TY - JOUR
T1 - Characteristics and Treatment of Patients with Clinical Illness Due to Synthetic Cannabinoid Inhalation Reported by Medical Toxicologists
T2 - A ToxIC Database Study
AU - On Behalf Of The Acmt Toxicology Investigators Consortium (Toxic)
AU - Monte, Andrew A.
AU - Calello, Diane P.
AU - Gerona, Roy R.
AU - Hamad, Eike
AU - Campleman, Sharan L.
AU - Brent, Jeffery
AU - Wax, Paul
AU - Carlson, Robert G.
N1 - Funding Information:
Dr. Monte receives support from NIH 1 K23 GM110516 and NIH CTSI UL1 TR001082. Dr. Monte has a patent pending for a synthetic cannabinoid clinical assay and has been awarded funding through the Department of Defense for examination of patterns of use of synthetic cannabinoids and assay development. A subset of the data collected was funded by the grant NIH R56 DA038366 (Carlson, Sheth, Boyer, PIs).
Publisher Copyright:
© 2017, American College of Medical Toxicology.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Introduction : Synthetic cannabinoid (SC) abuse has resulted in numerous outbreaks of severe clinical illness across the United States over the past decade. The primary objective of this study was to determine the clinical characteristics of patients abusing SC requiring bedside consultation by medical toxicologists. Methods: This was a multicenter analysis from a prospectively collected cohort of patients presenting to medical care after synthetic cannabinoid exposure, utilizing the ToxIC Registry. Management of cases by medical toxicologists in this cohort occurred in emergency departments, inpatient medical floors, and intensive care units. Cases were identified from January 5, 2010 – July 31, 2015. We characterized the clinical presentations, treatments, outcomes, and sociologic factors associated with SC use in these patients. Results: Medical toxicologists participating in the ToxIC Registry cared for 39,925 cases between 2010 and 2015. Three hundred fifty three of these cases were determined to be SC toxicity. The median age of patients was 25 (IQR: 18, 36) and the majority were males (84%). The most common symptoms were agitation, delirium and toxic psychosis, n=146 (41%). Forty-four (12.5%) had heart rates above 140 beats per minute. Bradycardia was the second most commonly reported severe vital sign abnormality with 20 (5.7%) having heart rates of less than 50 beats per minute. Fifteen (4.2%) patients had hypotension. Fifty-nine (17%) had seizures. The most common pharmacologic treatment provided was benzodiazepines (n=131, 37%) followed by antipsychotics (n=36, 10%).Disposition was available for 276; of these 167 (61%) were managed in the emergency department, 42 (15%) were admitted to the hospital floor, and 67 (24%) were admitted to the ICU. Conclusions: Synthetic cannabinoids are associated with severe central nervous system and cardiovascular effects.
AB - Introduction : Synthetic cannabinoid (SC) abuse has resulted in numerous outbreaks of severe clinical illness across the United States over the past decade. The primary objective of this study was to determine the clinical characteristics of patients abusing SC requiring bedside consultation by medical toxicologists. Methods: This was a multicenter analysis from a prospectively collected cohort of patients presenting to medical care after synthetic cannabinoid exposure, utilizing the ToxIC Registry. Management of cases by medical toxicologists in this cohort occurred in emergency departments, inpatient medical floors, and intensive care units. Cases were identified from January 5, 2010 – July 31, 2015. We characterized the clinical presentations, treatments, outcomes, and sociologic factors associated with SC use in these patients. Results: Medical toxicologists participating in the ToxIC Registry cared for 39,925 cases between 2010 and 2015. Three hundred fifty three of these cases were determined to be SC toxicity. The median age of patients was 25 (IQR: 18, 36) and the majority were males (84%). The most common symptoms were agitation, delirium and toxic psychosis, n=146 (41%). Forty-four (12.5%) had heart rates above 140 beats per minute. Bradycardia was the second most commonly reported severe vital sign abnormality with 20 (5.7%) having heart rates of less than 50 beats per minute. Fifteen (4.2%) patients had hypotension. Fifty-nine (17%) had seizures. The most common pharmacologic treatment provided was benzodiazepines (n=131, 37%) followed by antipsychotics (n=36, 10%).Disposition was available for 276; of these 167 (61%) were managed in the emergency department, 42 (15%) were admitted to the hospital floor, and 67 (24%) were admitted to the ICU. Conclusions: Synthetic cannabinoids are associated with severe central nervous system and cardiovascular effects.
KW - K2
KW - Novel psychoactive substance
KW - Spice
KW - Synthetic cannabinoid
KW - ToxIC
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U2 - 10.1007/s13181-017-0605-9
DO - 10.1007/s13181-017-0605-9
M3 - Article
C2 - 28397128
AN - SCOPUS:85017206762
SN - 1556-9039
VL - 13
SP - 146
EP - 152
JO - Journal of Medical Toxicology
JF - Journal of Medical Toxicology
IS - 2
ER -