Emergency Department Guide to Managing Cannabis Intoxication and Hyperemesis
A comprehensive review for emergency physicians covers the pathophysiology, clinical presentation, and best-practice management of both natural and synthetic cannabinoid intoxication, including emerging treatments for cannabinoid hyperemesis syndrome.
Quick Facts
What This Study Found
Emergency departments are seeing increasing cannabinoid-related presentations. Key management considerations include distinguishing natural from synthetic cannabinoid intoxication, recognizing CHS as a diagnosis of exclusion, and utilizing emerging treatments (haloperidol, topical capsaicin, hot water bathing) when standard antiemetics fail.
Key Numbers
Reviews both natural and synthetic cannabinoid presentations. Covers acute intoxication and chronic use complications. Discusses CHS treatments: hot water bathing, haloperidol, and topical capsaicin.
How They Did This
Comprehensive review of cannabinoid pathophysiology, clinical presentations, and current evidence for emergency department management.
Why This Research Matters
As cannabis legalization expands and synthetic cannabinoid products proliferate, emergency physicians need practical, evidence-based guidance for managing the increasing number of cannabinoid-related presentations.
The Bigger Picture
The increasing diversity of cannabinoid products (edibles, concentrates, synthetics) means emergency presentations are becoming more varied and complex. Physicians trained in an era of prohibition may lack familiarity with these presentations.
What This Study Doesn't Tell Us
Review covers a broad area with varying evidence quality. Some treatment recommendations are based on case reports. Rapidly evolving landscape may outdate some guidance.
Questions This Raises
- ?How should ED protocols change as cannabinoid presentations increase?
- ?Can point-of-care testing distinguish synthetic from natural cannabinoids?
- ?What is the optimal CHS treatment algorithm?
Trust & Context
- Key Stat:
- Three emerging CHS treatments covered: hot water bathing, early haloperidol, and topical capsaicin, for when standard antiemetics fail.
- Evidence Grade:
- Moderate - comprehensive clinical review synthesizing available evidence, though some recommendations are based on limited data.
- Study Age:
- Published in 2018.
- Original Title:
- Cannabinoids: emerging evidence in use and abuse.
- Published In:
- Emergency medicine practice, 20(8), 1-20 (2018)
- Authors:
- Williams, Molly V
- Database ID:
- RTHC-01880
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
How do doctors treat cannabis overdose in the ER?
This review outlines supportive care for most cannabis intoxication, with specific guidance for synthetic cannabinoid exposure (which can be more dangerous). For cannabinoid hyperemesis syndrome, hot water bathing, haloperidol, and topical capsaicin are emerging treatments.
How is synthetic cannabis different from natural cannabis in the ER?
Synthetic cannabinoids can produce more severe effects including psychosis, seizures, and organ damage. This review helps emergency physicians distinguish between natural and synthetic cannabinoid presentations and manage each appropriately.
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Cite This Study
https://rethinkthc.com/research/RTHC-01880APA
Williams, Molly V. (2018). Cannabinoids: emerging evidence in use and abuse.. Emergency medicine practice, 20(8), 1-20.
MLA
Williams, Molly V. "Cannabinoids: emerging evidence in use and abuse.." Emergency medicine practice, 2018.
RethinkTHC
RethinkTHC Research Database. "Cannabinoids: emerging evidence in use and abuse." RTHC-01880. Retrieved from https://rethinkthc.com/research/williams-2018-cannabinoids-emerging-evidence-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.