A Scoping Review Found Very Little Research on Cannabis Use Among ICU Patients

Cannabis-associated ICU admissions were primarily from vaping-associated lung injury (EVALI) and synthetic cannabinoid toxicity. Outcome studies were mostly limited to trauma and burns, showing inconsistent mortality effects and a trend toward increased pain scores and analgesic requirements. Two trials of synthetic cannabinoids for traumatic brain injury found no significant effect on intracranial pressure.

Systematic scoping review of four databases, screening 2,589 articles and including 22 for analysis, covering cannabis-associated admissions, outcomes, and therapeutic uses in adult ICU patients.

As cannabis use becomes more prevalent, ICU clinicians increasingly encounter patients who use cannabis. The near-absence of relevant research means clinical decisions are being made without adequate evidence.

Cannabis is the most used recreational drug worldwide, yet its impact on critically ill patients is barely studied. The trend toward increased pain and analgesic needs in cannabis-using ICU patients aligns with tolerance findings from other settings.

Scoping review design provides breadth but limited depth. The small number of included studies (22) reflects the literature gap rather than selective inclusion. Most outcome studies were in trauma/burns, limiting generalizability to other ICU populations.