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Dr. Codi Peterson
Chief Science Officer
The Cannigma
SPEAKER
MEDICINE

Through the Eyes of a Patient: Integrating Story and Science to Demystify CHS

Objective
Cannabinoid Hyperemesis Syndrome (CHS) is a paradoxical condition characterized by recurrent nausea, vomiting, and abdominal pain among chronic cannabis users. Despite growing recognition, its onset, clinical variability, and patient burden remain poorly defined. This study aimed to characterize patterns of cannabis use, symptom trajectories, and patient experiences to improve understanding and inform earlier recognition and management.

Methods
An anonymous, online survey was distributed through social media to individuals who reported cannabis use prior to CHS symptom onset. Respondents provided information about product types, routes, frequency of use, symptom profiles, healthcare interactions, and treatment responses. Quantitative data were analyzed descriptively, and qualitative responses were thematically reviewed to identify common experiences and care barriers.

Results
A total of 1,134 respondents met inclusion criteria. Nearly all (96.5%) used cannabis daily, and 45% reported use six or more times per day before developing symptoms. Two-thirds (65.4%) had consumed cannabis for over three years before onset. Nausea and abdominal pain were the most frequent prodromal symptoms, often occurring in the morning. Women reported longer and more severe symptom cycles than men. Inhaled Δ9-THC–dominant products were most common, especially smoking and vaping.

A second phase of analysis explored the healthcare and personal burden of CHS. Participants described multiple emergency department visits, delayed diagnosis, and significant emotional and financial distress. Reported management strategies ranged from hot showers and topical capsaicin to prescription antiemetics and haloperidol, with variable effectiveness.

Conclusions
CHS predominantly affects long-term, heavy users of inhaled THC-dominant cannabis and carries considerable personal and healthcare burden. Findings highlight the need for improved provider awareness, earlier recognition, and patient-centered harm-reduction strategies. By integrating patient-reported outcomes with real-world data, this work advances clinical understanding of CHS and underscores opportunities for better education and intervention.

Learning Objectives:

  • Identify the key signs, symptoms, and varied presentations of Cannabinoid Hyperemesis Syndrome
  • Explain the current understanding of CHS and how recent patient survey data expand that knowledge
  • Formulate focused assessment questions and communication strategies for patients afflicted with CHS
BIO
Dr. Codi Peterson is a pediatric pharmacist with over a decade of experience specializing in acute care and pediatric emergency medicine. He currently serves as a clinical pharmacist at Rady's Children's Health of Orange County, where he works night shifts in the Emergency Department and applies his expertise to optimize medication safety and therapeutic outcomes in children. Beyond the hospital, Codi is deeply committed to education and mentorship. He is an Associate Clinical Professor at the University of California, Irvine, where he teaches cannabis pharmacology and therapeutics, and a guest lecturer at OCEMT, instructing paramedics and firefighters in applied pharmacology.

Through these roles, he bridges the gap between theory and frontline practice, emphasizing real-world clinical decision-making and patient-centered care. Codi also holds a Master of Science in Medical Cannabis Science and Therapeutics, which informs his research and advocacy work at the intersection of pharmacy and cannabinoid medicine. He is an active researcher on Cannabinoid Hyperemesis Syndrome (CHS), having led one of the largest patient surveys on the condition to date. As a board member of Americans for Safe Access (ASA), Codi contributes to national advocacy efforts supporting evidence-based cannabis policy and patient access. He is also the co-founder of the Pharmacists Cannabis Coalition of California (PCCC), a nonprofit organization dedicated to empowering pharmacists to engage responsibly in the cannabis space through education, advocacy, and professional collaboration. Outside of the ER and the classroom, Codi is a passionate science communicator who translates complex pharmacologic and cannabinoid science into accessible content for healthcare professionals and the public. His work has been featured across podcasts, professional conferences, and digital platforms such as LinkedIn, where he is recognized for his thoughtful discussions on the evolving role of pharmacists in integrative and cannabinoid-based medicine.

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