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Marijuana intoxication

Definition

Marijuana ("pot") intoxication is the euphoria, relaxation, and sometimes undesirable side effects that can occur when people use marijuana. The ability to perform complex tasks may be adversely affected. Many users report excessive appetite after marijuana use.

Most states in the United States permit marijuana to be used legally to treat certain medical problems. Many states have also decriminalized or legalized its general use.

Symptoms

The intoxicating effects of marijuana include relaxation, sleepiness, and mild euphoria (getting high).

Smoking marijuana leads to fast and predictable signs and symptoms. Eating marijuana can cause slower, and sometimes less predictable, effects.

Marijuana can cause undesirable side effects, which increase with higher doses. These side effects include:

• Decreased short-term memory

• Dry mouth

• Impaired perception and motor skills

• Red eyes

More serious side effects include panic, paranoia, or acute psychosis, which may be more common with new users or in those who already have a psychiatric disease.

The degree of these side effects varies from person to person, as well as with the amount and strength of marijuana used.

Marijuana may be contaminated with more dangerous drugs that have more serious side effects than marijuana, but confirmed cases are exceedingly rare, and most reports in the US have turned out to be false.

Like other agricultural products, Marijuana may also be contaminated with pesticides, microbes, or heavy metals. These contaminants can have serious side effects.

Treatment

Treatment and care involves:

• Preventing injury

• Reassuring those who have panic reactions due to the drug

Sedatives, called benzodiazepines, such as diazepam (Valium) or lorazepam (Ativan), may be given. Children who have more serious symptoms or those with serious side effects may need to stay in the hospital for treatment. Treatment may include heart and brain monitoring.

In the emergency department, the person may receive:

• Activated charcoal, if the drug has been eaten

• Blood and urine tests

• Breathing support, including oxygen, tube through the mouth, and breathing machine (ventilator)

• Chest x-ray

• Computerized axial tomography (CT, or advanced imaging) scan

• ECG (electrocardiogram, or heart tracing)

• Fluids through the vein (intravenous, or IV)

• Medicines to relieve symptoms (see above)

Outlook (Prognosis)

Uncomplicated marijuana intoxication rarely needs medical advice or treatment. Recurrent anxiety attacks may occur and require medications or other ongoing treatment. Occasionally, serious symptoms occur. However, these symptoms are rare and usually associated with other drugs or compounds mixed in with marijuana.

When to Contact a Medical Professional

If someone who has been using marijuana develops any of the symptoms of intoxication, has trouble breathing, or cannot be awakened, call 911 or the local emergency number. If the person has stopped breathing or has no pulse, begin cardiopulmonary resuscitation (CPR) and continue it until help arrives.

References

Barrett W, Iwanicki JL. THC and hallucinogens. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 145.

Brust JCM. Effects of drug abuse on the nervous system. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff’s Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 87.

Dryburgh LM, Bolan NS, Grof CPL, et al. Cannabis contaminants: sources, distribution, human toxicity and pharmacologic effects. Br J Clin Pharmacol. 2018;84(11):2468-2476. PMID: 29953631. pubmed.ncbi.nlm.nih.gov/29953631/.

Review Date: 1/2/2023

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.