Division of Clinical Pharmacology and Toxicology, Basel University Hospital and University of Basel, Schanzenstrasse 55, 4056, Basel, Switzerland.
Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, 3010 Bern, Switzerland; Institute of Pharmacology, University of Bern, Freiburgstrasse 15, 3010, Bern, Switzerland.
Drug Alcohol Depend. 2020 Jan 1;206:107726. doi: 10.1016/j.drugalcdep.2019.107726. Epub 2019 Nov 7.
Concomitant use of cannabis and other psychoactive substances is common and it is often difficult to differentiate its acute effects from those of other substances. This study aimed to characterize the acute toxicity of cannabis with and without co-use of other substances.
Retrospective analysis of cases presenting at the emergency departments of three large hospitals in Switzerland due to acute toxicity related to cannabis recreational use.
Among 717 attendances related to acute cannabis toxicity, 186 (26 %) were due to use of cannabis alone. The median patient age was 26 years (range 14-68), and 73 % were male. Commonly reported symptoms/signs in lone-cannabis cases included nausea/vomiting (26 %), palpitations (25 %), anxiety (23 %), and chest pain (15 %); there were no fatalities and most intoxications were of minor severity (61 %). Most patients (83 %) using cannabis alone were discharged from the emergency department, 8 % were referred to psychiatric, and two (1 %) to the intensive care; severe complications included psychosis (7 %), coma (6 %), and seizures (5 %) and one patient (<1 %) required intubation. Lone-cannabis patients presented more often with palpitations, anxiety, panic attacks, and chest pain than patients in the co-use group, whereas the latter presented more often with impaired consciousness, agitation, respiratory depression and hallucinations, and were more often admitted to psychiatric or intensive care.
Intoxication with cannabis alone was mostly associated with minor toxicity. Nevertheless, severe complications and cases requiring admission to intensive or psychiatric care were also reported, which indicates that intoxication with cannabis alone does not exclude considerable health risks.
大麻与其他精神活性物质同时使用较为常见，且通常难以区分其急性作用与其他物质的作用。本研究旨在描述大麻单独使用和与其他物质同时使用时的急性毒性特征。
对瑞士 3 家大型医院急诊科因大麻消遣性使用导致的急性毒性而就诊的病例进行回顾性分析。
在 717 例与急性大麻毒性相关的就诊中，有 186 例（26%）是由于单独使用大麻所致。患者中位年龄为 26 岁（范围 14-68 岁），73%为男性。单独使用大麻的病例中常见的症状/体征包括恶心/呕吐（26%）、心悸（25%）、焦虑（23%）和胸痛（15%）；无死亡病例，大多数中毒程度较轻（61%）。大多数单独使用大麻的患者（83%）从急诊科出院，8%被转至精神科，2 例（1%）转至重症监护病房；严重并发症包括精神病（7%）、昏迷（6%）和癫痫发作（5%），1 例（<1%）患者需要插管。单独使用大麻的患者比同时使用大麻和其他物质的患者更常出现心悸、焦虑、惊恐发作和胸痛，而后者更常出现意识障碍、激越、呼吸抑制和幻觉，且更常被收治于精神科或重症监护病房。
单独使用大麻引起的中毒大多与轻度毒性相关。然而，也有严重并发症和需要入住重症或精神科的病例报告，这表明单独使用大麻并不能排除相当大的健康风险。
