A new side effect of synthetic cannabinoid use by the bucket (waterpipe) method: Acute respiratory distress syndrome (ARDS)

Abstract

The use and content of synthetic canibinden (SCs) has been rapidly increased in the last decades. The complex content of these substances bring along a wide spectrum of side effects. In addition to the expected neuropsychological side effects of pleasure-inducing substances such as agitation, anxiety, panic attack and hallucinations, rare cases of cerebrovascular diseases, seizures, acute renal injury, myocardial infarction and chronic lung injury have also been previously reported.Here we report a 19-year -old male who was presented with acute respiratory distress syndrome (ARDS) within hours of inhaled SC use with the rarely preferred bucket method. There is limited information in the literature about pulmonary effects of SCs and we could not detect any other ARDS case that develoed within hours after consumption of SC with the bucket method.

Utilization of Extracorporeal Membrane Oxygenation for Pulmonary Toxicity Caused by Inhaled Synthetic Cannabinoid. A Harbinger of Future Complications Associated with Inhaled Cannabinoid Products

“…The increased incidence of complications related to natural and synthetic cannabinoids has drawn great interest [17] [18]. In this recent time frame direct pulmonary toxicity caused by SC has also increased [10] [15]. Our patient developed ARDS and DAH as defined by the Berlin criteria.…”

“…Few case reports of diffuse lung injury caused by SC requiring mechanical ventilation have been found [10] [12]. In these patients chest x-rays were unremarkable because the effect of SC was on the central nervous system's control of respiratory drive rather than the lung parenchyma itself.…”

“…In these patients chest x-rays were unremarkable because the effect of SC was on the central nervous system's control of respiratory drive rather than the lung parenchyma itself. Since 2019, few reports of SC associated diffuse lung injury requiring mechanical ventilation have been described [10] [11] [13] [16]. Of these, only one utilized ECMO as a form of life-saving bridge therapy [16].…”

“…In addition, there are case series and case reports of stroke, hypertension, cardiac toxicity, and encephalopathy related to SC inhalation. Specifically, there has been a recent increase in reports of respiratory pathology such as acute respiratory distress syndrome (ARDS), diffuse alveolar hemorrhage (DAH), and chronic pulmonary findings associated with inhaled SC use [3] [7] [10] [11]. The acute and chronic findings of direct pulmonary toxicity do not include the depression of respiratory drive caused by SC [4] [5].…”

How much can synthetic cannabinoid damage the heart? A case of cardiogenic shock following resistant ventricular fibrillation after synthetic cannabinoid use

“…New substances are constantly being added to the content of SCs, known in the USA as “K2,” in Europe as “Spice” and in other countries as “Bonsai,” “Black Mamba” or “Jamaica.” This enhanced content is accompanied by a wide spectrum of side‐effects. Although these substances are typically associated with neuro‐psychological side‐effects such as euphoria, anxiety, panic attacks and hallucinations, they are also now known to be capable of affecting the cardiovascular, cerebrovascular system, and respiratory systems.…”