Cannabis ‘scromiting’ is hurling onto the public health scene

A mysterious and debilitating vomiting disorder tied to long-term marijuana use is rising sharply across the United States, prompting health officials to allow researchers to formally track and study the condition.

Known clinically as cannabis hyperemesis syndrome (CHS), and dubbed “scromiting” on social media for its combination of screaming and vomiting,  the syndrome has quickly emerged as a growing public-health concern as cannabis use expands nationwide.

A new study published in JAMA Network Open in November reviewed more than 188 million emergency department visits from 2016 through 2022 and found CHS cases surged abruptly during 2020 and 2021 among adults ages 18 to 35. The disorder, first identified in Australia in 2004, presents as cyclical and severe nausea, vomiting, and abdominal pain with no apparent medical cause. A hallmark symptom is compulsive hot bathing: patients report that only extremely hot showers temporarily relieve their distress.

“It’s pretty universal for these patients to say they need a really, really hot shower, or a really hot bath, to improve their symptoms,” Dr. Sam Wang, a pediatric emergency medicine specialist and toxicologist at Children’s Hospital Colorado, told CNN.

The study found that CHS diagnoses increased from 4.4 per 100,000 emergency visits in 2016 to a peak of 33.1 per 100,000 in the second quarter of 2020. Rates remained elevated through 2022 even as overall ER visits stabilized post-pandemic.

Key findings include:

• Younger adults are most affected: The highest risk groups were adults ages 18–25 and 26–35.

• Gender disparity: Females had a slightly lower risk of CHS than males.

• Regional differences: Patients in the South had significantly lower CHS risk compared with those in the Northeast.

• Shift in diagnosis patterns: As CHS-related cases rose, diagnoses of cyclic vomiting syndrome — a similar but unrelated condition — declined, suggesting that more clinicians are recognizing the cannabis link.

The study also notes that CHS is often misdiagnosed due to underreporting of cannabis use and the lack of a dedicated diagnostic code until recently. A specific ICD-10 code for CHS, F12.188, was only added in 2025, which researchers say should dramatically improve tracking and clinical recognition going forward.

Why It’s Increasing

Nearly half of Americans now live in states like Alaska with legalized recreational cannabis. As stronger products,  particularly high-potency concentrates and vapes,  become common, researchers suspect long-term, daily or near-daily use is driving the increase. CHS risk appears to rise after six months to a year of heavy consumption.

Despite speculation online, the study found no evidence that CHS is caused by environmental contaminants or unrelated gastrointestinal disorders. Instead, researchers pointed to potential neurological pathways involving cannabinoid receptors, thermoregulation, and genetic susceptibility.

The JAMA authors conclude that CHS represents a “growing share” of vomiting-related emergency visits and warn that many cases likely remain unidentified. Increased awareness among clinicians and the public will likely grow as cannabis legalization continues to expand nationwide.