Marijuana intoxication depends on the dosage and can occur through various consumption methods, including smoking, vaporizing, ingestion, or drinking.
The concentration of THC (tetrahydrocannabinol), the active compound in marijuana, varies widely, influencing the onset and severity of symptoms.
While marijuana is used for both recreational and therapeutic purposes, it’s essential to recognize that acute and chronic intoxication can occur.
Physical Effects of THC Toxicity
The initial state of acute intoxication presents a spectrum of symptoms, from euphoria and sensory intensification to motor impairment.
However, not all cannabis intoxication symptoms are positive, as users may also experience panic, fear, or depression. The impact extends to the cardiovascular system, inducing tachycardia and postural hypotension. In animal models, high doses have shown central nervous system and respiratory depression.
THC doses of 2 to 3 mg through inhalation or 5 to 20 mg through ingestion can impair attention, memory, and executive functioning. Higher doses may lead to edibles overdose and severe symptoms such as hypotension, panic, anxiety, respiratory depression, and ataxia. Chronic use may result in long-term cognitive effects, respiratory disorders, and conditions like cyclic vomiting syndrome.
Evaluation
Standard urine drug screens detect THC metabolites, with lower limits ranging from 20 to 100 ng/mL. False positives may occur due to various factors, including dronabinol, certain medications, and hemp seed oil.
The timeline for exposure and severity of cannabinoid poisoning can be challenging to correlate, with positive results reported up to 30 days after heavy daily use. Alternative detection methods include hair testing, oral fluid testing within 24 hours, blood testing within 14 to 21 days, and proposed breathalyzer tests.
Differential Diagnosis
Various conditions can mimic THC toxicity symptoms, including allergic asthma, anxiety disorders, atrial tachycardia, benzodiazepine toxicity, and hallucinogen use. A comprehensive evaluation is essential to differentiate and ensure appropriate management.
Treatment/Management
Most individuals with THC intoxication do not require testing, but if chest pain is present, an electrocardiogram and cardiac markers may be warranted.
Symptomatic management is the mainstay of treatment, considering factors like age and the amount ingested. Accidental poisoning, particularly in geriatric and pediatric patients, may necessitate intensive care admissions. Cannabis-induced psychotic disorders may require up to 24 hours for safe detoxification, potentially longer in persistent cases.
THC Poisoning in Teens
As THC levels in cannabis products approach 100 percent, teenagers are facing increased risks of poisoning, marked by severe consequences such as psychosis, addiction, and chronic vomiting.
The potency of current cannabis products, often containing around 90 percent THC, goes beyond the typical marijuana experience.
Teens exposed to these highly concentrated forms of THC are not only at risk of dependency but also vulnerable to dangerous health issues, highlighting the concerning impact of potent cannabis products on adolescent well-being.
Enhancing Healthcare Team Outcomes
THC toxicity is becoming increasingly common in emergency rooms due to limited quality control over manufacturing.
An interprofessional team, including internists, psychiatrists, and occasionally cardiologists, plays a crucial role in managing patients. Educating parents about the potential adverse effects of THC and secure storage away from children’s reach is crucial for effective prevention.
