Of 2,589 articles screened, only 22 studied cannabis in ICU settings, finding cannabis-associated admissions were mainly from EVALI and synthetic cannabinoid toxicity, with inconsistent effects on mortality and a trend toward increased pain and analgesic needs.
Intensivists, ICU nurses, critical care researchers, anesthesiologists.
Only 22 of 2,589 screened articles addressed cannabis use in ICU patients
What the researchers found
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.
Why it matters
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.
The numbers in context
2,589 articles screened. 22 included. Admissions mainly from EVALI and synthetic cannabinoid toxicity. Inconsistent mortality findings in trauma/burns populations. Two TBI trials showed no intracranial pressure effect.
How the study worked
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.
What this study cannot tell us
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.
How to read the evidence
Scoping review identifying a major gap in the literature. Included studies were limited in number and scope.
When this study was published
Published in 2023.
The bigger picture
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.
Questions still open
- Does chronic cannabis use affect ventilator weaning or sedation requirements in ICU?
- Should ICU protocols account for cannabis use history when managing pain and sedation?
Common questions
Does cannabis use affect ICU outcomes?
Can cannabinoids be used therapeutically in ICU?
Read the original research
Cannabis use in the intensive care setting: A scoping review.
Journal of critical care, 78, 154397
Citation
Renger, Laura; Pathmanathan, Kevin; Glynn, Rosie; Laupland, Kevin B. (2023). Cannabis use in the intensive care setting: A scoping review.. Journal of critical care, 78, 154397. https://doi.org/10.1016/j.jcrc.2023.154397
Explore the wider topic
- CBD Oil Quality Guide: How to Avoid Snake Oil
- Anxiety After Quitting Weed: When to Consider Medication
- Cannabis for Chemotherapy Nausea: What the Evidence Actually Shows
- Cannabis for Chronic Pain: What the Research Actually Supports
- Cannabis and Epilepsy: The Epidiolex Story and What It Means
- Does CBD Actually Work for Anxiety? What the Evidence Shows
- Does CBD Help with Weed Withdrawal? What Studies Show
- CBD vs THC: The Differences That Actually Matter
- The Proven Medical Benefits of Cannabis: What Research Supports
- Quitting Weed Before Surgery
- Weed and Medications: What Changes When You Quit
- Quitting Weed During Pregnancy: What You Need to Know
- Quitting Weed While Pregnant: What You Need to Know
- Cannabis and Older Adults: Risks Seniors Should Know
- Cannabis and Breastfeeding: THC in Breast Milk