Changes in clinical features and severity in patients presenting to European emergency departments with acute cannabis toxicity over the 10-year period from 2013 to 2022
Abstract
BACKGROUND AND AIMS
In recent years, the potency of natural cannabis products (herb and resin) has increased with a higher delta- 9-tetrahydrocannabinol (Δ9-THC) content, but there are limited data on trends on clinical presentation and severity of toxicity in cannabis users consulting the emergency department (ED) for acute intoxication. This study aimed to analyse the evolution over time of clinical findings and severity of presentations in a large series of patients presenting to European EDs with acute toxicity after lone cannabis use.
DESIGN
Secondary analysis of data included in the Euro-DEN Registry from 1 October 2013 to 31 December 2022.
SETTING
40 EDs in 25 European countries.
PARTICIPANTS/CASES
ED presentations reporting lone cannabis use. Presentations reporting concomitant use of, or having positive toxicological tests for, ethanol or other drugs were excluded. 3839 ED presentations reporting lone cannabis use were analysed (median age 25 years, interquartile range= 20-33; 71% male).
MEASUREMENTS
Temporal trends of 14 pre-defined clinical signs/symptoms and 4 markers of severity, which included the need for ambulance transfer to the ED, hospitalisation, intensive care unit admission (ICU) and death.
FINDINGS
The most frequent clinical features were anxiety (35%), agitation (22%), decreased alertness (drowsiness or coma, 21%) and vomiting (20%), while seizures, arrythmias and hyperthermia were observed in <3% of cases. Statistically significant changes over time…
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