The Vomiting Only Stops in a Hot Shower. The Cure Is the Part Nobody Wants to Hear.

Taylor Armendariz smoked cannabis “morning, noon, and night” for more than 15 years, by her own account to the Philadelphia Inquirer. At 4 a.m. the day after Christmas, the 37-year-old from Blackwood, New Jersey, woke up with stomach pain and started vomiting, and kept vomiting after there was nothing left. An urgent care doctor sent her to the ER for possible appendicitis. The scans and blood work came back normal. At home, the only thing that helped was a hot shower, and the relief lasted exactly until she dried off. When she went back and mentioned the shower, a doctor finally said the name: cannabinoid hyperemesis syndrome.

The illness has a name, a code, and a cure, and the cure is the one thing the person vomiting least wants to hear.

What it is, in plain words

Cannabinoid hyperemesis syndrome, or CHS, is a cycle of severe nausea, vomiting and belly pain in people who use cannabis heavily over a long time. Some people call it “scromiting,” because the vomiting can come with screaming. The strangest sign is the one that cracks the case: people with CHS feel better in hot water, often compulsively, sometimes for hours. Armendariz soaked in the tub for up to two hours at a time. She described forcing herself to vomit with a toothbrush and said it “felt animalistic.” The ordinary anti-nausea drugs usually do not work. What did work for her, in the ER, was an antipsychotic shot and IV fluids, which treat the episode but not the cause.

It is not only miserable; it can be dangerous. In Michigan, 19-year-old Andy Timmons, who began using cannabis at 15, was admitted on September 29 with uncontrollable vomiting. Doctors found dangerously low potassium and magnesium and an abnormal heart rhythm reading, the kind that worries cardiologists. A nurse connected the long hot showers to CHS. Her mother, Mindi Giorlando-Timmons, said: “I don’t want any other parent to have to go through this and not know this could happen.”

Why cannabis, of all drugs, would cause vomiting is the cruel joke at the center of this. THC normally calms nausea, which is why it is prescribed to chemotherapy patients. The leading theory is that years of heavy exposure overwhelm the body’s own cannabinoid system, which helps regulate nausea and body temperature, until it starts misfiring in the other direction. The hot-water relief probably works through the same temperature-sensing circuits. That is a theory, not a settled mechanism, and honest clinicians say so.

The numbers tripled overnight, and most of that is honesty

Until last fall, CHS had no diagnosis code of its own. ER doctors had to bill it as generic vomiting plus a cannabis code, which meant nobody could count it well. On October 1, 2025, a specific code, R11.16, took effect. In August the CDC published what happened next. Across 199,565 CHS-related ER visits between January 2023 and May 2026, the rate jumped from about 3.2 per 10,000 visits to 11.97 after the new code, a 3.7-fold rise. The rate among 15-to-24-year-olds hit 38.70 per 10,000.

Here is the calibration a clinician will want: the CDC itself says the overnight jump likely reflects “improved clinical recognition and coding of CHS rather than a true and immediate rise in incidence.” People did not get three times sicker in one month. They were already that sick; we just started writing it down. The post-code period is only eight months long, and the data count visits, not people, so one person cycling through the ER can appear many times. Local hospitals that were tracking it anyway saw a real climb: Jefferson Health’s two Philadelphia hospitals logged at least 300 cases in the year ending July 2025, three times the count two years earlier. Jefferson’s Kory London pointed out that cannabis in the 1970s ran about 2 or 3 percent THC, a fraction of what today’s concentrates deliver.

Jefferson’s Kory London pointed out that cannabis in the 1970s ran about 2 or 3 percent THC, a fraction of what today’s concentrates deliver.

It took twenty-one years to get a billing code, and the first patients were told it was in their heads

The history is worth knowing, because it explains why so many people with CHS spent years being misread. In 2004, doctors in South Australia led by Jonathan Allen published a case series in the journal Gut describing people who used cannabis heavily and suffered cycles of vomiting. Nine of the ten cases they presented showed the same strange hot-bathing behavior. One of them had previously been written up in the medical literature as “psychogenic vomiting,” meaning vomiting caused by the mind. Allen’s team concluded it was the cannabis. Of the people who stopped, seven saw the vomiting end. It then took more than two decades, and the legalization of cannabis across much of the U.S., before the illness got its own line in the coding book. For all those years, people were sent home with “gastritis,” “cyclic vomiting,” or “anxiety,” and kept using the one thing they believed was helping their stomach.

Why stopping is the cure, and why stopping is so hard

The only reliable cure is to stop using cannabis. Allen’s 2004 patients showed it, and today’s ER doctors say the same thing. If you are reading this with a hot shower already running in your head, you know what comes next: the voice that says the cannabis is what settles your stomach, so you need it to get through the nausea. That voice is the trap. When your body has adapted to a drug, its absence feels like illness, and the drug feels like medicine.

That adaptation is not weakness; it is biology. A 2020 meta-analysis in JAMA Network Open found that about 47% of people who use cannabis regularly go through withdrawal when they stop: irritability, anxiety, wrecked sleep, vivid dreams, cravings. It usually peaks in the first week and fades over weeks. It is not dangerous the way alcohol withdrawal can be, but it is real enough to send people back. Armendariz told the Inquirer she worried she could not quit, and also that she knew quitting was the only way to keep from ending up back in the ER. Both thoughts in one head, at once. If you have ever been there with any drug, you know that is not a contradiction. It is what dependence feels like from the inside.

There is help that works. A Cochrane review led by Peter Gates found that talk-based treatment, especially cognitive behavioral therapy combined with motivational interviewing, reduces cannabis use and dependence compared to no treatment, though many people do not stay fully abstinent and the effects fade over time. In plain terms: counseling helps, more sessions help more, and slipping is part of the process, not proof you failed. Support groups exist too, including cannabis-specific 12-step meetings, and the Inquirer reported that two Facebook support groups for CHS alone have about 40,000 members. You are not the only one in the bathtub at 3 a.m.

For providers, two changes this week. First, follow the CDC’s own advice: ask about cannabis frequency, product type and how it is used for anyone with recurrent vomiting, and ask about hot showers by name, because patients rarely volunteer it. Second, when you make the diagnosis, do not stop at “quit.” Screen for cannabis use disorder and for the anxiety or depression it often travels with, and hand the patient a next step: a counseling referral, a follow-up date, a plan for the first two withdrawal weeks. “Stop using” with no plan is how people end up back on the gurney.

This matters more this month than last. The federal hemp-THC ban that takes effect December 11 will push some people from low-dose hemp drinks toward stronger dispensary products and unregulated concentrates. More potency, used more often, is the exact recipe Allen described in 2004. Find more on the cannabinoids hub and in our science and medicine coverage.

More potency, used more often, is the exact recipe Allen described in 2004.

Andy Timmons is 19, and her mother says she is now depressed and may face long-term health problems. Taylor Armendariz spent two hours at a time in a bathtub, reading, waiting for her body to stop. Neither of them needed a lecture. They needed someone, years earlier, to say the name of the thing out loud, and then to stay in the room for what came after.