Assessment of patients hospitalized in the Clinical Toxicology and Cardiology Department in Lublin due to poisoning with Cannabis derivatives as a voice in the discussion on the legalization of marijuana
DOI:
https://doi.org/10.12775/JEHS.2025.79.59076Keywords
Cannabis, marijuana, healthcare, health, legalizationAbstract
The article aims to discuss the justification for the legalization of cannabinoids based on the analysis of data from countries where marijuana has been legalized for both medical and recreational use, as well as a retrospective analysis of the medical documentation of patients from the Clinical Toxicology and Cardiology Department and Internal Diseases of the Provincial Specialist Hospital named after Stefan Cardinal Wyszyński in Lublin (years 2020-2024).
During the analysis of hospital documentation, a slight upward trend in the number of hospitalizations due to cannabinoid poisoning was observed over the years 2020-2024. In 2024, 54 cases of hospitalization due to poisoning with Cannabis derivatives were recorded, with an average length of hospitalization of 3 days. The vast majority of patients were men (83%) under the age of 26. In 78% of patients, co-occurrence of poisoning with other psychoactive substances was noted, with the most common being alcohol (29 cases), LSD (12 cases), and benzodiazepines (11 cases).
44 patients required consultation with a psychologist or psychiatrist. Suspected suicide attempts were noted in 12 patients. In 38 patients, psychomotor agitation occurred, with pharmacological sedation required in 34 patients. In 22 cases, there was a significant increase in creatine levels, which may indicate an increased risk of rhabdomyolysis.
Press analysis showed that the legalization of marijuana does not lead to immediate and significant changes in public health indicators, except for issues related to road safety. Shortly after the legalization of recreational marijuana in some U.S. states and Canada, an increase in consultations with doctors was observed, caused by both acute and chronic effects of cannabinoid poisoning. Due to the short time since marijuana was legalized, research and statistical analyses are still incomplete and often lead to various, contradictory conclusions.
References
1. Pagano C, Navarra G, Coppola L, Avilia G, Bifulco M, Laezza C. Cannabinoids: Therapeutic Use in Clinical Practice. Int J Mol Sci. March 19, 2022;23(6):3344.
2. Skórzewska M, Gęca K. The Role of Cannabinoids in Advancing Cancer Treatment: Insights from Evidence-Based Medicine. Curr Oncol Rep. November 1, 2024;26(11):1334–48.
3. Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, et al. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science. December 18, 1992;258(5090):1946–9.
4. Voicu V, Brehar FM, Toader C, Covache-Busuioc RA, Corlatescu AD, Bordeianu A, et al. Cannabinoids in Medicine: A Multifaceted Exploration of Types, Therapeutic Applications, and Emerging Opportunities in Neurodegenerative Diseases and Cancer Therapy. Biomolecules. September 2023;13(9):1388.
5. Tashkin DP. Smoked marijuana as a cause of lung injury. Monaldi Arch Chest Dis Arch Monaldi Mal Torace. June 2005;63(2):93–100.
6. Hashibe M, Straif K, Tashkin DP, Morgenstern H, Greenland S, Zhang ZF. Epidemiologic review of marijuana use and cancer risk. Alcohol. April 1, 2005;35(3):265–75.
7. Microbial Infections, Immunomodulation, and Drugs of Abuse - PMC [Internet]. [cited January 24, 2025]. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC153143/
8. Huestis MA, Solimini R, Pichini S, Pacifici R, Carlier J, Busardò FP. Cannabidiol Adverse Effects and Toxicity. Curr Neuropharmacol. 2019;17(10):974–89.
9. Brown TT, Dobs AS. Endocrine effects of marijuana. J Clin Pharmacol. November 2002;42(S1):90S-96S.
10. Daling JR, Doody DR, Sun X, Trabert BL, Weiss NS, Chen C, et al. Association of marijuana use and the incidence of
testicular germ cell tumors. Cancer. March 15, 2009;115(6):1215–23.
11. Wadsworth EJK, Moss SC, Simpson SA, Smith AP. A community-based investigation of the association between cannabis use, injuries and accidents. J Psychopharmacol Oxf Engl. January 2006;20(1):5–13.
12. Moore THM, Zammit S, Lingford-Hughes A, Barnes TRE, Jones PB, Burke M, et al. Cannabis use and risk of
psychotic or affective mental health outcomes: a systematic review. Lancet Lond Engl. July 28, 2007;370(9584):319–28.
13. Large M, Sharma S, Compton MT, Slade T, Nielssen O. Cannabis use and earlier onset of psychosis: a systematic
meta-analysis. Arch Gen Psychiatry. June 2011;68(6):555–61.
14. Cannabis use disorder and age at onset of psychosis--a study in first-episode patients - PubMed [Internet].
[cited January 24, 2025]. Available at: https://pubmed.ncbi.nlm.nih.gov/21498049/
15. Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme
activities, and impact of genetic variation. Pharmacol Ther. April 2013;138(1):103–41.
16. Passmore MJ. The cannabinoid receptor agonist nabilone for the treatment of dementia-related agitation. Int J Geriatr Psychiatry. January 2008;23(1):116–7.
17. Subacute effects of heavy marijuana smoking on pulmonary function in healthy men - PubMed [Internet].
[cited January 24, 2025]. Available at: https://pubmed.ncbi.nlm.nih.gov/1244507/
18. Hézode C, Zafrani ES, Roudot-Thoraval F, Costentin C, Hessami A, Bouvier-Alias M, et al. Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C. Gastroenterology. February 2008;134(2):432–9.
19. Paton WD. Cannabis and its problems. Proc R Soc Med. July 1973;66(7):718–21.
20. Hasler JA. Pharmacogenetics of cytochromes P450. Mol Aspects Med. 1999;20(1–2):12–24, 25–137.
21. Schurman LD, Lu D, Kendall DA, Howlett AC, Lichtman AH. Molecular Mechanism and Cannabinoid
Pharmacology. Handb Exp Pharmacol. 2020;258:323–53.
22. Dyr W. The role of cannabinoids in alcohol action.
23. Neuromorphological background of cannabis addiction - PubMed [Internet]. [cited January 24, 2025].
Available at: https://pubmed.ncbi.nlm.nih.gov/12831997/
24. Hyman SE, Malenka RC, Nestler EJ. Neural mechanisms of addiction: the role of reward-related learning and
memory. Annu Rev Neurosci. 2006;29:565–98.
25. Henquet C, Krabbendam L, Spauwen J, Kaplan C, Lieb R, Wittchen HU, et al. Prospective cohort study of cannabis
use, predisposition for psychosis, and psychotic symptoms in young people. BMJ. January 1, 2005;330(7481):11.
26. Predictors of marijuana use in adolescents before and after licit drug use: examination of the gateway hypothesis
- PubMed [Internet]. [cited January 24, 2025]. Available at: https://pubmed.ncbi.nlm.nih.gov/17151165/
27. Guindon J, Hohmann AG. Cannabinoid CB2 receptors: a therapeutic target for the treatment of inflammatory and
neuropathic pain. Br J Pharmacol. January 2008;153(2):319–34.
28. Choo EK, Benz M, Zaller N, Warren O, Rising KL, McConnell KJ. The impact of state medical marijuana legislation
on adolescent marijuana use. J Adolesc Health Off Publ Soc Adolesc Med. August 2014;55(2):160–6.
29. Adolescent marijuana use from 2002 to 2008: higher in states with medical marijuana laws, cause still unclear -
PubMed [Internet]. [cited January 24, 2025]. Available at: https://pubmed.ncbi.nlm.nih.gov/21820632/
30. Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence - PubMed [Internet]. [cited January 24, 2025]. Available at: https://pubmed.ncbi.nlm.nih.gov/22099393/
31. Wang GS, Roosevelt G, Heard K. Pediatric marijuana exposures in a medical marijuana state. JAMA Pediatr. July
2013;167(7):630–3.
32. Thurstone C, Lieberman SA, Schmiege SJ. Medical marijuana diversion and associated problems in adolescent
substance treatment. Drug Alcohol Depend. November 1, 2011;118(2–3):489–92.
33. Salomonsen-Sautel S, Sakai JT, Thurstone C, Corley R, Hopfer C. Medical marijuana use among adolescents in
substance abuse treatment. J Am Acad Child Adolesc Psychiatry. July 2012;51
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