Cannabinoid Poisoning Treatment & Management

  • Author: Ani Aydin, MD; Chief Editor: Robert G Darling, MD, FACEP   more...
 
Updated: Nov 17, 2011
 

Emergency Department Care

  • In all patients, the use and abuse of cannabis should be addressed. The negative consequences on the patient’s professional and social life should be stressed. Speaking with the patient with empathy and without passing judgment is especially important.
  • Treatment depends on the clinical presentation, the age of the patient, and the presence of other legal or illicit substances.
  • Immediate management should be supportive, including cardiovascular and neurological monitoring, and placement in a quiet room.
  • Gastric decontamination may be considered in children younger than 16 years with an acute ingestion less than 2 hours prior to presentation.
  • Patients who are agitated or with psychosis should be treated with benzodiazepines. Patients with an acute psychotic episode should also undergo substance abuse counseling.
  • Those patients who request counseling should be referred for treatment.
  • Maladaptive behaviors associated with cannabis are more common in males, younger adolescents, patients in urban settings, patients presenting to emergency departments after midnight or on weekends, and patients with psychiatric comorbidities. These patients should be referred to substance abuse counseling.
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Consultations

  • Persons with cannabis dependency should be referred to social services.
  • Treatment programs differ for adolescents and young adults.
    • Adolescents should be counseled in a family-based approach with a well-defined but flexible intervention. Both outpatient and residential treatment facilities are effective in this age group. Home-based programs are an alternative to those families who do not wish to go to treatment centers.
    • Adults should be taught coping skills in situations that present a risk of use. In this population, group discussions related to cessation and support groups are more effective than one-on-one interventions.
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Contributor Information and Disclosures
Author

Ani Aydin, MD  Staff Physician, Department of Emergency Medicine, Bellevue Hospital/New York University Medical Center

Ani Aydin, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Jessica A Fulton, DO  Assistant Professor of Emergency Medicine, Assistant Residency Director, New York University and Bellevue Hospital Center; Medical Director of Chemical Biological Radiological Nuclear Explosives (CBRNE) Academy, Bellevue Hospital Center and New York City Department of Health and Mental Hygiene

Jessica A Fulton, DO is a member of the following medical societies: American College of Medical Toxicology

Disclosure: Nothing to disclose.

Specialty Editor Board

Suzanne White, MD  Medical Director, Regional Poison Control Center at Children's Hospital, Program Director of Medical Toxicology, Associate Professor, Departments of Emergency Medicine and Pediatrics, Wayne State University School of Medicine

Suzanne White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Clinical Toxicology, American College of Epidemiology, American College of Medical Toxicology, American Medical Association, and Michigan State Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Robert G Darling, MD, FACEP  Adjunct Clinical Assistant Professor of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Associate Director, Center for Disaster and Humanitarian Assistance Medicine

Robert G Darling, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Telemedicine Association, and Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Gregory R Bell, MD, and Alan H Hall, MD, to the development and writing of this article.

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