Not even a month in the hospital on a feeding tube was enough to make Sydni Collins quit pot.
Collins reached for her weed pen most days in high school since she turned 16, even as waves of extreme nausea and vomiting overtook her. One particularly brutal episode left her vomiting nonstop during her spring break flight senior year.
“There were some days when it lasted until noon and I would not go to school because of how bad it was,” Collins, 23, told The Post. “I would be puking all morning. I would let out yells or cries because nothing would come out; I was just dry heaving.”
She was experiencing cannabis hyperemesis syndrome (CHS), a debilitating disorder that triggers episodes of relentless nausea, abdominal pain and severe vomiting in chronic weed users. “Scromiting” is the nightmare blend of screaming and vomiting.
More than 2.5 million US teens — roughly 1 in 10 — were casual cannabis users in 2023, while an additional 600,000 teens were considered addicted to the drug.
Experts have long warned that weed can harm brain development, increase anxiety, depression and psychosis and impair coordination and decision-making in adolescents.
Add CHS to the list of concerns. ERs have seen such a steady rise in CHS cases over the last decade that the World Health Organization and Centers for Disease Control and Prevention recently added official diagnostic codes.
Collins didn’t get a diagnosis at her first hospital visit — she was an unfortunate trendsetter.
That spring break flight — and her inability to eat a full meal afterward — triggered seven ER visits in just one month. Symptoms would come and go, interrupting her ability to live a normal life. She wasn’t able to eat a full meal for weeks.
“There would be some days where I felt better than others and I would feel fine,” she explained. “I was like, ‘I can go eat, I can go out of the house.’ And then within hours, I would go back to vomiting and stomach pain.”
“I would be in the fetal position on the bed for hours because that was the only way my stomach didn’t hurt as bad.”
Sydni Collins
“When I was finally admitted, [doctors] told me I was 87 pounds and had to get a feeding tube,” Collins explained. “They said, ‘This is not normal, we need to figure it out.’”
She initially turned to hot baths for relief, but these were counterintuitive since she was already dehydrated. She also struggled getting back to a healthy weight, as the CHS made everything unappetizing.
“My mom got me a bunch of nutritional supplements and I could not bear the taste of anything, even Gatorade,” she shared. “I would chew on ice cubes, I would lick the salt off pretzel rods, cold washcloths helped.”
“But I would be in the fetal position on the bed for hours because that was the only way my stomach didn’t hurt as bad,” she added.
Collins’ doctors initially diagnosed her with superior mesenteric artery syndrome, a rare digestive disorder.
Misdiagnosis is common, thanks to the previous absence of a diagnostic code and a lack of clinician awareness. Patients are frequently told they have food poisoning or a stomach flu.
“The most common misconception about CHS is that it is even a real condition,” John Puls, a psychotherapist and master’s certified addiction professional, told The Post. “Most physicians, especially in emergency rooms where patients often end up with CHS, attribute the problem to some other type of G.I. issue.”
Dan McGovern was initially misdiagnosed at 20 with gastroesophageal reflux disease (GERD), which causes acid reflux and regurgitation.
He was fond of using concentrate wax, a highly potent form of marijuana, every day as a teenager.
“When I was consuming a lot of the concentrates, I would wake up with severe nausea that went on for a while,” McGovern, now 34, told The Post.
“I would start getting cold sweats. It just got even worse. I would wake up every morning and just start throwing up and involuntarily yelling during the dry heaving.”
His episodes would only last a few days at a time, getting so severe that he couldn’t even keep water down — and eventually went looking for answers on what was plaguing him.
“I went to a gastroenterologist,” he recalled. “They determined that the cause was the cannabis, that I was consuming too much, and it was too much for my body to handle, and it was almost rejecting it.”
While the exact cause of CHS is unknown, a leading theory is that long-term overstimulation of receptors in the endocannabinoid system may disrupt the body’s natural control of nausea and vomiting, per the Cleveland Clinic.
“Personally, I see it most in people who use THC in some form or another on a daily basis,” said Dr. Brian Kendall, an emergency medicine physician in Charleston, South Carolina. “It’s thought that chronic use of THC over-stimulates the CB1 receptors [in the brain and gut], which then desensitizes them and makes them stop behaving normally, leading to the whole system misfiring and causing hyperemesis.”
Continuing to light up
Despite their diagnoses, both Collins and McGovern continued using weed to manage symptoms, in conjunction with other treatments like hot baths and showers.
“Both [smoking and hot showers] usually got rid of the nausea,” McGovern explained. “But it was an unfortunate vicious cycle where if you smoked more, it just exacerbated the symptoms.”
After her first month-long hospitalization, Collins quit weed for about nine months, until she was diagnosed with Crohn’s disease, which causes inflammation of the digestive tract and leads to nausea, weight loss and stomach cramps.
“Getting diagnosed with that made me think that’s probably what [the original symptoms] were from and it wasn’t the weed,” she said.
This is fairly common, according to a statement released by the University of Washington School of Medicine. Since CHS strikes intermittently, some cannabis users assume their symptoms are unrelated and continue using — only to become severely ill again.
“I started doing [weed] again, and three years from my first big episode, I had another one and went to the hospital a bunch of times. [I] ended up having to get a feeding tube and lost a bunch of weight again,” Collins added.
Beyond the physical effects of CHS, McGovern’s and Collins’ mental health also suffered.
“Sometimes I would just be bedridden for days or weeks,” said McGovern. “I couldn’t go to work, so I would get anxiety about losing my job. I wasn’t seeing anybody; I would be super isolated for periods at a time.”
He still uses weed to this day, though he’s ditched the concentrates and edibles.
“I mainly just stick to flower and nighttime use, and I find the symptoms aren’t as bad. I don’t experience vomiting, just the morning nausea,” he said. Hot showers still seem to help the symptoms.
Collins, meanwhile, felt awash in humiliation as she battled CHS. “After 10 days of nonstop puking, I broke down and told my mom I didn’t want to be here anymore,” she explained of her many hospital stays. “I also just felt embarrassed having to tell my whole family that I smoke.”
“I’m not what you would think of as your typical stoner… and people outside of my friend group and close family didn’t even know I smoked,” she said, adding that one of the hardest parts was feeling like she had let people down.
Her last hospital stay prompted her to finally quit weed two years ago.
“The only way to figure out if [my symptoms] were from weed is if I stopped,” she continued. “So
I did, and I got better.”
She also found support through an online CHS group after sharing her journey on social media.
An app helps track her progress not smoking.
“That definitely held me accountable,” she said. “It was cool to see if I can do it for a day, then I can do it for a week. If I can do it for a week, I can do it for a month.”
