Diagnosis and management of cannabis-related emergencies

Despite current legal and medical controversies surrounding cannabinoids, it is a fact that emergency departments are seeing an increasing number of patients presenting with symptoms associated with the use of these drugs. This review outlines the pathophysiology of cannabinoids, the potential clinical findings associated with their use, and the current evidence for best practice management of patients who present with signs of acute intoxication and chronic use. Differences between natural and synthetic cannabinoids are discussed, along with evidence for diagnosing and managing patients presenting with the intractable vomiting of cannabinoid hyperemesis syndrome. Emerging treatments for cannabinoid hyperemesis syndrome are presented as well as an update on the legal status of medical cannabinoid substances.