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10/3/2014 Cannabinoid Poisoning Treatment & Management

Cannabinoid Poisoning Treatment & Management


Author: Ani Aydin, MD; Chief Editor: Robert G Darling, MD, FACEP more...

Updated: Jul 11, 2013

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.

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

http://emedicine.medscape.com/article/833828-treatment 1/3
10/3/2014 Cannabinoid Poisoning Treatment & Management
Disclosure: Nothing to disclose.

Additional Contributors
The authors and editors of Medscape Reference 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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