Medical Examiner

“Scromiting,” the New Panic Over Weed, Is Actually a Real Thing

Cannabinoid hyperemesis syndrome is rare but can involve severe or prolonged vomiting. Experts say it’s no reason to restrict marijuana use.

A woman screaming, next to a pot leaf.
It’s fine! Getty Images Plus

“Scromiting” isn’t anywhere in the medical literature. A portmanteau of “screaming” and “vomiting,” it’s slang for a side effect of marijuana use, according to a Daily Mail piece published Saturday.

“Legalising pot seems like a common-sense policy but in fact, it’s a public health disaster that the MJ industry is doing its darnedest to cover up,” the author of the piece wrote, citing the rise of “scromiting” as a concern.

Weed-induced vomiting does happen, and has a formal name: cannabinoid hyperemesis syndrome, or CHS. While CHS can result in severe or prolonged vomiting—that’s what hyperemesis means—it’s not something you necessarily need to worry about if you’re a casual weed user. It’s also not a reason to fear the legalization of pot, experts say, though it is good for medical professionals to be familiar with the symptoms, which yes, can include loud vocal sounds.

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“It’s a rare condition that only develops in the long term, daily use, of marijuana,” said Taylor Nichols, an emergency medicine physician in Northern California who has seen patients with CHS. “It’s not like somebody who is a nonuser goes out and smokes marijuana once and then develops ‘a poisoning.’ ”

For years, CHS was not taken seriously by the medical community, and it wasn’t described in the literature until the early 2000s. It’s now a pretty well-known entity in emergency rooms across the country, experts told me, but there’s still little data on the condition. Among the unknowns are “how many people are affected, how much cannabis you need to be exposed to, and which people get it, and which people who consume every day don’t get it,” said Andrew Meltzer, an emergency medicine doctor in D.C. There is not a commonly used medical code for the condition, which makes it especially hard to figure out how many people it affects.

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Though it’s unclear why CHS occurs, the symptoms are recognizable. There are three phases to CHS. The first phase often consists of nausea, abdominal pain, light heartburn, and burping. The next phase, which not everyone progresses to, is the hyperemetic phase, and is when that “constant vomiting” occurs, as Alice Moon, who works at the cannabis-focused PR firm Trailblaze explained to me. This might involve loud retching sounds, or “screaming,” hence “scromiting.” (Scromiting is not exclusively linked to pot use, according to Urban Dictionary, one might scromit because they have homework due soon.) The final phase of CHS is the recovery phase, where the individual must commit to not using cannabis to allow the body to go into recovery. Another way to look at this: The treatment for CHS is simply to stop using weed.

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Moon developed CHS herself in 2016. However, because it wasn’t as well known then, she wasn’t diagnosed until later. “I spent two years really really sick, lost a lot of weight, was throwing up constantly,” she explained. “I saw numerous doctors and no one knew what was wrong with me until 2018 I saw a doctor who knew about CHS and diagnosed me.”

Since then, she’s talked to doctors, spoken on panels alongside researchers, and even surveyed her peers on their experiences with CHS. She has data on 330 individuals around the world with CHS, many of whom are part of a 17,000-person Facebook group devoted to the condition, which has not been published. Moon says she learned from the survey that everyone’s experience with the illness can be a little different. “I’m devoted to trying to spread awareness, education, while still being pro-cannabis,” says Moon.

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Just because you feel off (or worse) after smoking a bowl doesn’t mean you have CHS. Nichols told me that he does see people who come in high from edibles or smoking weed that are nauseated or vomiting who do not have an ongoing condition. “They’re not accustomed to it,” he said. “It’s kind of like how people get sick from drinking alcohol. You can develop a reaction to any drug. Cannabinoids are a drug. Alcohol is a drug. Caffeine is a drug and your body has a response to a drug.”

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If you do find yourself with a rare case of CHS, there are ways to treat the symptoms. In the past, some medical professionals used opiates, but most have now turned to traditional antipsychotics with anti-nausea properties. Moon recommends looking out for warning signs of CHS, as it’s possible to stop before it progresses further. “People should be mindful of some of the early signs of heartburn, burping,  abdominal pain,” she explains.

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The key thing is that users with CHS stop cannabinoid intake as soon as possible. “People don’t want to hear it, the only way that CHS will resolve is to discontinue the use of cannabis,” Karen Randall, an emergency medicine physician in Colorado, wrote in an email to Slate. “And the CHS may recur for several months as there is a wash out time (which can vary from individual to individual).  The average time to resolve, I am estimating, is about 3 months.  I try to tell my patients that they are ‘allergic’ to cannabis (similar to having an intolerance to other medications).”

And like other medications, cannabis can be medically beneficial—ironically, including to help with vomiting. “This is an active medication that, in low doses, is an effective anti-emetic and reduces nausea and improves appetite, and that’s been shown,” Meltzer said.

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Weed is also of course a relaxing recreational drug for many. The existence of CHS isn’t a reason not to legalize pot more broadly, says Nichols. CHS “is much less of a concern than, say, immediate or long-term consequences of alcohol use,” he  explained.

The upsides of weed are big enough that Moon keeps promoting it for a living. “I’ve used cannabis throughout my life so much, I used it medicinally for years before I developed CHS and it helped with every aspect of my life,” Moon says.  “Cannabis is such a beneficial medicine to so many people. That’s why I still work in the industry.”

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