The first time it hit, 28-year-old Miguel thought he had food poisoning. A burning wave rose from his gut, doubled him over, and then came the sound the ER staff now call “scromiting”—a primal scream followed by non-stop vomiting that leaves ribs aching and throat raw. Between heaves he crawled to the shower, cranked the water to scalding, and sat in the steam until his skin turned lobster-red. “The heat was the only thing that made the pain pause,” he says. Four hours later his roommate found him passed out on the tiles and called 911. Miguel had smoked a high-THC vape the night before, something he’d done almost daily for five years. He never imagined cannabis could land him in an ambulance—especially in California, where it’s legal, taxed, and sold in glossy storefronts.
Doctors soon gave him a name for the nightmare: Cannabis Hyperemesis Syndrome (CHS). The condition is still barely known outside emergency wards, but visits have surged nationwide as pot grows stronger and more widely used. Classic anti-nausea drugs like Zofran or Phenergan often do nothing. Morphine, IV fluids, and sedatives buy time while the body wrestles with a poison it once considered harmless. “Patients arrive dehydrated, screaming, sometimes vomiting blood from torn tissue,” explains Dr. Chris Buresh, an emergency physician in Colorado. “We’ve coined the term ‘scromiting’ because they scream while they vomit. You can hear it down the hall.”
The cycle is cruelly predictable. Heavy use—especially high-potency waxes, shatter, or vapes—triggers the first attack. A day or two of misery ends, the user feels fine, and the obvious conclusion is: “It must have been bad Chinese food.” So they light up again, and within weeks the fire re-ignites. One study from George Washington University followed more than 1,000 CHS sufferers; the average patient needed four ER trips before realizing cannabis was the culprit. “Because episodes come and go, people refuse to believe weed is the trigger,” says research professor Beatriz Carlini. “They keep using, and each bout gets worse.”
Adolescents are now the fastest-growing group of CHS patients. Cases in teens jumped more than tenfold between 2016 and 2023, with the sharpest rises in states where recreational pot is still illegal—suggesting black-market products may be even riskier. ER docs in Texas, Georgia, and Indiana report kids arriving dehydrated, potassium crashed, begging for relief. “I’ve given birth,” says 19-year-old Kayla, who started dabbing at sixteen. “This pain was worse. I was on the bathroom floor praying to pass out so I wouldn’t feel it anymore.”
The only proven cure is complete abstinence. Within days of quitting, nausea fades, appetite returns, and the shower becomes just a shower again. Miguel has been clean six months; he keeps a photo on his phone of the hospital bracelet to remind himself what “just a plant” can do. Advocates still push cannabis for pain, seizures, and PTSD, and for many patients it works. But ER staffs want users to know the flip side. “Legal doesn’t mean harmless,” Dr. Buresh says. “If you’re vomiting and screaming at the same time, legality is the last thing on your mind.”
