<i>Notes from the Field:</i> Acute Poisonings from a Synthetic Cannabinoid Sold as Cannabidiol — Utah, 2017–2018

Horth, Roberta; Crouch, Barbara Insley; Horowitz, B. Zane; Prebish, Amelia; Slawson, Matthew H.; McNair, Jennifer; Elsholz, Chris; Gilley, Stephen; Robertson, Jenny; Risk, Ilene; Hill, Mary; Fletcher, Linnea; Hou, Wei; Peterson, Dallin; Adams, Karlee; Vitek, Dagmar; Nakashima, Allyn K.; Dunn, Angela

doi:10.15585/mmwr.mm6720a5

Cited by 33 publications

(21 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25 From that time to May 2018, a total of 52 people were harmed due to this adulterant. 25 Similarly, the International Cannabis and Cannabinoid Institute in the Czech Republic assessed 29 CBD products and found that 69% of them exceeded recommended levels of polycyclic aromatic hydrocarbons. Polycyclic aromatic hydrocarbons are classified as class IIa carcinogens and genotoxic mutagens according to the International Agency for Research on Cancer.…”

Section: Legality Of Cbd and Quality Controlmentioning

confidence: 99%

“…Five patients in Utah experienced symptoms such as seizures, confusion, unconsciousness, and hallucinations in 2017 due to CBD. An in‐depth investigation found that a CBD product included a synthetic cannabinoid . From that time to May 2018, a total of 52 people were harmed due to this adulterant .…”

Section: Legality Of Cbd and Quality Controlmentioning

confidence: 99%

“…An in‐depth investigation found that a CBD product included a synthetic cannabinoid . From that time to May 2018, a total of 52 people were harmed due to this adulterant . Similarly, the International Cannabis and Cannabinoid Institute in the Czech Republic assessed 29 CBD products and found that 69% of them exceeded recommended levels of polycyclic aromatic hydrocarbons.…”

Section: Legality Of Cbd and Quality Controlmentioning

confidence: 99%

See 2 more Smart Citations

A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential

White

2019

The Journal of Clinical Pharma

200

142

View full text Add to dashboard Cite

Cannabidiol (CBD) is a highly touted product for many different disorders among the lay press. Numerous CBD products are available, ranging from a US Food and Drug Administration (FDA)-approved product called Epidiolex to products created for medical marijuana dispensaries and products sold in smoke shops, convenience stores, and over the Internet. The legal status of the non-FDA-approved products differs depending on the source of the CBD and the state, while the consistency and quality of the non-FDA-approved products vary markedly. Without independent laboratory verification, it is impossible to know whether the labeled CBD dosage in non-FDA-approved CBD products is correct, that the delta-9-tetrahydrocannabinol content is <0.3%, and that it is free of adulteration and contamination. On the Internet, CBD has been touted for many ailments for which it has not been studied, and in those diseases with evaluable human data, it generally has weak or very weak evidence. The control of refractory seizures is a clear exception, with strong evidence of CBD's benefit. Acute CBD dosing before anxiety-provoking events like public speaking and the chronic use of CBD in schizophrenia are promising but not proven. CBD is not risk free, with adverse events (primarily somnolence and gastrointestinal in nature) and drug interactions. CBD has been shown to increase liver function tests and needs further study to assess its impact on suicidal ideation.

show abstract

Section: Legality Of Cbd and Quality Controlmentioning

confidence: 99%

Section: Legality Of Cbd and Quality Controlmentioning

confidence: 99%

Section: Legality Of Cbd and Quality Controlmentioning

confidence: 99%

See 1 more Smart Citation

A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential

White

2019

The Journal of Clinical Pharma

200

142

View full text Add to dashboard Cite

show abstract

“…Between 2010-2013 the USA Poison Centers received 1700 calls regarding exposures to electronic cigarettes [13], between 2010-2014 the calls were 2405 [163] whereas between 2010-2018 the calls were 17,358 [164]. In Texas, Poison Centers received 225 calls between 2009-2014 [165], while in Utah 52 cases were reported to have been poisoned by a synthetic cannabinoid in 2017-2018 [166]. Between 2012-2015, 277 calls were made to 10 European Countries' Poison Centers [12], while in the UK, between 2008-2016, 278 calls were made to the National Poisons Information Service (NPIS) regarding children under 16 years old [167].…”

Section: Poisoningmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

View full text Add to dashboard Cite

Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016–2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.

show abstract

“…Adulteration of CBD oils most likely diminishes the benefits associated with the entourage effects of the natural constituents [5][6][7][8]. Furthermore, acute poisoning due to the addition of a synthetic cannabinoid to CBD products has been reported by a growing number of users [9]. Clearly, the CBD oil industry needs manufacturing and testing standards, regulatory oversight, and further research.…”

Section: Introductionmentioning

confidence: 99%

Potency Assessment of CBD Oils by Their Effects on Cell Signaling Pathways

Urasaki

Beaumont²,

Workman³

et al. 2020

Nutrients

View full text Add to dashboard Cite

This study used nanofluidic protein posttranslational modification (PTM) profiling to measure the effects of six cannabidiol (CBD) oils and isolated CBD on the signaling pathways of a cultured SH-SY5Y neuronal cell line. Chemical composition analysis revealed that all CBD oils met the label claims and legal regulatory limit regarding the CBD and tetrahydrocannabinol (THC) contents, respectively. Isolated CBD was cytotoxic, with an effective concentration (EC50) of 40 µM. In contrast, the CBD oils had no effect on cell viability at CBD concentrations exceeding 1.2 mM. Interestingly, only an unadulterated CBD oil had strong and statistically significant suppressive effects on the pI3K/Akt/mTOR signaling pathway with an EC50 value of 143 µM and a slow-acting timescale requiring hours. Systematic profiling of twenty-six proteins, which served as biomarkers for nine signaling pathways, revealed that the unadulterated CBD oil downregulated seven signaling pathways but had no measurable effect on the other two signaling pathways. The remaining CBD oils, which were adulterated, and isolated CBD had weak, variable, or undetectable effects on neuronal signaling pathways. Our data clearly showed that adulteration diminished the biological activities of CBD oils. In addition, nanofluidic protein PTM profiling provided a robust means for potency assessment of CBD oils.

show abstract

Notes from the Field: Acute Poisonings from a Synthetic Cannabinoid Sold as Cannabidiol — Utah, 2017–2018

Cited by 33 publications

References 4 publications

A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential

A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Potency Assessment of CBD Oils by Their Effects on Cell Signaling Pathways

Contact Info

Product

Resources

About