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A new, gut-turning slang term for a symptom of prolonged cannabis use has started to circulate, and it's dividing experts.
Medical professionals say the symptom should serve as a warning, while marijuana advocates call it fearmongering.
In recent weeks,"scromiting" has made its way into headlines. The image-inducing term combines "vomiting" and "screaming," a common symptom of cannabinoid hyperemesis syndrome (CHS), according to the Cleveland Clinic. Intense pain from cyclical vomiting caused by CHS may cause patients to scream while they throw up.
The term has grown in popularity as more states legalize medical and recreational marijuana. As of December, 24 states had legalized the substance recreationally.
Dr. David Streem, medical director of the Cleveland Clinic's Alcohol and Drug Recovery Center, said he's treated a range of patients with CHS over the years. He explained that even the strongest anti-nausea medication given to chemotherapy patients, like Ondansetron, didn't stop it.
Streem told USA TODAY on Dec. 5 that most emergency department physicians he's spoken to in the Cleveland, Ohio, area have treated a case of CHS every day for the past five years.
But marijuana advocates like Paul Armentano, deputy director of cannabis reform organization NORML, say CHS is actually "very rare," and a lack of research on the syndrome is mudding the understanding of its cause. Armentano alleged CHS and "scromiting" are the latest anti-marijuana talking point.
"The very fact that we're rebranding what was known for two decades as cannabinoid hyperemesis syndrome as scromiting. Scromiting is clearly sensational," Armentano said. "It's a made up, non-scientific term in leu of a very specific term and diagnosis that has now been recognized in the literature for a couple of decades."
What is cannabinoid hyperemesis syndrome?
Cannabinoid hyperemesis syndrome is a side effect of prolonged marijuana use that results in nausea, vomiting and abdominal pain, according to the Cleveland Clinic. To be diagnosed with CHS, a patient must meet the following criteria, according to the Rome Foundation, a nonprofit that sets medical diagnosis and treatment for gut-related disorders:
- Cyclical vomiting
- Presentation after prolonged marijuana use
- Relief of vomiting after the cessation of marijuana use
How long has cannabinoid hyperemesis syndrome been diagnosed?
CHS was first reported in Australian medical literature in 2004. A small study analyzed 19 patients with cyclical vomiting after prolonged marijuana use.
What causes cannabinoid hyperemesis syndrome?
The cause of CHS – outside of prolonged marijuana use – remains murky because research is limited. Streem said "prolonged," in the case of CHS, means daily marijuana use.
"I haven't really been able to connect potency, and in the papers and literature that I've seen, there's no good understanding of any trends as far as what percent THC is needed to cause this," Streem said.
Armentano agreed, adding that toxicology tests of the marijuana patients used before developing CHS would be helpful in understanding a more direct cause.
"That's my first question: Is there something unique or different about the product they are consuming? Particularly when you hear stories about people who say, 'I started using cannabis in my late teens or early 20s and I used it for 30 years and it was only in my mid-40s that I developed this syndrome,'" Armentano said. "That strikes me that there is something different about the cannabis."
Armentano said he wonders if unregulated or synthetic cannabis products Delta 8 and Delta 10 could cause CHS. Delta 8 and Delta 10 are federally legal to purchase and consume, as long as they contain 0.3% or less THC. Delta 9, on the other hand, is the cannabinoid associated with medical and recreational marijuana legislation. It is regulated by the states.
"It's very possible, if not likely, that at least in some of these cases, these could be people who are exposed to synthetic cannabis ... and simply don't know any better," he said. "They simply present themselves to the ER and say, 'I used marijuana.' Without the marijuana, we don't know if this is a synthetically-derived cannabis, like K2, or a synthetic hemp intoxicant that contains something like Delta 8 ... or if it was actually more traditional cannabis flower."
How common is cannabinoid hyperemesis syndrome?
Because research on CHS remains thin, it's hard to determine just how common it is. And even current research is fairly inconsistent.
A study cited by the Cleveland Clinic found that about 33% of self-reported frequent marijuana users visited an emergency room and met the criteria for CHS. And in a small 2021 study of 321 patients who used marijuana and displayed nausea and vomiting, about 17% were suspected of having CHS.
For a more local perspective, Mercy Hospital in Springfield, Missouri, a state that legalized recreational marijuana in 2023, reported 32 cases of CHS in its emergency department since January, media relations and communication manager Ettie Berneking told USA TODAY on Dec. 5.
What treatment is used for cannabinoid hyperemesis syndrome?
The first step for treating CHS is ceasing marijuana use entirely, Streem said.
When it comes to medication, Streem said an IV drip of substances such as droperidol and haloperidol are often used in emergency rooms for CHS.
As for temporary relief, hot showers or baths can relieve the nausea and vomiting, according to the Cleveland Clinic. Capsaicin, commonly referred to as hot pepper cream, can also be used, rubbed on the abdomen for some relief, Streem said.
Greta Cross is a national trending reporter at USA TODAY. Story idea? Email her at gcross@usatoday.com.
This article originally appeared on USA TODAY: What is 'scromiting'? New medical slang divides health experts, cannabis advocates
Reporting by Greta Cross, USA TODAY / USA TODAY
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