Emergency Department Visits From Edible Versus Inhalable Cannabis
Authors: Nora D. Volkow, Ruben Baler
Journal: Annals of Internal Medicine (2019)

Editorials16 April 2019Emergency Department Visits From Edible Versus Inhalable CannabisNora D. Volkow, MD and Ruben Baler, PhDNora D. Volkow, MDNational Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (N.D.V., R.B.) and Ruben Baler, PhDNational Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (N.D.V., R.B.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0542 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The legalization of cannabis in a growing number of states coupled with the perception that marijuana is an innocuous drug has led to significant increases in cannabis consumption, both for its recreational properties and for its alleged medicinal properties. However, cannabis use is associated with adverse health effects (1), and cannabis-related emergency department (ED) visits and hospital admissions have increased (2).In this issue, Monte and colleagues reviewed health records from patients presenting to the UCHealth University of Colorado Hospital Emergency Department from 2012 to 2016 and found a more than 3-fold increase in cannabis-associated ED visits over this period ...References1. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370:2219-27. [PMID: 24897085] doi:10.1056/NEJMra1402309 CrossrefMedlineGoogle Scholar2. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Osterthaler KM, Banner W. 2017 annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 35th annual report. Clin Toxicol (Phila). 2018;56:1213-415. [PMID: 30576252] doi:10.1080/15563650.2018.1533727 CrossrefMedlineGoogle Scholar3. Monte AA, Shelton SK, Mills E, Saben J, Hopkinson A, Sonn B, et al. Acute illness associated with cannabis use, by route of exposure. An observational study. Ann Intern Med. 2019;170:531-7. doi:10.7326/M18-2809 LinkGoogle Scholar4. Allen JH, de Moore GM, Heddle R, Twartz JC. Cannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuse. Gut. 2004;53:1566-70. [PMID: 15479672] CrossrefMedlineGoogle Scholar5. Volkow ND, Swanson JM. Variables that affect the clinical use and abuse of methylphenidate in the treatment of ADHD. Am J Psychiatry. 2003;160:1909-18. [PMID: 14594733] CrossrefMedlineGoogle Scholar6. Noble MJ, Hedberg K, Hendrickson RG. Acute cannabis toxicity. Clin Toxicol (Phila). 2019:1-8. [PMID: 30676820] doi:10.1080/15563650.2018.1548708 CrossrefMedlineGoogle Scholar7. Vandrey R, Raber JC, Raber ME, Douglass B, Miller C, Bonn-Miller MO. Cannabinoid dose and label accuracy in edible medical cannabis products. JAMA. 2015;313:2491-3. [PMID: 26103034] doi:10.1001/jama.2015.6613 CrossrefMedlineGoogle Scholar8. Stott CG, White L, Wright S, Wilbraham D, Guy GW. A phase I study to assess the effect of food on the single dose bioavailability of the THC/CBD oromucosal spray. Eur J Clin Pharmacol. 2013;69:825-34. [PMID: 23052407] doi:10.1007/s00228-012-1393-4 CrossrefMedlineGoogle Scholar9. Zgair A, Wong JC, Lee JB, Mistry J, Sivak O, Wasan KM, et al. Dietary fats and pharmaceutical lipid excipients increase systemic exposure to orally administered cannabis and cannabis-based medicines. Am J Transl Res. 2016;8:3448-59. [PMID: 27648135] MedlineGoogle Scholar10. Damkier P, Lassen D, Christensen MMH, Madsen KG, Hellfritzsch M, Pottegård A. Interaction between warfarin and cannabis. Basic Clin Pharmacol Toxicol. 2019;124:28-31. [PMID: 30326170] doi:10.1111/bcpt.13152 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland (N.D.V., R.B.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0542.Corresponding Author: Nora D. Volkow, MD, National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, NSC Building, Room 5274, MS 9581, Rockville, MD 20852; e-mail, [email protected]nih.gov.Current Author Addresses: Dr. Volkow: National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, NSC Building, Room 5274, MS 9581, Rockville, MD 20852.Dr. Baler: Office of Science Policy and Communications, National Institute on Drug Abuse, 6001 Executive Boulevard, Room 5241, MSC 9561, Bethesda, MD 20892-9561.This article was published at Annals.org on 26 March 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAcute Illness Associated With Cannabis Use, by Route of Exposure Andrew A. Monte , Shelby K. Shelton , Eleanor Mills , Jessica Saben , Andrew Hopkinson , Brandon Sonn , Michael Devivo , Tae Chang , Jacob Fox , Cody Brevik , Kayla Williamson , and Diana Abbott Metrics Cited byA cross-sectional survey on cannabis: Characterizing motives, opinions, and subjective experiences associated with the use of various oral cannabis productsSelf-reported impacts of recreational and medicinal cannabis use on driving ability and amount of wait time before drivingOccurrence and correlated factors of physical and verbal violence among emergency physicians in ChinaAbuse Potential of Cathinones in Humans: A Systematic ReviewModes of cannabis use among Canadian youth in the COMPASS study; using LCA to examine patterns of smoking, vaping, and eating/drinking cannabis3. The Changing Cannabis Product Mix and Environmental Health and Quality ConcernsImportance of a standard unit dose for cannabis researchSerotonin Syndrome versus Cannabis Toxicity in the Emergency DepartmentLooking at Marijuana Through the Lens of Public HealthCannabis and Neuropsychiatric EffectsPriming primary care providers to engage in evidence-based discussions about cannabis with patientsMedicine Flying Blindly Into Marijuana Complications?International Perspectives on the Implications of Cannabis Legalization: A Systematic Review & Thematic AnalysisMedicine Flying Blindly Into Marijuana Complications? 16 April 2019Volume 170, Issue 8Page: 569-570KeywordsAdverse eventsBloodCannabisCannabis useDrug absorptionDrug abuseDrug usersDrugsEmergency departmentFats ePublished: 26 March 2019 Issue Published: 16 April 2019 PDF downloadLoading ...