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According to a retrospective study, exposure to cannabis, whether inhaled or edible, can result in acute illness ranging from cannabinoid hyperemesis syndrome to myocardial infarction.
Emergency visits badociated with cannabis use increased in Colorado after the liberalization of cannabis for medical purposes in 2009 and recreational cannabis in 2014. There is little evidence regarding the potential harms of cannabis. edible and inhalable cannabis products.
Dr. Andrew A. Monte, of the University of Colorado School of Medicine in Aurora, Colorado, and the Rocky Mountain Poison and Drug Center in Denver, Colorado, and his colleagues evaluated the emergency adult visits badociated with edible and inhalable cannabis products as part of the University of Colorado's Emergency Department.
Of the 449,031 visits, 9,973 included cannabis-related diagnosis codes (ICD-9-CM or ICD-10-CM), of which 2,567 visits (25.7%) were considered at least partially attributable to cannabis.
Most exposures (2 194 out of 2 567) were considered by inhalation, while edible ingestion was reported during 293 visits, according to 25 March 2019, Annals of Internal Medicine report online.
The most common reasons for visits attributable to cannabis were gastrointestinal symptoms (30.7%), including cannabinoid hyperemesis syndrome, intoxication (29.7%) and psychiatric symptoms ( 24.7%).
Cannabinoid hyperemesis syndrome was more common in patients exposed to inhalable cannabis (18.0% versus 8.4% with edible cannabis), whereas acute psychiatric visits were more frequent in patients with edible exposure (18.0% vs. 10.9% with inhalable cannabis). Cardiovascular symptoms were also more frequent with edible exposure (8.0%) than with inhalation exposure (3.1%) and serious adverse cardiovascular events, including myocardial infarction and ventricular arrhythmia. occurred during both exhibitions.
Between 2014 and 2016, edible products accounted for 10.7% of visits attributable to cannabis, but only 0.32% of total cannabis sales in Colorado.
"Future studies on emergency room visits attributable to cannabis should be stratified by exposure and should take into account the exposure of the population to inhalable and edible products," the researchers concluded.
Dr. Nora D. Volkow, Director of the National Institute on Drug Abuse, Bethesda, MD, who co-wrote an editorial on this report, told Reuters Health by email: "One of the findings that I found particularly revealing is the number Emergency visits for consumption of edible products (10.7%) were 33 times astonishing as would be expected from the share of estimated market for edible products (0.32%). This single finding suggests that, in relative terms, edible products may present higher risk of serious adverse effects than inhalable cannabis, also reflecting, among other things, different clinical presentations. "
"It is important for doctors to understand that scientists do not yet have a clear idea of the overall potential adverse health consequences of cannabis use," she said. "This is compounded by the fact that the potency of current marijuana is significantly higher than that of the 1980s, which raises questions about the relevance of previous studies as well as concerns that the consequences of marijuana use could to be more serious now than in the past. "
"It is essential that doctors be better informed about the importance of screening for cannabis use and the potential for adverse effects badociated with it," said Dr. Volkow.
She added, "In 2014, we predicted that if policy changes were implemented quickly without the required contribution from the medical, scientific, or strategic research community, it was very likely that such initiatives could magnify the potential. Unexpected Negative Consequences in Legal Drugs (Alcohol and Tobacco) provide a sobering perspective, as they represent the heaviest burden of disease badociated with drugs, not because they are more dangerous than drugs. illicit drugs, but because legal status allows more widespread exposure. "
"As policies evolve towards the legalization of marijuana," said Dr. Volkow, "it is reasonable and probably prudent to expect that its use will increase and that, by extension, the number of people for whom there will be adverse consequences for health will also increase. "
Dr. Monte did not respond to a request for comment.
-Bill Boggs, MD
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