Centre antipoison, CHU de Bordeaux, Bordeaux, France.
Laboratoire de Pharmacologie et Toxicologie, CHU de Bordeaux, Bordeaux, France.
Clin Toxicol (Phila). 2024 Feb;62(2):112-119. doi: 10.1080/15563650.2024.2318409. Epub 2024 Mar 1.
Hexahydrocannabinol is a hexahydro derivative of cannabinol. Poisoning with hexahydrocannabinol was first observed in Europe in May 2022.
This is a retrospective observational study of cases of self-reported hexahydrocannabinol exposure reported to French poison centres between 1 January 2022 and 31 May 2023.
There were 37 cases, including 19 in May 2023. The median age of the patients was 36 (interquartile range 28-43) years, and most were men. Eight patients had a history of substance use disorder. The route of exposure was ingestion in 24, inhalation (smoking or vaping) in 10, inhalation and ingestion in two and sublingual in one. Clinical features were neurological (85 per cent), cardiovascular (61 per cent), gastrointestinal (33 per cent), psychiatric (27 per cent) and ocular (21 per cent). Fifty-nine per cent of the patients were hospitalized. In four patients, the Poisoning Severity Score was 0 (asymptomatic); in 15 patients, the Score was 1 (minor); in 16, the Score was 2 (moderate); and in two cases, the Score was 3 (severe). In 70 per cent of patients, the outcome was known, and all recovered. Testing of biological samples was only undertaken in six cases. Five patients had positive blood or urine tests for hexahydrocannabinol; in two patients, tetrahydrocannabinol and metabolites were also detected. In addition, there was an additional patient in whom Δ- and Δ-tetrahydrocannabinol was detected in the substances used.
Clinical effects reported in this series included neuropsychiatric and somatic effects. Whilst these cases related to self-reported hexahydrocannabinol use, it is likely that tetrahydrocannabinol use also contributed to the effects in a substantial proportion of cases. This study has some limitations, such as the lack of available information due to the retrospective nature of the study. As a result, it probably overestimates the number of moderate and severe cases due to under-reporting of cases of little or no severity. Analysis of the patient's blood and urine was performed only in six patients, so we cannot be certain that the products consumed by the other patients were hexahydrocannabinol.
The clinical effects attributed to hexahydrocannabinol were neurological, cardiovascular, gastrointestinal, psychiatric and ocular predominantly and were sometimes serious.
六氢大麻酚是大麻酚的六氢衍生物。2022 年 5 月，在欧洲首次观察到六氢大麻酚中毒。
这是一项对 2022 年 1 月 1 日至 2023 年 5 月 31 日期间向法国中毒中心报告的自我报告的六氢大麻酚暴露病例进行的回顾性观察研究。
共有 37 例病例，其中 2023 年 5 月有 19 例。患者的中位年龄为 36 岁（四分位距 28-43 岁），大多数为男性。8 例有物质使用障碍史。暴露途径为摄入 24 例，吸入（吸烟或蒸气吸入）10 例，吸入和摄入各 2 例，舌下含服 1 例。临床表现为神经系统（85%）、心血管（61%）、胃肠道（33%）、精神（27%）和眼部（21%）。59%的患者住院。4 例患者的中毒严重度评分（PS）为 0（无症状）；15 例 PS 为 1（轻度）；16 例 PS 为 2（中度）；2 例 PS 为 3（重度）。在 70%的患者中，结局已知，所有患者均康复。仅在 6 例患者中进行了生物样本检测。5 例患者血液或尿液中六氢大麻酚检测阳性；2 例患者还检测到四氢大麻酚及其代谢物。此外，在使用的物质中还发现了另外 1 例患者的Δ-和Δ-四氢大麻酚。
本系列报告的临床效应包括神经精神和躯体效应。虽然这些病例与自我报告的六氢大麻酚使用有关，但在很大一部分病例中，四氢大麻酚的使用也可能导致了这些效应。本研究存在一些局限性，例如由于研究的回顾性，缺乏可用信息。因此，由于轻度或无严重程度的病例报告不足，它可能高估了中度和重度病例的数量。仅对 6 例患者进行了患者血液和尿液分析，因此我们不能确定其他患者所消费的产品是否为六氢大麻酚。
归因于六氢大麻酚的临床效应主要为神经、心血管、胃肠道、精神和眼部效应，有时较为严重。
