatment with addictive use of marijuana and related products as their main
presenting problem. We help such people see the full danger they are putting
themselves in, and we give them the tools they need to get out of cycle of
compulsive use. Most importantly, we help them see they can live happy and
fulfilling lives without the use of marijuana or any other drug.

The Bottom Line

Marijuana is not the harmless, “all natural” drug that many
think it is. Marijuana hyperemesis is not the only danger it poses, or even the
worst, but it is one that many people do not realize exists. Thus, increased
education is vital to keep people safe. When someone realizes that their
marijuana use is compulsive and problematic, help is available.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.