S1191 Real-World Treatment Patterns and Patient-Perceived Effectiveness in Cannabinoid Hyperemesis Syndrome: A Survey of 829 Individuals

Introduction: Cannabinoid hyperemesis syndrome (CHS) is an increasingly recognized condition characterized by recurrent nausea and vomiting in chronic cannabis users. Despite its growing prevalence, data on treatment effectiveness remain limited and are largely derived from small case series. Methods: We analyzed self-reported data from 829 individuals with CHS using the crowdsourced health platform StuffThatWorks, which collects structured patient-reported data on symptoms and treatment effectiveness across medical conditions. Of these, 459 provided treatment effectiveness ratings for the four most commonly reported interventions: cannabis reduction, hot showers, smoking cessation, and ondansetron. Respondents rated each treatment as “very effective,” “fairly effective,” or “not effective.” Chi-square testing with Bonferroni-adjusted post-hoc comparisons was used to assess differences in perceived treatment effectiveness among these four interventions. Results: Vomiting (70%) and nausea (58%) were the most frequently reported symptoms. Among the four most commonly reported interventions, cannabis reduction and smoking cessation were rated as “very effective” by 81% and 83% of respondents, respectively. Hot showers and ondansetron received more mixed ratings, with only 40% and 46% reporting them as “very effective.” Chi-square analysis revealed significant differences in effectiveness among all four treatments (χ² (6, N = 459) = 90.86; P < 0.001). Pairwise post-hoc analysis with Bonferroni adjustment indicated statistically significant differences between all pairs of treatments (all P-values < 0.0083). Among 22 individuals who continued cannabis use as a form of symptom relief, none reported benefit, and 18% experienced symptom worsening. Conclusion: In this large patient-reported study, cannabis reduction and smoking cessation were significantly more effective for CHS symptom relief than symptomatic treatments such as hot showers and ondansetron. These findings align with CHS pathophysiology and underscore the critical role of clinician-led cessation counseling and patient education. Given high relapse rates and misconceptions about cannabis's antiemetic role, patient education and structured follow-up are critical for sustained recovery. Limitations include reliance on self-reported data and potential selection bias. Future research should focus on controlled trials and targeted educational initiatives to improve CHS recognition, reduce misdiagnosis, and alleviate healthcare burden.