Have you had patients recently with repeat EMS calls and lots of ED visits for nausea and vomiting? They say the only thing that works for them is scalding hot showers and that drug that starts with a "D." Did they happen to smoke a lot of weed? In this episode, Dr. Jarvis discusses cannabinoid hyperemesis syndrome and reviews an RCT comparing topical capsaicin cream (yes... the stuff of pepper spray fame) vs placebo.