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

The takeaway

Among 615 cannabinoid poisoning cases in Israel (2007-2018), synthetic cannabinoids caused more cardiovascular and gastrointestinal symptoms than recreational cannabis, while medical cannabis cases were milder and more often called in by the public.

Emergency physicians, poison center staff, and cannabis safety educators.

615 poisonings: synthetic more severe; synthetic cases peaked 2014 then declined

What the researchers found

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.

Why it matters

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 numbers in context

615 cases; 55% recreational cannabis; 33% synthetic; 12% medical; synthetic: more CV and GI symptoms; medical: less co-use, more public-reported; synthetic peaked 2014 then declined.

How the study worked

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.

What this study cannot tell us

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.

How to read the evidence

Moderate: 12-year poison center database with comparative analysis, but likely underestimates actual incidence.

When this study was published

Published 2020.

The bigger picture

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.

Questions still open

Would further cannabis legalization continue to reduce synthetic cannabinoid poisonings? Should medical cannabis patients receive specific safety education about overdose signs?

Common questions

Are synthetic cannabinoids more dangerous than regular cannabis?

Yes. In 615 poisoning cases, synthetic cannabinoid exposures caused more cardiovascular and gastrointestinal symptoms than recreational cannabis and were more often reported by healthcare professionals rather than the public, suggesting greater severity.

Can medical cannabis cause poisoning?

Yes, but these cases were milder. Medical cannabis poisonings (12% of cases) had fewer co-used substances and were more often reported by the public (not hospitals), suggesting lower severity. GI symptoms (likely from oils) were common.

Read the original research

Cannabis and synthetic cannabinoid exposure reported to the Israel poison information center: Examining differences in exposures to medical and recreational compounds.

The International journal on drug policy, 77, 102711

View on PubMed ↗Publisher’s paper ↗

Citation

Sznitman, Sharon R; Pinsky-Talbi, Lianna; Salameh, Maisar; Moed, Taleb; Bentur, Yedidia. (2020). Cannabis and synthetic cannabinoid exposure reported to the Israel poison information center: Examining differences in exposures to medical and recreational compounds.. The International journal on drug policy, 77, 102711. https://doi.org/10.1016/j.drugpo.2020.102711