Links between cannabinoid hyperemesis syndrome symptoms and drug use, mental health problems, antisocial behavior, and personality in a national survey of adults in the United States.

Abstract

Cannabinoid hyperemesis syndrome (CHS) is characterized by episodes of severe nausea, vomiting, and abdominal pain among those with heavy cannabis use. We estimated differences between those reporting CHS symptoms and those who use cannabis daily and less frequently on drug use, psychiatric symptoms, other health aliments, antisocial behavior, and personality. The National Firearms, Alcohol, Cannabis, and Suicide survey was administered to 7034 US adults (3427 male, 3607 female) in 2025. Survey items assessed substance use, common psychiatric symptoms, personality traits, and symptoms of CHS. Those with CHS symptoms reported the highest rates and greatest variety of drug use compared to others who used cannabis. Those with CHS symptoms reported higher rates of other drug use than those who used cannabis daily without CHS symptoms for opioids, hallucinogens, and sedatives, higher rates of drug overdoses, and greater use of all drug classes than those with less-than-daily cannabis use. Those with CHS symptoms also reported more depression, anxiety, sleep disturbances, chronic pain, antisocial behavior, intimate partner violence, and disinhibited personality traits than those who used cannabis daily (mean d = 0.58) and less frequently (mean d = 0.69) and those with no cannabis use in the past 12 months (mean d = 0.99). Those with CHS symptoms exhibit a variety of psychological and behavioral difficulties including higher rates of other drug use, psychiatric symptoms, antisocial behavior, and dysfunctional personality traits. Results highlight the importance of understanding and addressing the broader psychosocial challenges faced by people experiencing CHS symptoms.