BIRMINGHAM, A.L. (WIAT) — At age 13, Leonna Davis lost her father to suicide. Years later, a little-known, marijuana-related disease forced Davis to a place where she, too, considered taking her own life.
Cannabinoid Hyperemesis Syndrome (CHS), a disease caused by the chronic use of marijuana, has become increasingly common across the country. Its symptoms — severe stomach pain and nausea, with relief coming only from scalding hot showers or heating pads — have caused increasing health care and utility bill costs, emotional and physical distress, and even, in some cases, suicidal thoughts among those who suffer from the syndrome.
For Davis, in the wake of her father’s death, smoking marijuana helped ease her pain. It was a relief from her PTSD and anxiety. Only a year later, though, the role of the drug in her life changed dramatically.
“Every morning, I’d wake up, and I’d have to throw up. I couldn’t eat. I couldn’t sleep. It was a complete nightmare,” Davis, a Huntsville native, said. “My episodes would last for hours at a time. I would throw up fifteen times in one, four-hour episode. I threw up for eight hours once, to the point that my throat was bleeding.”
Davis went to the doctor, who conducted a colonoscopy and endoscopy, saying the 15-year-old may be suffering from early-onset colon cancer. The results were normal. Doctors then shifted their concerns, worrying that Davis was bulimic. She was not.
“The only thing that ever helped with the nausea was scorching hot, boiling showers,” Davis said. “I would put hot rags on my face while I was in there. The only thing I could consume was popsicles and only while I was in the shower. And I could drink Ensure shakes. I didn’t eat solid food.”
From the time her symptoms began, Davis lost a total of 85 pounds. Because of her near-constant hot showers, her utility bills went up by $100 a month. She racked up over $1000 in hospital bills, even after insurance. She nearly lost her job in a dental lab because of her absences, even with doctor’s notes.
Eventually, Davis stopped consuming marijuana. Her symptoms subsided. “But I didn’t connect those dots,” she said.
When she began smoking again at age 17, her symptoms came back. Davis had undergone another colonoscopy by the time she was 18, but she would not find out that she suffered from CHS until she was 22.
Eight months ago, Davis was once again in the hospital and admitted to staff that she smoked marijuana. A nurse suggested that CHS may be the cause. The nurse was right.
“I was in the hospital with extreme dehydration. I was in and out of consciousness,” Davis said.
Davis stopped smoking immediately. Within a few months, all of her symptoms subsided.
Despite Davis’ experience, she said that she is not opposed to legalization that would legalize marijuana. Her message, instead, is a call for education.
“If you smoke weed,” Davis said, “please be informed. If you feel like you are starting to feel sick every day, in the mornings especially, and if hot showers are the only thing that helps you, please seek medical advice and mention CHS to get more information. This could kill you. People that continue to smoke have lost their lives because they were so dehydrated and didn’t seek help. I was lucky. I was able to get to the hospital in time. “
Davis is right about the danger of CHS. In 2019, for example, a 17-year-old in Indiana died after suffering from dehydration due to the disease, according to the coroner’s report.
Nina Griffith’s story doesn’t match Davis’ exactly, but it rhymes.
Griffith, who is originally from Florida, attended the University of Alabama from 2016 until 2019, when she moved to Denver, Colorado. In December, she will graduate from UA and from the Colorado Film School, but for a while, she didn’t know if she’d make it.
Around the time that COVID-19 began to grip the nation, closing businesses and forcing universities online, Griffith began to feel isolated and bored. While she had smoked occasionally before, the new normal that came with the coronavirus pushed her smoking into overdrive. She became a daily, heavy smoker. Then, the symptoms set in.
“I was nauseous all morning. I lost almost 30 pounds,” Griffith said.
Her only relief, like for Davis, came from hot showers.
“Hot showers were the only thing that helped me,” Griffith explained. “I would spend up to eight hours in the shower, literally just laying there.”
Griffith began to search the internet for answers and stumbled across information on CHS.
After five days of symptoms, and with a vague suspicion of what was causing them, Griffith went to the hospital for the first time. Doctors gave her fluids and confirmed she had the syndrome.
After the hospital visit, Griffith quit smoking for a while.
Three months ago, however, Griffith took a road trip with her boyfriend from her Denver home to visit family in Florida. Once they arrived, Griffith’s symptoms came back.
“When we got there, I completely shut down,” she said. “That’s when I realized that stress and trigger foods could lead to episodes. My sickness ruined the trip.”
When it was time for the return drive across the country, Griffith didn’t think she could make it. Her boyfriend drove back alone. Griffith would fly back a week later when her symptoms had settled.
“I knew then how serious this disease can be,” Griffith said. “It’s been debilitating.”
Griffith has now been sober for months, and while she feels fine, she says she doesn’t feel normal anymore.
“Something has permanently changed,” Griffith said.
Stories like Davis’ and Griffith’s resonate with Sue Justice, an 84-year-old who lives in Athens, Georgia.
Justice smoked marijuana for 30 years, but for the last 15, she’s suffered from the symptoms Davis and Griffith know all too well.
“Pain and nausea, pain and nausea, all the time,” Justice said. “I’d been to the ER four times.”
Once, while sick in the bathroom of her home, Justice fainted, causing a laceration. Her husband came in to check on her, asking what was wrong.
“I fainted,” Justice told him, lying on the marble floor. “Just let me lay here.”
Justice was never asked whether she smoked marijuana. Instead of a CHS diagnosis, Justice was given a colonoscopy and endoscopy. Like Davis’, the results were normal. Doctors then asked Justice to see an oncologist, who suggested that she may have cancer.
For Justice, “cancer” wasn’t what she wanted to hear, but at least it was something she could understand.
“And I thought, you know, maybe I have cancer, but at least I’ll know. I’m so sick. Just give me an answer,” she said.
After testing, the oncologist ruled out the possibility.
With her symptoms still a puzzle, Justice turned to a place CHS patients often do: Google. She began scouring any and every website she could to find a disease that fit her symptoms.
Somehow along the way, Justice found a Facebook support group for CHS. The group, she said, would save her life.
“If I hadn’t found the group,” Justice said, “I wouldn’t be here today. I might’ve killed myself. I didn’t want to be here anymore.”
Justice was also dealing with the stress of a husband whose Alzheimer’s disease was progressing.
“If I’d have had my choice to live or die, I’d have rather been dead,” Justice said.
Once she stopped smoking, the symptoms began to subside. The pain and nausea gradually went away. Justice could eat normally again. Her weight went from 129 back up to 155 pounds.
“Some people just don’t want to believe that it’s the pot, but it is,” Justice said. “It’s nothing but the pot.”
Like Davis and Griffith, though, CHS hasn’t changed Justice’s opinion on the legalization of weed, particularly for medicinal uses.
“Weed is the biggest healer on the planet when used right,” Justice said. “It will alleviate nausea. It’s the best thing since sliced bread, just not for us.”
The group that Justice said saved her life was intended to do just that.
The Facebook group, called “Cannabinoid Hyperemesis Syndrome Recovery,” now has over 12,000 members.
Erica Hagler, who lives in New England, started the group around a year and a half ago after her own experience with CHS.
Hagler smoked marijuana for around 18 years. Her symptoms started around eight years ago, and about three years ago, they became unbearable.
“It got to the point where I couldn’t go out anymore,” she told CBS 42. “I would start cancelling plans, not wanting to hang out with friends.”
Hagler even started having fainting spells, but she never attributed it to the weed.
Three years ago, Hagler and her then-boyfriend traveled to Martha’s Vineyard, where he proposed. The stress and excitement from the engagement pushed Hagler over the edge.
“That’s when I had my first full-blown episode,” she explained. “I went to the hospital for two weeks the day after my engagement.”
Just like Davis, Griffith and Justice, Hagler would not get a quick answer from health care professionals.
“The doctors tested me for everything they could think of,” Hagler said. “It got to the point where they said there’s nothing else we can test you for and asked me to leave the hospital.”
Hagler continued to suffer, losing 20 pounds in just three weeks.
“Once I had started vomiting, I could not stop,” she said. “I almost died.”
Hagler then began to do her own research and read about CHS. She stopped smoking and slowly began to feel better.
“I had been in another support group that would blame the disease on the pesticides and not the weed itself,” she said.
So Hagler started a support group of her own. That group has now grown to a community of thousands — the group that Sue Justice said saved her life.
“People have said I work for ‘big pharma,’ that I’m anti-weed,” Hagler said. “That’s not true. I’m just a person that refused to be sick anymore, and if there was any way I could stop people from feeling the way I was feeling, I was going to do it.”
Dr. Joseph Habboushe has heard many stories like these.
Habboushe is an Assistant Professor of Clinical Emergency Medicine at Weill Cornell Medical College and works at emergency rooms across New York City. He has conducted multiple studies about CHS.
“We started seeing more and more patients with this disease, and it was something that we knew very little about,” he said of CHS. “It’s a syndrome that has been grossly under diagnosed.”
Habboushe was also intrigued by the paradox of CHS: that what it cures in some, it causes in others.
“Marijuana decreases nausea in the acute setting and here you have something paradoxical, where it’s increasing nausea and pain.”
Habboushe’s first research on the topic, though, was spurred by one of his own patients.
Habboushe had a patient that he worried would suffer kidney failure from severe dehydration.
“But that doesn’t happen from one day of vomiting. That happens after significant, significant vomiting,” the doctor said. “But I had this patient with CHS who had a day or so of vomiting and had acute renal failure.”
While he knew that constant vomiting and the inability to drink water were present in CHS patients, he thought there must be another factor contributing to these kidney issues. The answer? Hot showers.
“A lot of CHS patients are taking showers in very hot temperatures — hotter than hot tubs, which you aren’t supposed to be in for more than 20 or 30 minutes,” he said.
Habboushe’s second study on CHS garnered even more attention. Using survey data from an emergency room setting, he found that about a third of those smoking marijuana 20 or more days a month experienced symptoms like those of the people documented in this story. Based on these numbers, the study estimated that upwards of 2.75 million Americans may be suffering from symptoms of CHS, a number that has likely increased as marijuana laws have become more relaxed.
“Folks would call CHS rare in the medical literature, and I hated that,” Habboushe said. “I’m a scientist and you shouldn’t use a word if you don’t have evidence to back it up. They called it rare, but it wasn’t rare. We doctors were just rarely noticing what it was, and that was our bad.”
Habboushe said that while ER doctors are becoming more familiar with CHS, there is always room for improvement. Among primary care doctors, he said that the disease is lesser known.
Ignorance of CHS, its symptoms, and its treatment — cessation of marijuana consumption — can lead to increased health care costs, like for the colonoscopies and endoscopies that those in this story were subjected to. As CHS becomes more commonly known and better understood, though, Habboushe said those costs may be reduced.
“Now that we know CHS better,” Habboushe said, “I think we can start to avoid those costs and those workups.”
Habboushe said that while he’s apolitical when it comes to the legalization of marijuana, what those on both sides of the argument should agree on is an effort to study the effects of the drug.
“One commonality on both sides of the argument — folks who want to legalize and those completely against it — is that they’re not arguing that we should study things,” Habboushe said. “We should study these things. We shouldn’t be shy to study it. All of us should agree that science should be involved.”
As for those who may be suffering with CHS, Habboushe said that the “cure” to their ailment is relatively simple.
“If you consume cannabis and hot showers help, the next thing should be cessation,” Habboushe said. “It’s not easy, and patients may need support to stop, but quitting is the answer.”