Photo by Olga Kononenko on Unsplash
The risk of death or acute bodily harm from the overconsumption of cannabis is very low, but this fact has lead to the incorrect conclusion that cannabis use is without risks or is of little concern to the medical system. Contrary to this conclusion is the fact that cannabis use results in over 1.5 million visits to the ER every year, making it the second most common for being in the ER associated with substance use, ahead of alcohol, cocaine, and heroin.
This trend is getting more severe due to cannabis legalization. In one Colorado medical center, ER visits for cannabis doubled after medical cannabis licenses became largely available in 2009, and rates increased 72% again following the full legalization.
Acute cannabis intoxication (ACI) can take multiple forms based on the patient’s dose and prior use history. Roughly a quarter of ER visits are for acute psychiatric disturbances, including psychosis. This includes acute psychosis as well as the exacerbation of an underlying psychotic disorder, often undiagnosed. Another third of patients have gastrointestinal distress including cannabinoid hyperemesis syndrome (CHS), a bout of uncontrollable vomiting that can last 48 hours or more.
Even in less sever cases, the treatment of these patients typically requires sedation to alleviate severe anxiety, paranoia, and confusions, and takes significant patient resources in the emergency department. It can take many hours for a cannabis high to wear off following overconsumption, particularly in the case of edibles.
Moreover, the risk to children from over-consumption is even greater. Children under 10 have far more severe effects from consuming cannabis, which include tachycardia, encephalopathy, respiratory depression severe enough to require ventilation, and coma. The increased availability of cannabis edibles are increasing the risks to children, as these products are frequently produced as gummies, brownies, cookies and other sweets, often with very large doses.
The Changing Treatment Landscape
Until recently, perhaps due to incorrect perceptions regarding the prevalence and severity of cannabis related complications, there has been little effort to develop a solution to these problems. Anebulo Pharmaceuticals (NASDAQ:ANEB) is a company that is changing this by focusing its efforts on developing an antidote to cannabis and THC intoxication. It’s lead compound in development is ANEB-001, a CB1 antagnonist. THC is a CB1 agonist and most of its qualitative effects are due to this activity. ANEB-001 works by blocking this receptor and preventing the activation of this pathway in the brain. This is a well understood class of molecule and it has already completed Phase I safety testing, but it has never been applied to this problem before. The company will be investigating it in a Phase II study in cannabis users starting in 2021.
