Synthetic cannabinoid poisonings were more severe than cannabis, with more cardiovascular and GI symptoms

Of 615 cannabinoid poisoning cases, 55% were recreational cannabis, 33% synthetic cannabinoids, and 12% medical cannabis. Synthetic cannabinoid cases were more likely male, had more cardiovascular and GI symptoms, and were more often reported by healthcare professionals (not the public). Medical cannabis cases were less likely male, more likely called in by the public, had more GI symptoms, and less substance co-use. Synthetic cases peaked in 2014 then steeply declined, while recreational and medical cases increased throughout.

Retrospective analysis of 615 cannabinoid exposure cases reported to the Israel Poison Information Center (2007-2018), comparing demographic and clinical characteristics across three cannabinoid types.

This is one of the largest comparative analyses of three cannabinoid poisoning types. The distinct clinical profiles help emergency physicians identify the type of cannabinoid exposure and guide treatment.

The steep decline in synthetic cannabinoid poisonings after 2014 parallels regulatory scheduling. Meanwhile, medical cannabis poisonings are rising, likely reflecting expanded access. The different clinical profiles suggest different mechanisms of toxicity.

Poison center data (underestimates actual poisonings); Israel-specific drug market; self-reported substance identification may be inaccurate; cannot assess long-term outcomes; severity metrics limited to symptoms present at report.