Emergency department presentations related to acute toxicity following recreational use of cannabis products in Switzerland.
Yasmin Schmid, Irene Scholz, Laura Mueller, Aristomenis K Exadaktylos, Alessandro Ceschi, Matthias E. Liechti, Evangelia Liakoni
Drug and Alcohol Dependence 2020 DOI: 10.1016/j.drugalcdep.2019.107726 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective analysis Peer reviewed |
|---|---|
| Sample size | 717 |
| Population | Patients presenting at emergency departments of three large hospitals in Switzerland due to acute toxicity related to cannabis recreational use |
| Topics | Cannabis |
| Keywords | Acute toxicity Emergency department Recreational use |
| Key points | Intoxication with cannabis alone was mostly associated with minor toxicity, but severe complications such as psychosis, coma, and seizures occurred, indicating considerable health risks. |
Abstract
Concomitant use of cannabis and other psychoactive substances is common and it is often difficult to differentiate its acute effects from those of other substances. This study aimed to characterize the acute toxicity of cannabis with and without co-use of other substances. Retrospective analysis of cases presenting at the emergency departments of three large hospitals in Switzerland due to acute toxicity related to cannabis recreational use. Among 717 attendances related to acute cannabis toxicity, 186 (26 %) were due to use of cannabis alone. The median patient age was 26 years (range 14-68), and 73 % were male. Commonly reported symptoms/signs in lone-cannabis cases included nausea/vomiting (26 %), palpitations (25 %), anxiety (23 %), and chest pain (15 %); there were no fatalities and most intoxications were of minor severity (61 %). Most patients (83 %) using cannabis alone were discharged from the emergency department, 8 % were referred to psychiatric, and two (1 %) to the intensive care; severe complications included psychosis (7 %), coma (6 %), and seizures (5 %) and one patient (<1 %) required intubation. Lone-cannabis patients presented more often with palpitations, anxiety, panic attacks, and chest pain than patients in the co-use group, whereas the latter presented more often with impaired consciousness, agitation, respiratory depression and hallucinations, and were more often admitted to psychiatric or intensive care. Intoxication with cannabis alone was mostly associated with minor toxicity. Nevertheless, severe complications and cases requiring admission to intensive or psychiatric care were also reported, which indicates that intoxication with cannabis alone does not exclude considerable health risks.
Comparable studies
Other observational and cohort studies on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| High-potency cannabis and the risk of psychosis People with first episode of psychosis and healthy controls from the local population | 2009 | Case-control study | n = 454 |
| Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada Rural aboriginal population | 2013 | Observational study | |
| Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people | 2000 | Observational | |
| Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study Individuals from the general population in Germany aged 14-24 at baseline | 2011 | Observational cohort | n = 1,923 |
| Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases Patients treated for cannabis-induced psychotic symptoms in Denmark between 1994 and... | 2005 | Observational cohort | n = 535 |
Citations in the library
Cited by 4
- Rates and correlates of cannabis-associated psychotic symptoms in over 230,000 people who use cannabis Translational Psychiatry September 6, 2022
- Predictive impact of different acute cannabis intoxication effects with regard to abstinence motivation and cessation of use Scientific Reports January 13, 2023
- Comparison between pediatric and adult acute natural cannabinoids toxicity: A 5-year retrospective study with special consideration of acute synthetic cannabinoids toxicity. Toxicology Reports June 1, 2025
- Differences in clinical features associated with cannabis intoxication in presentations to European emergency departments according to patient age and sex. Clinical Toxicology August 2022
Cites 10
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and 5 more in the library