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Critical Illness Secondary to Synthetic Cannabinoid Ingestion
Ismini Kourouni1,2, Bashar Mourad1,3, Hassan Khouli1,4
1Department of Medicine, Mount Sinai Morningside and Mount Sinai West Hospitals, Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA Network Open
|July 21, 2020
Summary
Synthetic cannabinoid (SC) intoxication poses a severe public health risk, often leading to life-threatening complications like respiratory failure and coma. These drugs are undetectable by standard toxicology tests, necessitating clinical vigilance for diagnosis and treatment.
Area of Science:
- Toxicology
- Emergency Medicine
- Public Health
Background:
- Synthetic cannabinoids (SCs), known as K2 or spice, are artificial drugs causing significant public health concerns.
- Their low cost and accessibility contribute to widespread recreational use and associated health risks.
Purpose of the Study:
- To detail the clinical symptoms and outcomes of synthetic cannabinoid intoxication.
- To highlight the challenges in diagnosing SC use due to limitations in standard toxicology screening.
Main Methods:
- A case series was conducted on adult patients admitted to the ICU between 2014 and 2016.
- Data collected included demographics, medical history, symptoms, physical findings, lab results, and ICU/hospital course.
Main Results:
- Thirty patients with SC ingestion presented with coma, agitation, or seizures.
- Acute respiratory failure occurred in 60% of patients, requiring intubation in 70%. Rhabdomyolysis was present in 26% of cases.
- Routine toxicology was negative in 53% of patients, indicating SCs are difficult to detect.
Conclusions:
- Synthetic cannabinoid use can result in severe, life-threatening conditions including toxic encephalopathy, respiratory failure, and death.
- Clinicians must suspect SC intoxication based on clinical presentation, as standard tests are often unrevealing.
- Awareness and vigilance are crucial for frontline healthcare providers managing SC intoxication cases.
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