What is Marijuana Toxicity (Marijuana Overdose)?
“Marijuana” generally refers to a product made from the leaves and flowers of the cannabis sativa and cannabis indica plants, comparable to tobacco. These plants contain many compounds that can affect the mind, often called cannabinoids. The main one, believed to be responsible for the intoxicating effects users feel, is tetrahydrocannabinol (THC). The strength of different marijuana products can vary a lot, because the amount of THC in the cannabis plant itself can change based on factors like weather, soil, and how it’s grown. Plus, the amount of THC that actually enters a person’s body depends on how the marijuana is consumed. The effect that marijuana has on a person can depend on many things, such as how much they take, how they take it, their past experiences with marijuana, their thoughts and feelings about the drug, and the social setting they’re in when they use it.
What Causes Marijuana Toxicity (Marijuana Overdose)?
Marijuana use, also referred to as grass, ganja, hashish, etc., can cause a high that depends on how much is used. The effect on the body varies because of its concentration and the method of use.
Use of marijuana includes smoking or vaporizing because they can bring immediate effects. But, people can also consume marijuana through food, like in brownies, or as a drink, like in tea. It is believed that smoking marijuana has a stronger effect, up to 2.6 times more potent according to some reports.
Marijuana is used for both stress relief and entertainment but also for medical treatment. However, even though some individuals believe marijuana is harmless, it’s possible to experience both immediate and long-term negative effects.
Risk Factors and Frequency for Marijuana Toxicity (Marijuana Overdose)
The World Health Organization (WHO) states that marijuana is the most widely grown, trafficked, and misused illegal drug in the world. About 2.5% of the global population, or 147 million people, use it. Men use it more often than women, and this gender gap has grown from 2007 to 2014. Marijuana use is particularly common among teenagers and young adults.
- An annual American survey of drug use among middle and high school students (“Monitoring the Future”) found that yearly marijuana use rates ranged from around 9% for 8th graders to 35% for 12th graders.
- In the United States, marijuana is classified as a Schedule 1 drug, which means it is not approved for medical use at the federal level and has a high risk of misuse.
Signs and Symptoms of Marijuana Toxicity (Marijuana Overdose)
Acute intoxication from consuming too much cannabis can lead to a range of symptoms and effects. On the positive side, people might experience feelings of extreme happiness, a different perception of time and space, enhanced sensory experiences, and impaired motor functions. However, not all effects are enjoyable. Some people might experience negative reactions like panic, fear, or depression.
Acute intoxication can also have an impact on the heart and blood vessels, leading to side effects like increased heart rate and low blood pressure when standing up. Consuming large doses can depress the central nervous system and respiratory systems. For example, inhaled doses between 2 to 3 mg of THC or ingested doses between 5 to 20 mg of THC can cause problems with attention, memory, and other cognitive functions. More severe symptoms like low blood pressure, panic, anxiety, small, involuntary muscle movements, confusion, breathing problems, and uncoordinated movements can occur when adults inhale doses > 7.5 mg/m2 or when children ingest doses between 5 to 300 mg.
Physical examination can often detect inflammation of the eyes, regardless of how the cannabis was consumed. In children, signs of serious poisoning can be detected through nervous system abnormalities like lethargy and excessive activity. In adults, serious toxicity is rare, but those needing medical help often suffer from severe episodes of vomiting, behavioural issues, or a medical emergency like severe asthma due to inhalation.
The duration of these effects varies, from hours to days. In the long term, frequent use can lead to cognitive impairment, lack of motivation and energy, respiratory disorders, and in some instances, a condition that causes severe, cyclical vomiting. Cannabis can also lead to acute psychosis in those predisposed and can worsen pre-existing psychotic conditions like schizophrenia. Some affected individuals often face psychiatric symptoms including feeling detached from oneself, fear of impending death, irrational panic and paranoia.
- Feelings of extreme happiness
- Different perception of time and space
- Enhanced sensory experiences
- Impaired motor functions
- Panic, fear, or depression
- Increase in heart rate or low blood pressure when standing up
- Cognitive problems related to attention and memory
- Small, involuntary muscle movements
- Confusion
- Respiratory issues
- Uncoordinated movements
- Inflammation of the eyes
- Cognitive impairment
- Lack of motivation or energy
- Respiratory disorders
- A condition that causes severe, cyclical vomiting
- Acute psychosis
Testing for Marijuana Toxicity (Marijuana Overdose)
A standard urine drug test can detect THC metabolites, mainly THC carboxylase. These tests can pick up lower limits between 20 to 100 ng/mL. Testing positive because of second-hand exposure is highly unlikely in teenagers and adults, and we don’t know about children yet. Some substances may lead to false positives for THC. These include dronabinol, efavirenz, protons pump inhibitors (PPIs), hemp seed oil, Nonsteroidal anti-inflammatory drugs (NSAIDs), and baby wash products in infants. However, false positives are much less likely in labs that can use gas chromatography. The timeframe to test positive can be up to 10 days after weekly use or up to 30 days after heavy daily use. Consequently, correlating the severity of intoxication can be quite difficult.
Although not as common, there are other ways to detect marijuana use. One method is to look for THC carboxylase in hair samples. This method can identify use up to three months after, but it will not show positive until weeks after use has started. Detection of THC can also be accomplished in saliva within 24 hours and in blood within about 14 to 21 days of use. Breathalyzer tests have been proposed, but this method is not widely used. This is because small amounts of cannabis continue to be released from fat into the blood long after the user no longer feels high, making the results unreliable.
Treatment Options for Marijuana Toxicity (Marijuana Overdose)
Generally, teenagers and adults do not require testing for the diagnosis or treatment of cannabis intoxication. However, if one experiences chest pain, it is reasonable to get a 12-lead electrocardiogram and potentially check for signs of heart damage. This is because there is an estimated 4.8 times higher risk of a heart attack within an hour of using marijuana.
People who have ingested toxic substances should also be screened for the ingestion of other substances, especially if there are signs of electrolyte abnormalities or changes in their EKG. In some cases, particularly with children or when the exposure is unknown, more extensive tests may be necessary. These could include checking blood sugar levels, electrolytes, blood gas analysis, and brain scans like CT scans. However, in cases of known cannabis exposure, brain scans should be avoided unless there are specific neurological symptoms or concerns for other issues such as head trauma.
The treatment for cannabis intoxication largely involves managing the symptoms. The extent of the treatment depends on various factors such as the person’s age and the amount of cannabis consumed. There have been several instances of accidental cannabis poisoning in elderly patients leading to intensive care admissions due to a decrease in central nervous system activity. Unintentional ingestion by children has also led to similar hospital admissions. For those experiencing cannabis-induced psychotic disorders, safe detoxification typically takes about 24 hours, but it can sometimes take longer if persistent psychosis or unstable vitals signs occur.
What else can Marijuana Toxicity (Marijuana Overdose) be?
These terms are related to various health conditions and issues. Here’s a breakdown for easier understanding:
- Allergic and environmental asthma: A type of asthma triggered by allergies or environmental factors like dust or smoke.
- Anxiety disorders: A group of mental health disorders characterized by feelings of anxiety and fear.
- Atrial tachycardia: An abnormal heart rhythm that makes your heart beat faster than normal while at rest.
- Benzodiazepine toxicity: A potentially severe medical condition that occurs as a result of an overdose of medication called benzodiazepines.
- Brief psychotic disorders: A short-term condition when a person experiences sudden and severe symptoms of psychosis including delusions, hallucinations, and confused speech.
- Delirium: An abrupt change in the brain that causes confusion and reduced awareness of the environment.
- Depression: A common mental health disorder that involves persistent sadness, loss of interest, and negative feelings.
- Hallucinogen use: The ingestion of substances that can cause hallucinations, changes in thought processes, or other alterations in perception.
- Panic disorder: A type of anxiety disorder where a person experiences sudden attacks of panic and fear without any obvious reason.
- Primary hypersomnia: A sleep disorder where a person experiences excessive daytime sleepiness or prolonged night sleep.
