As cannabis use among youth rises in Canada — and THC potency reaches record highs — emergency departments are seeing a surge in cases of a once-rare condition: cannabis hyperemesis syndrome (CHS).
Characterized by relentless vomiting, abdominal pain and temporary relief through compulsive hot showers or baths, CHS is increasingly affecting adolescents and young adults. Yet few people — including many clinicians — know it exists.
Canada ranks among the highest globally for youth cannabis use, with 43 per cent of 16-19-year-olds reporting use in the past year. Usage peaks among those 20–24 years, with nearly half (48 per cent) reporting past-year use.
This rise in regular, heavy use coincides with a 400 per cent increase in THC potency since the 1980s. Strains with THC levels above 25 per cent are now common. As cannabis becomes more potent and accessible, clinicians are seeing more cases of CHS, a condition virtually unheard of before 2004.
CHS unfolds in three phases:
Prodromal phase: Nausea and early morning discomfort begin. Users increase cannabis consumption, thinking it will relieve symptoms.
Hyperemetic phase: Intense vomiting, dehydration and abdominal pain follow. Hot showers or baths provide temporary relief — a hallmark of CHS.
Recovery phase: Symptoms resolve after stopping cannabis entirely.
Diagnosis is often delayed. One reason is because CHS mimics conditions like gastroenteritis or eating disorders, leading to costly CT scans, MRIs and gastric emptying tests. One telltale sign — compulsive hot bathing — is frequently overlooked, despite its strong diagnostic value.
Youth face unique risks. The brain continues to develop until about age 25, and THC exposure during this critical window can impair cognitive functions like memory, learning and emotional regulation. Heavy cannabis use is associated with heightened risks of anxiety, depression, psychosis and self-harm.
Edit, the link in the article goes to this study:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796355
Results There were 12 866 ED visits for CHS from 8140 individuals during the study. Overall, the mean (SD) age was 27.4 (10.5) years, with 2834 individuals (34.8%) aged 19 to 24 years, 4163 (51.5%) females, and 1353 individuals (16.6%) with a mental health ED visit or hospitalization in the 2 years before their first CHS ED visit. Nearly 10% of visits (1135 visits [8.8%]) led to hospital admissions. Monthly rates of CHS ED visits increased 13-fold during the 7.5-year study period, from 0.26 visits per 100 000 population in January 2014 to 3.43 visits per 100 000 population in June 2021. Legalization was not associated with an immediate or gradual change in rates of ED visits for CHS; however, commercialization during the COVID-19 pandemic period was associated with an immediate increase in rates of CHS ED visits (incidence rate ratio [IRR], 1.49; 95% CI, 1.31-1.70). During commercialization, rates of CHS ED visits increased more in women (IRR, 1.49; 95% CI, 1.16-1.92) and individuals older than the legal age of cannabis purchase (eg, age 19-24 years: IRR, 1.60; 95% CI, 1.19-2.16) than men (IRR, 1.08; 95% CI, 0.85-1.37) and individuals younger than the legal age of purchase (IRR, 0.78; 95% CI, 0.42-1.45).
Before legalization, pretty much every cannabis magazine and website was being cited as saying it was totally safe. Even mocked people for thinking otherwise.
That changed public opinion, and experts were ignored. These risks were known many years ago, so why has the industry been allowed to keep selling stronger strains, marketing to young people, and making these drugs available everywhere?
Now that the consequences are being seen, what are we going to do about it? This shit is being sold at every street corner, sometimes multiple cannabis shops at the same intersection. It's nuts.
Ah ok, "they" meant cannabis magazines.
The experts were on the side of legalization, so they weren't really ignored. If by experts you mean people who study public health policy and narcotrafficking.
What are these experts saying nowadays? What I see is a consensus that legalization was a pretty good move. There's probably more we should do, but it's stuff that builds on top of legalization.
Before legalization, there really weren't many other places promoting cannabis (maybe there was, but marketing back then was very different from now), so the promotion of their safety came from those sources (unfortunately).
Worse yet, as the plans to legalize were getting closer, I remember a massive push on social media by people promoting cannabis as a cure-all for just about anything: mental health, cancer, anxiety, bowel problems, etc. They used the Trojan horse of “medicinal use” to bring it into everyone's life.
I'm sure there was industry influence, because it was extremely rare to see people pointing out the harms of cannabis back then.
Decriminalization is one thing, and experts were certainly in support of decriminalization.
But legalization, as in "allow stores to sell these everywhere and to everyone", just like alcohol and cigarettes, became a fucking disaster, and now we are seeing the result of what the experts warned us about.
Again, they still agree that decriminalization was the right move. But experts, doctors, law enforcement, educators... all see what a disaster this has become.
We knew that normalizing cannabis and selling it everywhere would lead to more DUI, more hospitalizations, more poisoning of small children, lower academic performance in teens... just wait until the wave of long-term harm begins to surface. How will our healthcare system even handle that burden? Experts have warned us for decades, and still do.
Looks like we have different groups of experts in our respective informational sources
The "experts" looked a lot different on 2016 Social Media... and that's what drove much of the public support.
The real experts would have never wanted cannabis to be sold and promoted the way it has been.
Only marketing I’ve seen is anti-drug ads
And per the above article, drinking until you puke seems to be worse
Recently, or around the time of legalization? Even pulling up Google Maps will highlight the cannabis shops, which is an insidious way to promote them.
Both? But I only use maps to find addresses I know
You're lucky, I guess. Even just driving/riding around, I see cannabis shop signs everywhere. And I don't want to see them, so I can only imagine how they stick out to an addict or vulnerable person.
Alcoholic here. Booze at every restaurant, at every corner store, empty cans in the ditch, at every sporting event, liquor stores everywhere, every adult gathering I go to and most family ones too has booze, concerts, music venues even the movies have booze now. It need to all go. I don't want to see it. I also don't want to see maple magats, huge diesel trucks idling with no one in them, indigenous people being arrested,killed and harassed for existing, churches...I hate fucking churches...every single one needs to go. Google maps also has all those places. They're promoting hatred and alcoholism.
You sound like a child.
Sounds like we agree.
Not sure what any of that has to do with drugs harming kids, but OK.
They are. We agree on that, too.
OK. We seem to be agreeing on the same things, so... I guess you sound like a child, too? 🤔
I have concerns about drugs influencing our most vulnerable, and the external pressures that make it difficult for them to avoid it.
As an alcoholic, one would think you'd agree that it's a problem.
Not sure what your personal beef with me is, though. 🤷♂️
You are using an argument you have no idea about. You sound childish. Framing it to protect me and people like me is a cop out because you do not understand us at all or addiction and recovery so it's certainly not about that. It is evident in the way you speak and your ideas about people in situations like mine.
My comments were sarcasm. Obviously lost on you. To think that you could eliminate or hide everything that offends someone from life completely is also a childish outlook. It's simply not possible and most grown ups recognise this.
On the other hand....can we start with the churches? Should we burn or bulldoze them?
"Everything". I never suggested such.
Look, we were able to drop cigarette use by using simple strategies like not having them displayed "in your face" at shops, and cutting advertising.
If we can't do the same for other drugs, then it's due to a lack of trying.
We dropped cigarette use with a massive anti smoking campaign that lasted decades. Not by hiding it behind the counter.
How come I can't extend your outrage to churches? Seems a reasonable expectation since we're hiding things that destroy lives.
We used many approaches, which should be applied to the currently promoted drugs you see being sold in stores.
Churches... the building? Or religion? I'd love to organized religion die, but church buildings should stand as either historical landmarks, or repurposed to house the homeless.
Where do we start?
Education! Real, honest education to school age kids. Prohibition just creates a more dangerous black market, and lying (by hyperbole) about drug effects makes kids not believe the warnings which is just as bad (see: US’s failed D.A.R.E. Program in the 90s where they said marijuana is as bad as heroin)
I don't think prohibition is the way to go. But we (society) should treat these drugs like we treat cigarettes: keep them out of view (i.e. "behind the counter") and stop allowing them to be marketed at every street corner.
I view it from the perspective of someone who might never want to get into drugs, or may have recently become sober: they see cannabis shops at every turn, they are being primed to fail, and that's not right.
We were able to get sensible people to stop smoking once we stopped allowing cigarettes to be displayed and marketed everywhere. I feel we need to do the same for cannabis (and alcohol) because of the harm we are causing to the most vulnerable in our society (youth and the poor).
One could argue it is safe in reasonable moderation. CHS devlops due to extreme and excessive daily use of cannabis. Enjoying a joint every now and then is far safer than toking every 30 minutes.
If i ate 30 chocolate bars everyday for weeks on end, I'd have some serious health issues, but one every weekend would be nearly unnoticeable from a health perspective.
The problem is, what Health Canada once labelled as "heavy use" is pretty much normal use these days. Daily use, or using multiple times a day, is very common.
If people (and teens) were only consuming once in a while, I doubt we'd be in this mess.
They consume often, partly because they've been told "it helps with XYZ", so they self-medicate, which leads to greater problems. But also because they believe it's "safe".
Single cannabis use can also lead to acute impairment and puts stresses on the body. I've never heard of someone getting in a car and killing someone because they were impaired on having chocolate that afternoon. 😆