An analysis of cannabinoid hyperemesis syndrome Reddit posts and themes

Figures & data

Figure 1. Flowchart illustrating our data analysis process. *indicates the number of posts reviewed for triggers; **indicates the number of posts reviewed for therapies.

Table 1. Distribution of themes for the manually annotated cannabinoid hyperemesis syndrome posts (n = 69). Each post could be classified into multiple themes.

Theme	Count	%	Description	Subthemes
Timing	25	36.2	Time course of cannabinoid hyperemesis syndrome symptoms (e.g., cannabis use patterns recent and historical, timing onset cannabis use and symptoms, frequency and duration of cyclic vomiting episodes)	Frequency / duration of episodes Age at first cannabis use Time since daily use to onset of symptom Time since first use Time from termination of use to cessation of symptoms Definitions of stages of symptoms prodrome, retching, full episode
Treatment/prevention	19	27.5	Management strategies for cannabinoid hyperemesis syndrome symptoms (e.g., triggers, therapies, prevention strategy)	Strategies to prevent episodes Treating symptoms Triggers for episodes
Science	16	23.2	Proposed mechanisms and theories of drivers of cannabinoid hyperemesis syndrome (e.g., cannabis strain, tetrahydrocannabinol potency, pesticides, stress)	Other causes Drivers (mood): anxiety, stress, pain management Drivers (product): product type/strain; % tetrahydrocannabinol
Diagnosis/learning	13	18.8	Where and how gather information about cannabinoid hyperemesis syndrome (e.g., diagnosis, health care experience, questions of disease validity)	Diagnosis Emergency department experience Information Doubt that it is a real disease
Health impacts	12	17.4	Physical and psychosocial outcomes (e.g., anxiety, stress, loss of job, weight loss, kidney injury)	Health outcomes Consequences
N/A	18	26.1

Figure 2. Distribution of themes and posts in cannabinoid hyperemesis syndrome Reddit over time, August 2018 to November 2022.

Table 2. Machine learning model performances.

	F1 scores
	Timing	Health impacts	Treatment/prevention	Science	Diagnosis/learning	Macro-average
Naïve Bayes	0.55	0	0.55	0.57	0	0.33
Random Forest	0.75	0.67	0.75	0.75	0.67	0.72
RoBERTa	0.65	0.0	0.47	0.0	0.0	0.22

Table 3. Distribution of themes inferred via machine learning in 2,683 cannabinoid hyperemesis syndrome Reddit posts.

Theme	Number of posts
Science	492
Timing	320
Treatment/prevention	114
Diagnosis/learning	113
Health impacts	42

Figure 3. Triggers (top) and therapies (bottom) mentioned at least three times in our reviewed sample displaying words and phrases of posts.

Table 4. Health impacts theme sample excerpts from CHS Reddit posts.

Friends and Family Impacts

… i have missed moments with family and friends, i have stopped resting properly for months and i feel that this accumulated fatigue is beginning to affect my day to day. i really like how i feel when i‘m high but it’s really not worth it. i want to start a new stage in my life, be more responsible, dedicate myself to work, family, friends, good times.

… i can have people stay over or stay at friends/family house without constant fear of getting sick or actually getting sick and having to drive home throwing up the whole way and the list goes on !!

… it hasn’t been easy and it sucks knowing the pain and worry i‘ve put my family through. chs is very real. don’t be a dumbass like me

Work and School Impacts

… and i‘m finally, finally quiting for good because i can’t keep a job or take care of my son when i have these episodes. also, it’s the *only* times i‘ve ever wanted to… die.

… i have a full time job. this most recent bout of chs has put me out of work for over a month and it has absolutely ruined my life. i miss my job so much

… it was a monkey, rather a gorilla, in my gut, that kept me from a normal life, it cost me jobs, it cost me time, it cost me water and power bill money.

… had to take a month brake from school sadly to get everything sorted out after being hospitalized for chs.