Cannabinoid Poisoning Workup

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

Laboratory Studies

  • Urine immunoassays are used to detect a conjugated THC metabolite, 11-nor-delta-9-THC carboxylic acid.
    • After a single, acute use, THC is detectable in the urine for 7 days.
    • With chronic use, THC is detectable in the urine for 10-30 days.
    • Enzyme-multiplied immunoassay technique (EMIT) can detect urine levels as low as 20-100 ng/mL.
    • These screening tests correlate with prior exposure not with the amount used or degree of clinical effect.
    • False-positive results can occur with ibuprofen, naproxen, dronabinol, efavirenz, and hemp seed oil.
    • False-positive results are unlikely to result from second-hand smoke inhalation or health-food store products containing hemp, unless the exposure occurs in an unventilated space.
  • Quantitative assays for 11-nor-delta-9-THC carboxylic acid are available in most laboratories, but it must be specifically requested.
  • Blood tests can also be used to detect THC; however, the levels correlate poorly with the clinical effects.
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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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