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

Abstract 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 c...

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Main Authors: Kevin M. Takakuwa, Raquel M. Schears
Format: Article
Language:English
Published: BMC 2021-02-01
Series:International Journal of Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12245-021-00330-3
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author Kevin M. Takakuwa
Raquel M. Schears
author_facet Kevin M. Takakuwa
Raquel M. Schears
author_sort Kevin M. Takakuwa
collection DOAJ
description Abstract 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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spelling doaj.art-555aeb95da574e7290b850cc00b217112022-12-21T22:39:38ZengBMCInternational Journal of Emergency Medicine1865-13721865-13802021-02-0114111810.1186/s12245-021-00330-3The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative reviewKevin M. Takakuwa0Raquel M. Schears1Society of Cannabis CliniciansUniversity of Central FloridaAbstract 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.https://doi.org/10.1186/s12245-021-00330-3CannabisMarijuanaCannabinoid hyperemesis syndromeWithdrawalEVALISynthetic cannabinoids
spellingShingle Kevin M. Takakuwa
Raquel M. Schears
The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review
International Journal of Emergency Medicine
Cannabis
Marijuana
Cannabinoid hyperemesis syndrome
Withdrawal
EVALI
Synthetic cannabinoids
title The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review
title_full The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review
title_fullStr The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review
title_full_unstemmed The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review
title_short The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review
title_sort emergency department care of the cannabis and synthetic cannabinoid patient a narrative review
topic Cannabis
Marijuana
Cannabinoid hyperemesis syndrome
Withdrawal
EVALI
Synthetic cannabinoids
url https://doi.org/10.1186/s12245-021-00330-3
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