Emergency department presentations related to acute toxicity following recreational use of cannabis products in Switzerland

Schmid, Yasmin; Scholz, Irene; Mueller, Laura; Exadaktylos, Aristomenis K.; Ceschi, Alessandro; Liechti, Matthias E.; Liakoni, Evangelia

doi:10.1016/j.drugalcdep.2019.107726

Cited by 26 publications

(30 citation statements)

References 36 publications

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“…A study of three Swiss hospitals found that 26% of 717 ED visits for cannabis were due to cannabis use alone [55]. These 186 patients presented with complaints of nausea/vomiting 26%, palpitations 25%, anxiety 23% and chest pain 15%.…”

Section: Ed Cannabis Presentations Acute Intoxication/overdosementioning

confidence: 99%

“…Therefore, if a patient using cannabis presents with any cardiac symptoms, particularly one with known structural heart disease, we would recommend treating the patient as a potential cardiac patient first and foremost keeping in mind that even young people may have undiagnosed structural heart disease or could have a dysrhythmia. We propose performing a sound cardiac workup that considers an ECG, cardiac markers and a chest X-ray rather than attributing or disregarding cannabis as the culprit of their symptoms without the need for further workup, recalling that palpitations and chest pain are common complaints with cannabis use [33,51,55]. Future research may reveal prognostic cardiovascular responses in children and adults when using varying modes, quantities and types of cannabis.…”

Section: Ed Cannabis Presentations Acute Intoxication/overdosementioning

confidence: 99%

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The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

Takakuwa¹,

Schears

2021

Int J Emerg Med

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Background Cannabis is the most prevalent illegal drug used and the second most common cause of ED drug-related complaints in the USA. Recently, newer more potent strains, concentrated THC products, and consumption methods have become available. Objective Our first objective was to define cannabis use in the USA and provide a summary background on its current preparations, pharmacokinetics, vital sign and physical exam findings, adverse effects, and laboratory testing. Our second objective, using the aforementioned summary as relevant background information, was to present and summarize the care and treatment of the most commonly reported cannabis-related topics relevant to ED physicians. Methods We first performed an extensive literature search of peer-reviewed publications using New PubMed and Cochrane Central Register of Controlled Trials to identify the most commonly reported cannabis-related topics in emergency care. Once the six topic areas were identified, we undertook an extensive narrative literature review for each section of this paper using New PubMed and Cochrane Central Register of Controlled Trials from the inception of the databases to September 30, 2020. Results The six subject areas that were most frequently reported in the medical literature relevant to cannabis-related ED care were acute intoxication/overdose, pediatric exposure, cannabinoid hyperemesis syndrome, cannabis withdrawal, e-cigarette or vaping product use-associated lung injury (EVALI), and synthetic cannabinoids. Conclusion As cannabis becomes more widely available with the adoption of state medical cannabis laws, ED-related cannabis visits will likely rise. While cannabis has historically been considered a relatively safe drug, increased legal and illegal access to newer formulations of higher potency products and consumption methods have altered the management and approach to ED patient care and forced physicians to become more vigilant about recognizing and treating some new cannabis-related life-threatening conditions.

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Section: Ed Cannabis Presentations Acute Intoxication/overdosementioning

confidence: 99%

Section: Ed Cannabis Presentations Acute Intoxication/overdosementioning

confidence: 99%

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

Takakuwa¹,

Schears

2021

Int J Emerg Med

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“…Emergency department visits secondary to cannabis toxicity have enhanced in adolescents and adults, with doubled rates in those aged 12 to 17 years between 2004 and 2011, and also in the pediatric population after producing new cannabis edibles, such as hemp oil, candy, popcorn, and beverages [10,12]. Also, parents' outbreak of cannabis usage with their children at home has risen from 4.9% to 6.8% from 2002 to 2015 and increased in the call volume to poison control centers for unintentional pediatric cannabis exposure [11,13]. This rise in pediatric unintentional cannabis intoxication is likely multifactorial: it is mostly associated with diverse modes of delivery, increased availability, and improved palatability of cannabis [10].…”

Section: Cannabis-related Emergency Visit In Pediatric Populationmentioning

confidence: 99%

“…Overall, cannabis use alone usually does not demand an emergency visit. However, severe symptoms might emerge when cannabis use is concomitant with other substances, especially psychoactive substances (approximately 1/4 of the cases), and emergency admission might be needed [13]. Cannabis use alone mostly leads to minor toxicity with neurobehavioral symptoms, including panic attacks, nausea, anxiety, cardiovascular activation, and vomiting [13].…”

Section: Severe Cannabis-related Adverse Outcome Requiring Emergency Admissionmentioning

confidence: 99%

“…However, severe symptoms might emerge when cannabis use is concomitant with other substances, especially psychoactive substances (approximately 1/4 of the cases), and emergency admission might be needed [13]. Cannabis use alone mostly leads to minor toxicity with neurobehavioral symptoms, including panic attacks, nausea, anxiety, cardiovascular activation, and vomiting [13]. There are rare but severe complications, such as coma, and other cases require intubation and intensive care unit admission or psychiatric care [13].…”

Section: Severe Cannabis-related Adverse Outcome Requiring Emergency Admissionmentioning

confidence: 99%

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Cannabinoid Acute Intoxication, Diagnosis, and Management

Alghamdi¹,

Samman²,

Bahader³

et al. 2021

Int j pharm res allied sci

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Cannabis use is a common behavior among adults and adolescents, particularly after legalization in certain countries. It also reported that pediatric exposure to cannabinoid-containing products has increased for the same reason. Acute cannabinoid intoxication affects almost every part of the body, especially cardiovascular, nervous, and gastrointestinal systems, in addition to its psychoactive effects. This article aims to review the background of cannabis and its impact on the human body and review the common adverse outcomes, including the fatal consequences. Also, in this article, we aim to address the therapeutic approach of cannabinoid intoxication in the emergency setting. We used the PubMed database looking for relevant articles on the topic, addressing the emergency setting specifically. We used the following Mesh words: Cannabis, delta-9-tetrahydrocannabinol, cannabinoid intoxication, emergency department. Cannabinoid provides various body effects, but gastrointestinal and psychiatric complaints were the most common symptoms requiring emergency visits. Luckily, most of those patients do not demand hospital admission and are successfully discharged after symptomatic management. However, severe but rare symptoms must be adequately addressed, especially in concomitant use of another illicit drug, leading to respiratory depression, severe cardiovascular outcomes, or even death.

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Development and initial validation of a reliable German self‐report measure to assess acute cannabis intoxication‐effects (CanTox‐17)

Schüler

Moritz

Schnell

2022

Int J Methods Psych Res

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Objectives Both positive and negative including psychotic‐like cannabis intoxication effects are well‐established. Yet, consequences for consumption patterns, addictive behavior or psychotic developments are poorly researched in general, in Germany not at all. Thus, objective was to develop the first German‐language questionnaire operationalizing acute cannabis intoxication effects, based on the original “Cannabis Experience Questionnaire” (CEQ). Methods After expert translation of the CEQ, items related to acute intoxication effects were presented to a sample of 537 cannabis users. Four‐ and five‐factorial solutions of explorative factor analysis with a randomly split sub‐sample 1 were cross‐validated by confirmatory factor analysis on sub‐sample 2. Results After content review of factors and analysis of external validity, a 17 item four‐factorial model was approved. Factors are (1) “paranoia/dysphoria”, (2) “confusion/disorientation”, (3) “euphoria/creativity”, (4) “psychosis‐like/loss of reality”. Model fit is satisfactory (RMSEA = 0.058, SRMR = 0.065, CFI = 0.929, TLI = 0.914). Correlations with corresponding external measures support construct validity. Conclusions The present questionnaire is a time‐efficient, valid and reliable instrument. Thus, predictors of different cannabis intoxication effects can be analysed for the first time in German‐speaking area, as well as their significance for substance use or psychosis risk.

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Emergency department presentations related to acute toxicity following recreational use of cannabis products in Switzerland

Cited by 26 publications

References 36 publications

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

Cannabinoid Acute Intoxication, Diagnosis, and Management

Development and initial validation of a reliable German self‐report measure to assess acute cannabis intoxication‐effects (CanTox‐17)

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