How long does vomiting from marijuana use typically last?

Duration of Marijuana-Induced Vomiting

Vomiting from acute marijuana intoxication typically resolves within 2-3 hours as the psychoactive effects wear off, but if you're dealing with cannabinoid hyperemesis syndrome from chronic heavy use, the cyclical vomiting episodes will only stop with complete cannabis cessation. 1

Acute Marijuana Intoxication

For typical marijuana-induced nausea and vomiting from a single use or overdose:

• Inhaled/smoked cannabis: Psychoactive effects including nausea peak within seconds to minutes and last 2-3 hours 1
• Oral cannabis products: Onset is 30 minutes to 2 hours with effects lasting 5-8 hours 1
• The vomiting associated with acute intoxication resolves as the THC effects dissipate within this timeframe 1

Critical pitfall: Adults unfamiliar with oral cannabis often "stack doses" before the first dose takes effect (≥1 hour), leading to prolonged symptoms including nausea that can last the full 5-8 hour duration 1

Cannabinoid Hyperemesis Syndrome (CHS)

If vomiting is from CHS—which occurs after long-standing heavy cannabis use (typically >4 times per week for over a year):

• The cyclical vomiting episodes will NOT resolve without complete cannabis cessation 1
• CHS is characterized by recurrent emetic episodes that mimic cyclic vomiting syndrome 1
• Episodes are temporarily relieved by hot showers or baths 1, 2
• Treatment focuses exclusively on cannabis cessation—there is no other effective intervention 1

Withdrawal Timeline After Cessation

Once cannabis is stopped in heavy chronic users:

• Withdrawal symptoms begin within 24-72 hours (typically within 3 days) 1, 3
• Symptoms include irritability, restlessness, anxiety, sleep disturbances, appetite changes, and abdominal pain 1, 3
• Symptoms typically last up to 14 days 1
• In extreme cases with 5+ years of extremely heavy daily use, some symptoms may persist up to 12 weeks 2
• Complete THC elimination takes 4-12 weeks in chronic heavy users due to slow release from adipose tissue 2

Clinical Decision Algorithm

Step 1: Determine if this is acute intoxication or CHS

• Acute: Single/occasional use → expect resolution in 2-8 hours depending on route 1
• CHS: Chronic heavy use (>4x/week for >1 year) + cyclical vomiting + hot shower relief → requires cessation 1

Step 2: If CHS is suspected

• Counsel that vomiting will continue cyclically until cannabis is completely stopped 1
• Warn that withdrawal symptoms will emerge within 3 days and last up to 2 weeks 1, 3
• Provide symptomatic relief for withdrawal (sleep aids, anxiety management) but avoid opioids which worsen nausea 2

Step 3: Monitor for complications

• In older adults, watch for cardiovascular events (myocardial ischemia, arrhythmias) during acute toxicity 4, 2
• Screen for depression or psychosis during withdrawal, which requires specialist consultation 3

Key distinction: Unlike opioid overdose, cannabis overdose does not cause respiratory depression, but excessive ingestion can cause distressing symptoms and increase fall risk 1