Abstract
Cannabis has a long history of human use for recreational and medicinal purposes. Recently, its legal status has been in transition with legalization of cannabis occurring in multiple US states and many more allowing its medicinal use. The marijuana plant has several psychoactive compounds, with the primary components being tetrahydrocannabinol (THC) and cannabidiol (CBD). Cannabis can be consumed in a variety of formulations, including those derived from the marijuana plant, as well as synthetic cannabinoid agents. Intoxication with cannabis typically presents with euphoria and perceptual changes, although psychotic and anxiety symptoms can also occur. Intoxication infrequently leads to psychiatric or medical admission, and distressing psychiatric symptoms often resolve with sobriety. In individuals with underlying psychiatric illness, including psychotic disorders, cannabis and synthetic cannabinoid use may contribute to onset, recurrence, or exacerbation of symptoms.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Pain S. A potted history. Nature. 2015;525(7570):S10–1.
Mechoulam R, Parker LA. The endocannabinoid system and the brain. Annu Rev Psychol. 2013;64:21–47.
Leggett T, United Nations Office on Drugs and Crime. A review of the world cannabis situation. Bull Narc. 2006;58(1):1–155.
United Nations Office on Drugs and Crime, World Drug Report 2016. Vienna United Nations.
Gomez-Ruiz M, Hernandez M, de Miguel R, Ramos JA. An overview on the biochemistry of the cannabinoid system. Mol Neurobiol. 2007;36(1):3–14.
McGuire P, Robson P, Cubala WJ, Vasile D, Morrison PD, Barron R, et al. Cannabidiol (CBD) as an adjunctive therapy in schizophrenia: a multicenter randomized controlled trial. Am J Psychiatry. 2018;175(3):225–31.
Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825–36.
Gunderson EW, Haughey HM, Ait-Daoud N, Joshi AS, Hart CL. “Spice” and “K2” herbal highs: a case series and systematic review of the clinical effects and biopsychosocial implications of synthetic cannabinoid use in humans. Am J Addict. 2012;21(4):320–6.
Barnett BOM. Synthetic cannabinoid use in a transitional housing shelter: a survey to characterize awareness of risks and reasons for use. Am J Psychiatry Residents’ J. 2016;11(10):4–6.
Every-Palmer S. Synthetic cannabinoid JWH-018 and psychosis: an explorative study. Drug Alcohol Depend. 2011;117(2–3):152–7.
700 Street Names for Synthetic Marijuana (Spice, K2, etc.).
Monte AA, Calello DP, Gerona RR, Hamad E, Campleman SL, Brent J, et al. Characteristics and treatment of patients with clinical illness due to synthetic cannabinoid inhalation reported by medical toxicologists: a ToxIC database study. J Med Toxicol. 2017;13(2):146–52.
Tournebize J, Gibaja V, Kahn JP. Acute effects of synthetic cannabinoids: update 2015. Subst Abus. 2017;38(3):344–66.
Lev-Ran S, Le Foll B, McKenzie K, George TP, Rehm J. Cannabis use and cannabis use disorders among individuals with mental illness. Compr Psychiatry. 2013;54(6):589–98.
Conway KP, Compton W, Stinson FS, Grant BF. Lifetime comorbidity of DSM-IV mood and anxiety disorders and specific drug use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006;67(2):247–57.
Foti DJ, Kotov R, Guey LT, Bromet EJ. Cannabis use and the course of schizophrenia: 10-year follow-up after first hospitalization. Am J Psychiatry. 2010;167(8):987–93.
Subbaraman MS, Kerr WC. Simultaneous versus concurrent use of alcohol and cannabis in the National Alcohol Survey. Alcohol Clin Exp Res. 2015;39(5):872–9.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, D.C.: American Psychiatric Association; 2013.
Ashton CH. Pharmacology and effects of cannabis: a brief review. Br J Psychiatry. 2001;178:101–6.
Ranganathan M, D’Souza DC. The acute effects of cannabinoids on memory in humans: a review. Psychopharmacology. 2006;188(4):425–44.
Neavyn MJ, Blohm E, Babu KM, Bird SB. Medical marijuana and driving: a review. J Med Toxicol. 2014;10(3):269–79.
Rogeberg O, Elvik R. The effects of cannabis intoxication on motor vehicle collision revisited and revised. Addiction. 2016;111(8):1348–59.
Adams AJ, Banister SD, Irizarry L, Trecki J, Schwartz M, Gerona R. “Zombie” outbreak caused by the synthetic cannabinoid AMB-FUBINACA in New York. N Engl J Med. 2017;376(3):235–42.
Hurst D, Loeffler G, McLay R. Psychosis associated with synthetic cannabinoid agonists: a case series. Am J Psychiatry. 2011;168(10):1119.
Radhakrishnan R, Wilkinson ST, D’Souza DC. Gone to pot – a review of the Association between Cannabis and Psychosis. Front Psych. 2014;5:54.
Blackstone M, Callahan J. An unsteady walk in the park. Pediatr Emerg Care. 2008;24(3):193–5.
Wang GS, Roosevelt G, Heard K. Pediatric marijuana exposures in a medical marijuana state. JAMA Pediatr. 2013;167(7):630–3.
Bonkowsky JSD, Pomeroy S. Ataxia and shaking in a 2-year-old girl: acute marijuana intoxication presenting as seizure. Pediatr Emerg Care. 2005;21(8):527–8.
Appelboam A, Oades PJ. Coma due to cannabis toxicity in an infant. Eur J Emerg Med. 2006;13(3):177–9.
Boros CA, Parsons DW, Zoanetti GD, Ketteridge D, Kennedy D. Cannabis cookies: a cause of coma. J Paediatr Child Health. 1996;32(2):194–5.
Carstairs SD, Fujinaka MK, Keeney GE, Ly BT. Prolonged coma in a child due to hashish ingestion with quantitation of THC metabolites in urine. J Emerg Med. 2011;41(3):e69–71.
Bonnet U, Preuss UW. The cannabis withdrawal syndrome: current insights. Subst Abus Rehabil. 2017;8:9–37.
Budney AJ, Moore BA, Vandrey RG, Hughes JR. The time course and significance of cannabis withdrawal. J Abnorm Psychol. 2003;112(3):393–402.
Hirvonen J, Goodwin RS, Li CT, Terry GE, Zoghbi SS, Morse C, et al. Reversible and regionally selective downregulation of brain cannabinoid CB1 receptors in chronic daily cannabis smokers. Mol Psychiatry. 2012;17(6):642–9.
Vandrey RG, Budney AJ, Hughes JR, Liguori A. A within-subject comparison of withdrawal symptoms during abstinence from cannabis, tobacco, and both substances. Drug Alcohol Depend. 2008;92(1–3):48–54.
Allsop DJ, Copeland J, Norberg MM, Fu S, Molnar A, Lewis J, et al. Quantifying the clinical significance of cannabis withdrawal. PLoS One. 2012;7(9):e44864.
Levin KH, Copersino ML, Heishman SJ, Liu F, Kelly DL, Boggs DL, et al. Cannabis withdrawal symptoms in non-treatment-seeking adult cannabis smokers. Drug Alcohol Depend. 2010;111(1–2):120–7.
Macfarlane V, Christie G. Synthetic cannabinoid withdrawal: a new demand on detoxification services. Drug Alcohol Rev. 2015;34(2):147–53.
Aryana A, Williams MA. Marijuana as a trigger of cardiovascular events: speculation or scientific certainty? Int J Cardiol. 2007;118(2):141–4.
Dines AM, Wood DM, Galicia M, Yates CM, Heyerdahl F, Hovda KE, et al. Presentations to the emergency department following cannabis use – a multi-centre case series from ten European countries. J Med Toxicol. 2015;11(4):415–21.
Sun S, Zimmermann AE. Cannabinoid hyperemesis syndrome. Hosp Pharm. 2013;48(8):650–5.
Witsil JC, Mycyk MB. Haloperidol, a novel treatment for cannabinoid hyperemesis syndrome. Am J Ther. 2017;24(1):e64–e7.
Hamadeh R, Ardehali A, Locksley RM, York MK. Fatal aspergillosis associated with smoking contaminated marijuana, in a marrow transplant recipient. Chest. 1988;94(2):432–3.
Havakuk O, Rezkalla SH, Kloner RA. The cardiovascular effects of cocaine. J Am Coll Cardiol. 2017;70(1):101–13.
Monte AA, Zane RD, Heard KJ. The implications of marijuana legalization in Colorado. JAMA. 2015;313(3):241–2.
Riederer AM, Campleman SL, Carlson RG, Boyer EW, Manini AF, Wax PM, et al. Acute poisonings from synthetic cannabinoids – 50 U.S. Toxicology Investigators Consortium Registry Sites, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016;65(27):692–5.
Cooper Z. Adverse effects of synthetic cannabinoids: management of acute toxicity and withdrawal. Curr Psychiatry Rep. 2016;18(5):52.
Sampson CS, Bedy SM, Carlisle T. Withdrawal seizures seen in the setting of synthetic cannabinoid abuse. Am J Emerg Med. 2015;33(11):1712.
Huestis MA, Mitchell JM, Cone EJ. Detection times of marijuana metabolites in urine by immunoassay and GC-MS. J Anal Toxicol. 1995;19(6):443–9.
Wohlfarth A, Scheidweiler KB, Castaneto M, Gandhi AS, Desrosiers NA, Klette KL, et al. Urinary prevalence, metabolite detection rates, temporal patterns and evaluation of suitable LC-MS/MS targets to document synthetic cannabinoid intake in US military urine specimens. Clin Chem Lab Med. 2015;53(3):423–34.
Leweke FM, Gerth CW, Klosterkotter J. Cannabis-associated psychosis: current status of research. CNS Drugs. 2004;18(13):895–910.
Leikin JB, Amusina O. Use of dexmedetomidine to treat delirium primarily caused by cannabis. Am J Emerg Med. 2017;35(3):524 e1–2.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Sidelnik, S.A., Benzer, T.I. (2019). Cannabis Use Disorders and Related Emergencies. In: Donovan, A., Bird, S. (eds) Substance Use and the Acute Psychiatric Patient. Current Clinical Psychiatry. Humana, Cham. https://doi.org/10.1007/978-3-319-23961-3_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-23961-3_4
Published:
Publisher Name: Humana, Cham
Print ISBN: 978-3-319-23960-6
Online ISBN: 978-3-319-23961-3
eBook Packages: MedicineMedicine (R0)