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Delta-8 THC poisonings: CDC issues national health advisory reporting cases of adverse events

The Centers for Disease Control issued a health advisory Sept. 14 to alert public health departments, healthcare professionals, first responders, poison control centers, laboratories and the public of cannabis products containing delta-8 tetrahydrocannabinol (THC) and the potential for adverse events due to insufficient labeling of products.

In March, the West Virginia Poison Control Center reported two cases of adverse events related to use of delta-8 THC products in adults, said the CDC. In both instances, individuals mistook the products containing delta-8 THC for CBD-like products. These exposures led to symptoms consistent with cannabis intoxication.

The Michigan Poison Control Center also reported two cases of severe adverse events to delta-8 THC in two children who ingested a parent’s delta-8 THC-infused gummies purchased from a vape shop, said the CDC. Both children experienced deep sedation and slowed breathing with initial increased heart rate progressing to slowed heart rate and decreased blood pressure. The children were admitted to the intensive care unit for further monitoring and oxygen supplementation.

In June, the Blue Ridge Poison Center at University of Virginia Medical Center in Charlottesville reported it received dozens of calls related to delta-8 THC poisonings.

The American Association of Poison Control Centers introduced a product code specific to delta-8 THC into its National Poison Data System in 2021, allowing for the monitoring of delta-8 THC adverse events.

From Jan. 1 to July 31, 2021, 660 delta-8 THC exposures were recorded with the new product code, and one additional case was recoded as a delta-8 THC exposure from Oct. 2020. Eighteen percent of exposures (119 of 661 cases) required hospitalization, and 39% (258 of 661 cases) involved pediatric patients less than 18 years of age, according to the CDC health advisory.

Syndromic surveillance data from emergency departments participating in the CDC’s National Syndromic Surveillance Program show an increase in visits with a mention of delta-8 THC or some variation in the chief complaint text in recent months, said the CDC.

The first suspected visit associated with delta-8 THC was observed in Sept. 2020, with three additional visits observed through the end of 2020. Suspected visits have generally increased monthly in 2021 (three suspected visits were observed in January; six in February; 16 in March; 11 in April; 29 in May; 32 in June; and 48 in July 2021).

The majority of these visits (73%, 109 of 149 visits) occurred in the U.S. Department of Health and Human Services’ Regions 4 and 6, which are composed primarily of Southern states that have not passed state laws to allow non-medical adult cannabis use, said the CDC.

These numbers are likely an underestimate due to the potential for inaccurate and incomplete information about products used by consumers, said the CDC.

Delta-8 THC adverse effects:

  • Lethargy
  • Uncoordinated movements and decreased psychomotor activity
  • Slurred speech
  • Increased heart rate progressing to slowed heart rate
  • Low blood pressure
  • Difficulty breathing
  • Sedation
  • Coma

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Understanding delta-8 THC

The term THC most often refers to marijuana extracts with more than 0.3% delta-9 THC isomer. However, THC has several other isomers that occur in the cannabis plant, including delta-8 THC. Delta-8 THC exists naturally in the cannabis plant in only small quantities and is estimated to be about 50-75% as psychoactive as delta-9 THC, according to the CDC.

CBD can be synthetically converted into delta-8 THC, as well as delta-9 THC and other THC isomers, with a solvent, acid and heat to produce higher concentrations of delta-8 THC than those found naturally in the cannabis plant.

This conversion process, used to produce some marketed products, may create harmful by-products that presently are not well-characterized. According to the CDC, the health effects of delta-8 THC have not yet been researched extensively and are not well-understood.

In addition, the sale of delta-8 THC products is not limited to regulated marijuana dispensaries in states, territories or tribal nations where marketplaces operate under law. Rather, delta-8 THC products are sold by a wide range of businesses that sell hemp. As a result, delta-8 THC products may also have the potential to be confused with hemp or CBD products that are not intoxicating, said the CDC.

A wide variety of delta-8 THC-containing products have entered the marketplace, including, vapes, smokable hemp sprayed with delta-8 THC extract, distillates, tinctures, gummies, chocolates and infused beverages. Products sold as concentrated delta-8 THC are also available online. Delta-8 THC products are sometimes marketed as “weed light” or “diet weed.”

Because testing methods for products like synthetically derived delta-8 THC are still being developed, delta-8 THC products may not be tested systematically for contaminants such as heavy metals, solvents or pesticides that may have adverse health effects, said the CDC.

CDC recommendations for the public

Consumers should be aware of possible limitations in the labeling of products containing THC and CBD.

Consumers should be aware that products labeled as hemp or CBD may contain delta-8 THC, and that products containing delta-8 THC can result in psychoactive effects.

Delta-8 THC products are currently being sold in many states, territories and tribal nations where non-medical adult cannabis use is not permitted by law.

Retailers may sell products outside of regulated dispensaries in states, territories and tribal nations where cannabis use is permitted by law. This may provide consumers with a false sense of safety, as delta-8 THC products may be labeled as hemp or CBD, which consumers may not associate with psychoactive ingredients, said the CDC.

Parents who consume edibles and other products that contain THC and CBD should store them safely away from children. Children may mistake edibles that contain THC and CBD (i.e. gummies containing delta-8 THC) as candy.

If consumers experience adverse effects of THC- or CBD-containing products that are an immediate danger to their health, they should call their local or regional poison control center at 1-800-222-1222 or 911 or seek medical attention at their local emergency room and report the ingredients of ingested products to healthcare providers.

Other cannabis-derived products of potential concern have emerged recently, such as those containing delta-10 THC and THC-O acetate. More research is needed to understand the health effects of products containing these compounds, said the CDC.

Is This Cannabis Ingredient the Key to Better Sleep?

For something that regulates mood, helps skin glow, prevents illness and is free it’s a wonder Americans don’t prioritize the original detox; sleep. Over a third of all Americans are sleep deprived which, according to the CDC, leads to “increased risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and frequent mental distress.”

There are endless options out there for the sleep-needy ranging from holistic to pharmaceutical, but now there’s a chemical in weed that might be added to that list. No, it’s not THC or CBD—it’s Cannabinol, or CBN. While most attention gets paid to the two most dominant chemicals in weed, THC and CBD, CBN is a cannabinoid found only in small doses until the weed ages. As weed oxidizes, THC converts to CBN. Remember the cannabis they found in that ancient Chinese tomb? The most abundant cannabinoid when the lab results came back was CBN.

Dr. Jeremy Riggle, the Chief Science Officer of Mary’s Medicinals, clarified that CBN has been a known cannabinoid since the 1940s. Cannabis research is limited due to federal restrictions, but, Riggle says that CBN appears to be similar in many ways to THC but has a “weaker binding affinity for CB1 receptors,” meaning it won’t make you as high but you may get other benefits including drowsiness and a better night’s sleep.

Cannabis brands are already starting to market CBN products for sleep. Kinslips recently released Shut Eye, a sublingual strip with 5mg of CBD and 5mg of CBN, Mary’s Medicinals has CBN options, and Mineral, a tincture and topical line that looks like Aesop’s cooler cousin just dropped a CBN-dominant sleep tincture. But is there any real evidence that it works?

So far, not really. The most commonly cited source for CBN’s benefits is this report from cannabis testing lab Steep Hill, which likens CBN to diazepam, but the findings were based on extrapolated data from a 1995 study on mice. Dr. Michele Ross, founder of Infused Health and a neuroscientist who focuses on cannabis, noted that preclinical CBN studies show promise in a few realms that could help people stay asleep and is best when combined with other cannabinoids like CBD or THC. It has the potential to reduce inflammation around the eyes (due to lack of sleep), reduce neural and muscle spasms, boost mood, and fight depression: all issues that can interfere with sleep.

So while there is some preliminary evidence linking CBN to sleep, most of our knowledge is pre-clinical and anecdotal from doctors like Dr. Alex Capano, Chief Science Officer at Ananda Hemp, who recently helped formulate a sleep tincture for the cannabis lifestyle magazine Gossamer. Called Dusk, the tincture is a custom blend of CBD, CBN, and other compounds that help you sleep. Capano has personally “observed improvements in a several patients with insomnia and restless leg syndrome in patients who use CBD products with higher CBN levels (present at all or up to 0.5mg/serving).” According to Capano the patients didn’t “ respond as well to CBD products with absent or lower doses of CBN.”

Until more CBN products hit the market, doctors are likely to recommend CBD and THC–dominant products which are readily available in dispensaries, or, in the case of CBD, online. In the end, getting to the bottom of CBN, like so many other aspects of cannabis, will require the federal government to stop classifying it as a Schedule I drug in the company of substances like heroin, which will allow medical communities to fully study it. In the meantime, brands will continue rolling out CBN products, and—if our national obsession with sleep is any indicator—people will continue to buy them.