What Is 'Scromiting'? New Medical Slang Divides Experts

A new gut-turning slang term for a symptom of prolonged cannabis use has started circulating, and it's dividing experts. Medical professionals say the symptom should serve as a warning. Marijuana advocates call it fearmongering.

In recent weeks, "scromiting" has made its way into headlines. The 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, told USA TODAY that most emergency department physicians he's spoken to in Cleveland 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 lack of research is muddying understanding of its cause. Armentano alleged CHS and "scromiting" are the latest anti-marijuana talking points.

"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 lieu 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 these criteria, according to the Rome Foundation:

• Cyclical vomiting

• Presentation after prolonged marijuana use

• Relief of vomiting after cessation of marijuana use

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 It?

The cause of CHS—outside of prolonged marijuana use—remains murky because research is limited. Streem said "prolonged," in this case, 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 marijuana patients used before developing CHS would help understand 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 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 is the cannabinoid associated with medical and recreational marijuana legislation and is regulated by 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.

How Common Is It?

Because research on CHS remains thin, it's hard to determine how common it is. Even current research is fairly inconsistent.

A study cited by the Cleveland Clinic found about 33% of self-reported frequent marijuana users visited an emergency room and met criteria for CHS. A small 2021 study of 321 patients who used marijuana and displayed nausea and vomiting found about 17% were suspected of having CHS.

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 manager Ettie Berneking told USA TODAY.

Treatment

The first step for treating CHS is ceasing marijuana use entirely, Streem said.

When it comes to medication, Streem said IV drips of substances like droperidol and haloperidol are often used in emergency rooms for CHS. Even the strongest anti-nausea medication given to chemotherapy patients, like Ondansetron, didn't stop it.

For temporary relief, hot showers or baths can relieve nausea and vomiting, according to the Cleveland Clinic. Capsaicin—hot pepper cream—can also be rubbed on the abdomen for some relief, Streem said.

The Controversy

Medical professionals see CHS as a real issue they're treating daily in emergency rooms. Cannabis advocates see it as rare and potentially linked to synthetic products, not traditional cannabis.

What's clear: some heavy marijuana users develop severe cyclical vomiting that only stops when they quit using cannabis. Whether that's common, rare, or linked to specific products remains debated.

The tried and true treatment? Stop using marijuana entirely. Not the answer cannabis advocates want to hear, but it's what stops the vomiting.

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