A 4-Year Retrospective Analysis of Patients Presenting at the Emergency Department With Synthetic Cannabinoid Intoxication in Turkey

J Clin Psychopharmacol. 2020 Sep/Oct;40(5):464-467. doi: 10.1097/JCP.0000000000001275.

Abstract

Purpose/background: The number of patients with acute synthetic cannabinoid intoxication (SCI) has increased in recent years although the prohibition of its legal sale and use in Turkey despite other countries allowing to some extent sale and use. The reported clinical findings of acute SCI are similar to the symptoms of several diseases. The first case of acute SCI seen in our hospital was in 2014. The aim of this study was to share the data of synthetic cannabinoid use in a research hospital in Turkey and to contribute the epidemiologic data globally betwen 2014 and 2017.

Methods/procedures: A retrospective evaluation was made of patients who presented at emergency department (ED) because of SCI between January 2014 and December 2017. The initial diagnosis of the patients was done either via their self-report or clinician's clinical observation (family history with hallucination, lethargy, convulsions, dizziness, etc.). Totally, 352 patients were included to the study whose cannabioid use was proven with their urine drug analysis.

Findings/results: Men were predominantly high (93.8%). Nearly all patients (93.5%) were followed up and discharged in 24 hours. Among them, 21 (5.9%) patients were admitted for hospitalization, and mortality was seen in 2 (0.6%). The mean number of previous presentations at ED with a similar diagnosis was 8.6 ± 10.31.

Implications/conclusions: Great care must be taken in respect of complications related to SCI, which can even result in death. Patients have a tendency to not disclose the substance they have taken because it is illegal. Patients presenting at ED with recurrent symptoms must be referred to relevant legal authorities. For patients presenting with different clinical effects, SCI must be considered.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cannabinoids / adverse effects*
  • Cannabinoids / chemical synthesis
  • Cannabinoids / urine
  • Emergency Service, Hospital*
  • Female
  • Hallucinogens / adverse effects*
  • Hallucinogens / chemical synthesis
  • Hallucinogens / urine
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Substance Abuse Detection
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / urine
  • Time Factors
  • Turkey / epidemiology
  • Urinalysis
  • Young Adult

Substances

  • Cannabinoids
  • Hallucinogens