Unintentional ingestion of psychoactive cannabis products among adults: A scoping review

Cannabis products are widely accessible, yet adult presentations after unintentional ingestion of psychoactive Δ9-tetrahydrocannabinol (THC), synthetic cannabinoids, or adulterated cannabidiol (CBD) remain poorly described. This scoping review summarizes adult unintentional THC exposures among adults seeking medical care with confirmed ingestion, verified either by positive THC urine drug screens or detection of THC/synthetic cannabinoids in partially consumed food products, using five major databases (2023-2025). Of 370 manuscripts screened, 16 met criteria, reporting 84 adult cases (ages 18-94 years). Most involved THC-containing baked goods or candy. Common presenting symptoms included dizziness, dry mouth/mucous membranes, confusion, vision changes, paresthesia, nausea/vomiting, speech difficulties, anxiety, and somnolence. Hypertension, memory impairment, lethargy, incoordination, and tachycardia were frequent. Stroke was often the leading differential, with food poisoning commonly suspected. Most patients recovered within 24 h, though some reported lingering subjective symptoms (e.g., fatigue, anxiety). Clinicians should consider inadvertent cannabis ingestion in patients with stroke-like presentations lacking focal findings or with altered mental status plus gastrointestinal complaints, and ask about consumption of foods prepared by others, as well as use of purported CBD-only supplements.