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Cannabinoid hyperemesis syndrome is an increasingly common problem associated with significant morbidity. Decriminalization of marijuana use in many states and widespread availability and acceptance in many other jurisdictions has led to increased use of marijuana. Nearly 1 in 5 persons in the United States over age 12 years (nearly 50 million persons) endorses annual use of marijuana. Within this group, an increasing number are frequent or even daily users. Among the side effects of daily use is the cannabinoid hyperemesis syndrome (CHS). Characterized by cyclical, sometime unrelenting emesis, CHS is best treated by cessation of cannabinoid ingestion; supportive care and effective pharmaceutical treatments may be necessary for more serious cases.