Cannabinoid Hyperemesis Syndrome: Unveiling the National Impact on Youth

BACKGROUND Cannabis use (CU) among youth is an increasing public health concern, driven in part by evolving policies that expand access and shift social norms. An emerging consequence is the rise in cannabinoid hyperemesis syndrome (CHS), a condition associated with chronic CU. This study examined trends CHS-related acute health care encounters among youth across diverse sociodemographic groups using a nationally representative dataset. METHODS We conducted a retrospective cohort study using Epic COSMOS, a database encompassing a nationally representative sample of youth across the United States. The study included individuals aged 6 to 18 years who were diagnosed with CHS from 2017 to 2024. We calculated CHS-related encounter rates per 100 000 using the number of unique pediatric patients with acute health care encounters as the denominator. Trends were assessed using joinpoint regression to estimate the annual percent change (APC) and average annual percent change. RESULTS A total of 61 908 CHS-related acute health care encounters were identified among youth between 2017 and 2024. CHS encounter rates were consistently higher among female youth and continued to increase at a faster pace than male youth, with an APC of 16.1, compared with 11.2. Black youth had an APC of 18.5, and youth from other minority groups had the highest APC at 26.2, compared with other racial groups. CONCLUSIONS AND RELEVANCE CHS-related encounters are rising rapidly, with disproportionately higher increases among female and minority youth. These findings highlight the need for CU prevention efforts tailored to high-risk youth and improved clinical awareness of CHS to support timely diagnosis and management.