Cannabis Hyperemesis Syndrome Is Spiking in DC, Maryland, and Virginia: What Consumers Need to Know

This article is general consumer health information only and is not medical advice. If you are experiencing symptoms, consult a qualified healthcare provider.

What Is Cannabis Hyperemesis Syndrome? The Short Answer

Cannabis hyperemesis syndrome, commonly called CHS, is a condition that can develop in some people who use cannabis heavily over long periods of time. It causes recurring cycles of severe nausea, intense vomiting, and abdominal cramping that can last for hours or days. One unusual feature, according to researchers, is that hot showers or baths often bring temporary relief. Clinicians now use that bathing behavior as a diagnostic clue.

A major federal surveillance report published August 6, 2026 in the CDC's Morbidity and Mortality Weekly Report found that cannabis hyperemesis syndrome symptoms 2026 data show identified CHS-related emergency department visits running 3.7 times higher than previously estimated. The spike is partly explained by a new, dedicated ICD-10 diagnosis code (R11.16) introduced in October 2025. But researchers say more potent cannabis products and higher-frequency use are also driving real increases, not just better counting.

If you are an adult cannabis consumer in DC, Maryland, or Virginia, here is what the current evidence says and what it means for you.

The CDC Report: What the August 2026 Data Actually Shows

Between January 2023 and May 2026, the CDC identified 199,565 emergency department visits involving CHS across the United States, according to the August 6, 2026 MMWR report. Before October 2025, there was no specific ICD-10 code for CHS. Clinicians typically coded these cases as cyclical vomiting syndrome (R11.15) combined with a cannabis-related code. That was an imperfect match that almost certainly undercounted the true burden.

When the dedicated CHS code R11.16 launched on October 1, 2025, the identified rate jumped immediately: from 3.35 per 10,000 emergency department visits in September 2025 to 11.26 per 10,000 visits in October 2025. That is the 3.7x increase the headlines are citing.

The CDC researchers are careful to note that better coding explains a portion of the apparent surge. But they also point to real trends: more potent products on the market, higher rates of daily use, and a demographic shift toward younger, heavier users. The report found the highest CHS-related ER visit rates among adults aged 15 to 24.

Source: CDC MMWR, "Trends in Emergency Department Visits Involving Cannabis Hyperemesis Syndrome Identified Using a New Diagnosis Code, United States, January 2023 to May 2026," August 6, 2026. cdc.gov/mmwr

Virginia and DC Are Seeing This Firsthand

The national data is matched by regional evidence closer to home.

Virginia: A 29% Rise Over Five Years

The Virginia Hospital and Healthcare Association (VHHA) published an analysis in February 2026 showing that adult emergency department visits for CHS in Virginia rose by nearly 29 percent between 2020 and 2024, from 4,027 annual visits to 5,175. Over the full five-year period, Virginia hospitals recorded approximately 24,960 CHS-related adult ER visits combined.

Health officials cited in the VHHA report noted that the rise tracked closely with Virginia's cannabis policy shifts: decriminalization in 2020 and the legalization of adult-use possession in 2021. Greater legal access changed how many people use cannabis, how frequently, and with what types of products.

Source: Virginia Hospital and Healthcare Association, "Cannabis Hyperemesis Syndrome Cases in Virginia ERs Up by 29%," February 2026. vhha.com

Washington, DC: Most CHS Patients End Up in the ER

A study led by researchers at George Washington University, published in the Annals of Emergency Medicine in February 2025, surveyed 1,052 people who self-reported having CHS. The findings were striking: 85 percent reported at least one emergency department visit because of their symptoms. 44 percent reported at least one hospitalization.

The GWU team, led by Dr. Andrew Meltzer, described CHS as a "costly and largely hidden public health problem." Many patients in the survey did not initially connect their recurring illness to their cannabis use. That led to repeated ER visits, diagnostic confusion, and significant personal burden before the underlying cause was identified.

Source: Meltzer et al., "Cannabinoid Hyperemesis Syndrome Is Associated With High Disease Burden: An Internet-Based Survey," Annals of Emergency Medicine, February 2025. annemergmed.com

What CHS Actually Feels Like: Symptoms and Stages

Researchers describe CHS as moving through three phases, according to clinical literature reviewed in 2026.

Prodromal phase: Early-stage symptoms that may include morning nausea, mild abdominal discomfort, and an anxious relationship with food. During this phase, some users report increasing their cannabis intake, mistakenly believing it will settle the nausea, since cannabis is sometimes associated with anti-nausea effects in other contexts.

Hyperemetic phase: The acute stage. This involves intense, cyclical vomiting. The episodes can be severe enough that clinicians use the informal term "scromiting" (screaming while vomiting) to describe them. Abdominal cramping can be severe. Dehydration and electrolyte imbalances become a real risk, which is why so many patients end up in emergency departments.

Recovery phase: Symptoms resolve after cannabis use stops. Normal eating patterns return, though full recovery may take days to weeks depending on the individual and their history of use.

The hot shower phenomenon: One of the most distinctive features of CHS is that long hot showers or baths provide temporary relief during the hyperemetic phase, according to researchers. The proposed mechanism involves TRPV1 receptors, sensory receptors that regulate both body temperature and gastrointestinal signaling. Chronic high-potency THC exposure may dysregulate these receptors in some users; heat applied to the skin appears to temporarily reset the overstimulated signals. This behavioral pattern of compulsive bathing for relief is now considered a meaningful diagnostic indicator by clinicians.

Who Is at Risk?

Based on the available research, CHS appears to develop in a subset of heavy, long-term cannabis users. Key risk factors identified in the literature include:

• Daily or near-daily use, particularly use five or more times per day

• Long duration of use: the GWU study found 44% of CHS patients had used cannabis regularly for more than five years before symptoms appeared

• Early onset of use: starting in adolescence was associated with higher odds of eventually requiring emergency care, according to the GWU research

• High-potency products: concentrates, vape cartridges, and high-THC flower are frequently cited in the literature as potential contributing factors

It is important to note that CHS does not appear to affect all cannabis users, or even most regular users. The research consistently points to chronic, heavy, high-frequency use as the primary risk profile. Casual or infrequent consumers are not the population represented in these ER statistics.

What You Can and Cannot Do in the DMV

This section covers what is legal and publicly documented in the DC, Maryland, and Virginia region. It is not legal advice.

Washington, DC: Adult-use cannabis is legal for personal possession and home consumption for adults 21 and over. The gifting market remains the primary retail mechanism in the District.

Maryland: Adult-use cannabis sales launched in July 2023. Licensed dispensaries operate across the state. Adults 21 and over may possess and use cannabis legally.

Virginia: Adult-use cannabis is legal for possession and home cultivation. Licensed retail cannabis stores are open across the Commonwealth.

In all three jurisdictions, consuming cannabis in public spaces, in vehicles, or near schools remains prohibited. Driving under the influence of cannabis is illegal in all three and carries serious penalties.

If you are experiencing symptoms consistent with CHS: Tell the emergency room staff about your cannabis use. This is critical for getting an accurate diagnosis. According to the GWU research, many CHS patients experience repeated ER visits and prolonged diagnostic confusion when providers do not have a complete picture of a patient's cannabis use history. Being upfront gets you better care, faster.

Products, Potency, and Responsible Consumption

The CDC report and the clinical literature both point toward high-potency products and high-frequency use as contributing factors in CHS cases. This is a harm reduction signal worth taking seriously.

CHS research does not definitively establish that one specific product type causes the condition. But the pattern in the data, heavy daily users with high-potency formats over long durations, suggests that how much you use and how often matters more than any single product decision.

Practical harm reduction guidance drawn from the public health literature:

• Take tolerance breaks. Regular periods of non-use allow the body to reset. This is broadly recommended across cannabis health literature regardless of CHS risk.

• Consider lower-potency options. Flower and edibles with moderate THC levels may place less burden on the endocannabinoid system over time than concentrates or ultra-high-potency vape products.

• Monitor your relationship with use. Daily, multiple-times-per-day use is the profile most associated with CHS. If use has become habitual rather than intentional, that is worth reflecting on.

• Know the warning signs. Morning nausea that improves temporarily with cannabis use, recurring vomiting cycles, and compulsive hot showers for relief are the signals the research flags.

Bud Lords carries a range of products across formats and potency levels. If you are looking for options with more moderate THC profiles, browse the Bud Lords shop or visit budlords.com for more information. For more consumer education content like this, the Bud Lords Cannabis Newsroom covers cannabis health, law, and culture regularly.

This is not a medical recommendation. For personal health decisions, consult a licensed healthcare provider.

Frequently Asked Questions

What is cannabis hyperemesis syndrome?

Cannabis hyperemesis syndrome (CHS) is a condition associated with long-term, heavy cannabis use that causes recurring cycles of severe nausea, vomiting, and abdominal cramping. According to the CDC and clinical researchers, the only currently known way to stop the cycles is to cease cannabis use. This is general information; speak with a healthcare provider for anything related to your personal health.

How do I know if I have CHS?

Only a healthcare provider can diagnose CHS. Clinically recognized indicators include recurring vomiting episodes in a long-term heavy cannabis user, temporary relief from hot showers or baths, and symptom resolution after stopping cannabis use. If you are experiencing recurring nausea and vomiting and use cannabis regularly, tell your doctor or emergency room provider about your use history.

Are CHS cases really increasing, or is it just better reporting?

Both, according to the CDC's August 2026 MMWR report. The 3.7x jump in identified cases largely reflects the introduction of a new, specific ICD-10 code (R11.16) in October 2025 that allows clinicians to code CHS directly. But the researchers also point to real trends, including more potent products, higher frequency of use, and a growing population of long-term users, as contributing to actual increases beyond improved counting.

Does CHS affect all cannabis users?

No. The research consistently identifies the at-risk profile as heavy daily users over extended periods, particularly those using high-potency products. Casual or infrequent consumers are not the population represented in the ER data. That said, anyone experiencing persistent cyclical vomiting should speak with a healthcare provider.

Why does a hot shower help with CHS?

Researchers believe it relates to TRPV1 receptors, which regulate both body temperature and gastrointestinal pain signals. Chronic high-potency THC use may dysregulate these receptors in some people; hot water on the skin appears to temporarily reset the overactive signaling. This is a proposed mechanism based on current research, not a confirmed cure, and it only provides temporary relief. Cessation of cannabis use is the only approach associated with resolving the underlying condition, according to current clinical guidance.

Is CHS dangerous?

The hyperemetic phase can lead to significant dehydration and electrolyte imbalances, which is why many CHS patients end up in emergency departments. The GWU study found 85% of self-reported CHS patients had at least one ER visit and 44% had been hospitalized. Untreated severe dehydration carries real health risks. Anyone experiencing prolonged vomiting should seek medical care promptly.

What should I tell the ER if I think I have CHS?

Be honest about your cannabis use, including how frequently you use, what products you use, and how long you have been using regularly. This information is essential for an accurate diagnosis. The GWU study found that many CHS patients experienced multiple ER visits before being correctly diagnosed, often because cannabis use was not disclosed or not considered. Disclosure leads to better, faster care.

Is it safe to discuss cannabis use with a doctor in DC, Maryland, and Virginia?

Yes. Cannabis is legal for adult use in all three jurisdictions. Healthcare providers cannot report legal cannabis use to law enforcement. Being transparent with your provider about cannabis use is always in your best health interest.

Sources

1. CDC MMWR, "Trends in Emergency Department Visits Involving Cannabis Hyperemesis Syndrome Identified Using a New Diagnosis Code, United States, January 2023 to May 2026." Published August 6, 2026. https://www.cdc.gov/mmwr/index.html

2. Virginia Hospital and Healthcare Association (VHHA), "Cannabis Hyperemesis Syndrome Cases in Virginia ERs Up by 29%." February 2026. https://www.vhha.com

3. Meltzer A et al., "Cannabinoid Hyperemesis Syndrome Is Associated With High Disease Burden: An Internet-Based Survey." Annals of Emergency Medicine, February 2025. George Washington University School of Medicine and Health Sciences. https://www.annemergmed.com/article/S0196-0644(25)00008-6/fulltext

4. George Washington University Media Relations, "Syndrome Linked with Chronic Cannabis Use Rises 10-Fold in Adolescents." https://mediarelations.gwu.edu/syndrome-linked-chronic-cannabis-use-rises-10-fold-adolescents

5. Association of American Medical Colleges (AAMC), "ER visits rise for cannabinoid hyperemesis syndrome." July 1, 2026. https://www.aamc.org

Author: Bud Lords Newsroom Editorial Team | Last verified: August 8, 2026

This article is general consumer health information only and is not medical advice. Consult a qualified healthcare provider for any personal health concerns.

This article was researched and written with AI assistance by the Bud Lords AI Newsroom.