151% Increase in hospitalization costs for severe vomiting and nausea from marijuana use after MA legalizes marijuana

Chronic marijuana users are at risk of developing a condition called Cannabis Hyperemesis Syndrome, also known as CHS. Patients with CHS experience severe and continuous vomiting and abdominal pain attributed to their marijuana use. Due to the lack of data on the utilization and costs of hospital services for patients with CHS post marijuana legalization, researchers analyzed a decade of data from January 1, 2012 to June 1, 2021, from the large urban hospital, Tufts Medical Center, in Boston, Massachusetts. They examined inpatient hospitalization services and related costs for putative (presumed) CHS pre- and post-marijuana legalization.

Compared to pre-legalization, there were significant increases observed for patients with putative CHS during the post-marijuana legalization period, that included the following:

  • hospital admissions,
  • length of hospital stay per patient (from one day to three days),
  • the cost of inpatient hospitalization (after accounting for inflation, rose from $8,520 to $18,714),
  • treatment with medications to treat vomiting and nausea, and
  • costs for IV fluids and endoscopy services.

Data also revealed, although not statistically significant, that no patients with putative CHS prior to legalization needed intensive care (ICU) whereas 9 patients with putative CHS required ICU post marijuana legalization. Similarly, the number of endoscopies and imaging studies performed as well as gastrointestinal consults/service admissions all increased for patients with putative CHS post legalization.

Like the authors highlight, the rise in imaging studies, endoscopies, and use of gastrointestinal consults, signify the trouble in diagnosing CHS and the need to educate providers on this condition. These findings reveal the significant burden that the condition CHS has on not only the patient but the healthcare system and needs to be factored in when evaluating the impacts of legalization and development of health policy.


Marshall, A., Fai, C., Han, J., Yule, A. M., & Jangi, S. (2023). Rising Inpatient Utilization and Costs of Cannabis Hyperemesis Syndrome Hospitalizations in Massachusetts After Cannabis Legalization. J Clin Gastroenterol. doi: 10.1097/MCG.0000000000001857