Bad weed: synthetic cannabinoid-associated coagulopathy

Area of Science:

• Toxicology
• Public Health
• Pharmacology

Background:

• Recent outbreaks link brodifacoum-tainted synthetic cannabinoids to coagulopathy.
• Long-acting anticoagulant rodenticides (LAARs) are implicated in these poisonings.

Purpose of the Study:

• To inform about synthetic cannabinoids and LAARs.
• To describe coagulopathic manifestations from adulterated synthetic cannabinoids.
• To outline management strategies for affected patients.

Main Methods:

• Review of clinical presentations and laboratory findings in patients with brodifacoum exposure.
• Analysis of the toxicological profile of brodifacoum and synthetic cannabinoids.
• Synthesis of current medical literature on LAAR toxicity and coagulopathy.

Main Results:

• Patients exhibit isolated vitamin K antagonism with or without bleeding.
• Detectable levels of brodifacoum and other LAARs are found in circulation.
• Synthetic cannabinoid use is a common factor in these cases.

Conclusions:

• Adulteration of synthetic cannabinoids with LAARs poses a significant public health risk.
• Prompt recognition of coagulopathy and toxic agent identification are crucial for effective management.
• Vitamin K therapy and supportive care are essential for patient recovery.