Marijuana toxicity


  • Marijuana is the most commonly used illegal substance in the world[1]
  • THC concentrations have been steadily increasing in multiple formulations due to strain engineering
  • Pediatric overdoses increasing, though unintentional, due to increased legalization and access

Clinical Features

  • Excessive and purposeless motor activity of the extremities (hyperkinesis)
  • Lethargy
  • Tachycardia
  • hypertension or orthostatic hypotension
  • Tachypnea
  • Conjunctival injection
  • Dry mouth
  • Increased appetite
  • Nystagmus
  • Ataxia
  • Slurred speech

Differential Diagnosis

  • Hypoglycemia
  • Meningitis/Encephalitis
  • TBI
  • Drugs - Opioids, Antihistamines, Anticholinergics, Antipsychotic agents
  • CO poisoning

Drugs of abuse


Peak Plasma Concentration Time[2]

  • Inhalation: 3-10 minutes
  • Ingestion/oral: 1-6 hours
  • Intravenous: 10 minutes
  • Rectal: 2-8 hours


  • Supportive care, if concerned for mixed ingestion, try other reversal agents


  • Discharge when clinically sober

See Also

External Links


  1. Leggett T, United Nations Office on Drugs and Crime. A review of the world cannabis situation. Bull Narc 2006; 58:1.
  2. Kim HS, Monte AA. Colorado cannabis legalization and its effect on emergency care. Ann Emerg Med. 2016;68(1):71-75