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Cluster of Acute Toxicity from Ingestion of Synthetic Cannabinoid-Laced Brownies.

Adebisi I Obafemi, Kurt Kleinschmidt, Collin Goto, Drew Fout

Journal of Medical Toxicology December 1, 2015 DOI: 10.1007/s13181-015-0482-z (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case series Case report Peer reviewed
Sample size 11
Population Patients who ingested brownies laced with synthetic cannabinoid receptor agonist AM-2201
Duration Within 10 hours of exposure
Topics Cannabis
Keywords Acute toxicity Novel psychoactive substance Tachycardia
Key findings Oral exposure to brownies laced with AM-2201 caused neuropsychiatric and cardiovascular symptoms that resolved within hours.

Abstract

Synthetic cannabinoid receptor agonists (SCRAs) are emerging designer drugs of abuse. Most reports on the health effects of these drugs are case reports. Unlike SCRAs, marijuana has classically been used via many routes of exposure including oral, such as in brownies. We report on 11 symptomatic patients who unknowingly ingested brownies laced with analytically confirmed SCRA and presented with mostly neuropsychiatric and cardiovascular symptoms. All 11 patients were taken to the ED within 1 h of exposure with the onset of various symptoms. There were five males and six females, age range 20-57 years. Neuropsychiatric and cardiovascular symptoms predominated: memory impairment (91 %, 10/11) and inappropriate giggling (36 %, 4/11). All the patients had light-headedness, perioral and facial numbness and tingling sensation, dry mouth, difficulty focusing/blurring of vision, and sluggishness. No patient had depressed consciousness. Two patients had heart rates >100, and 4 of 11 (36 %) had BP >140/80. One patient had chest pain. All the symptoms were completely resolved 4 h following their onset except two patients who had ongoing weakness and fatigue. All patients had negative urine drugs of abuse immunoassays and ethanol, acetaminophen, and salicylate concentrations, as well as normal electrocardiograms (ECGS) and metabolic panels. The SCRA was confirmed to be AM-2201. All the patients were discharged from the ED in stable condition within 10 h of the exposure. Oral exposure of 11 patients to brownies laced with analytically confirmed SCRA resulted in neuropsychiatric and cardiovascular symptoms. This series reflects that like marijuana, oral exposures to SCRAs can lead to symptoms.

Comparable studies

Other case reports and case series on cannabis, most cited first.

Study Year Design Participants
Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication 2005 Case study n = 1
Cannabis‐induced Koro in Americans American men aged 22-26 with years of cannabis experience who reported negative... 2001 Case series n = 3
“Hallucinations” Following Acute Cannabis Dosing: A Case Report and Comparison to Other Hallucinogenic Drugs Healthy 30-year-old male 2018 Case study n = 1
Hallucinogen persisting perception disorder: A literature review and three case reports Patients with hallucinogen persisting perception disorder 2018 Case series n = 3
A Case of Butane Hash Oil (Marijuana Wax)–Induced Psychosis A 34-year-old male veteran 2016 Case study n = 1

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