Marijuana cookie lands elderly woman in ER for a 'stroke'
The cookie was brought to the woman's senior center by a person of "questionable character."
When the woman arrived at the emergency room, doctors thought she was having a stroke. But it turned out she was just really high. The woman was intoxicated with THC, which she had unknowingly ingested right before her symptoms started, according to a new case report.
The 64-year-old woman went to the emergency room after experiencing general weakness, mostly in her right arm and leg, according to the report, published Jan. 22 in The Journal of Emergency Medicine. Her husband also noted that her speech had suddenly changed and did not sound normal. The paramedics who brought her to the hospital had called in a "code stroke" to alert doctors of a potential stroke patient. (The code is used because stroke patients require urgent treatment with clot-busting drugs.)
The woman also said she felt odd and "apart from her body." During a physical exam, doctors noted she spoke slowly, but was able to form full sentences. She also had some weakness in her lower right leg. Doctors took some blood samples and sent her for a CT scan.
Related: 27 Oddest Medical Case Reports
The scan didn't show any signs of a stroke — there were no signs of bleeding or blockages in the brain. Other tests, including an MRI, chest X-ray and electrocardiogram (EKG), or a test of the heart's electrical activity, were also normal.
Soon, the woman said she no longer felt weak and could walk normally. Doctors canceled the stroke code and determined that she was not a candidate for emergency stroke treatment with clot-busting drugs.
But why had she reported such an odd feeling when she arrived at the hospital? Doctors asked her a few more questions about what happened. They learned that, shortly before her symptoms started, "she had eaten a cookie that was brought to their senior center social area by one of the other seniors to share," the report said. "The patient's husband noted that this person was of questionable character."
Based on this new piece of information, doctors performed a drug test, which came back positive for tetrahydrocannabinol (THC), the active ingredient in marijuana. In other words, the woman had ingested the drug without knowing it.
THC is well known to cause certain effects on the body, including decreased concentration, altered mental state, eye redness and increased appetite. But this appears to be the first case of "focal neurologic deficits," such as weakness in the arms and legs, tied to use of THC, the authors said.
It's possible that the woman's weakness was a side effect of THC use. However, exactly how THC would cause temporary limb weakness is unclear, the authors wrote. They also noted that they cannot rule out the possibility that the woman had a ministroke, or transient ischemic attack — a stroke that typically lasts only a few minutes and doesn't cause any lasting effects. Still, if the latter were the cause, "the timing of her intoxication with a possible transient ischemic attack would be an intriguing co-occurrence," the authors wrote.
By publishing this case, the authors hope that "this knowledge will encourage physicians to consider THC intoxication as a cause of new onset extremity weakness," they concluded.
Other than a positive drug test, the woman's medical evaluation was "unremarkable," and she soon was released from the hospital, the report said.
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Originally published on Live Science.
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Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.
By Briley Lewis
By Harry Baker
Cannabis smoke also causes lung inflammation and bronchitis, and some research links regular cannabis smoking to several forms of cancer.
Ingesting edibles does not appear to have these effects on lung function or cancer risk, which means they may be safer in these ways.
Edible use is on the rise with the legalization of marijuana for recreational use in more and more states. Studies of adolescents show that edible use is increasing among high school seniors, while the number of students smoking marijuana is dropping.
Teenage edible users are also more likely to use them daily opposed to those who smoke marijuana.
Since edibles are often found in candy form, children may mistake them for regular snacks or candy, which can make them sick or lead to an edible overdose.
Marijuana edibles, on the other hand, have been unquestionably linked to multiple negative outcomes.
Edibles are food and drink products that are made with marijuana extract. Marijuana edibles come in various forms and can be commercially made or homemade, and can include:
Candies, chocolates, and gummies.
Cooking oils and butter.Before crunching your way into this relatively new market, you need to understand what edibles are and what they aren’t. At the very least, you’ll want to be proactive by getting familiar with the dangers these confections pose.
And on that note, let’s look at five very real problems and/or outcomes caused by the use, quantity and sale of marijuana edibles.
Marijuana edibles produce a much longer-lasting and potent high than smoking, which can prove severely detrimental for novice users. While smoking marijuana produces a more immediate high that quickly dissipates, edibles kick in after about an hour and the effects can last from six to 10 hours.
THC overdoses typically aren’t fatal but can lead to extreme discomfort, unpleasant experiences, accidental injury, and even death because of cannabis-induced behavioral impairment.
Taken in large doses, or if the particular edible contains a large dose, marijuana edibles can lead to anxiety attacks, paranoia and hallucinations. Several case reports involving kids who took edibles found that respiratory insufficiency can also be a major side effect in young children.
Marijuana edibles have played a major role in two recent well publicized capers.
Oklahoma native Caleb Fowler, 23, shot himself earlier this month after eating five times the recommended dosage of edibles. Last year, Wyoming college student Levy Thamba Pongi jumped to his death after eating a marijuana cookie. A coroner ruled that “marijuana intoxication” played a major role in the tragedy after a toxicology screen showed an abnormally high level of THC (tetrahydrocannabinol), the active ingredient in marijuana, in the victim's blood.
In states where marijuana is legal, the lack of edible-specific regulations has caused public safety concerns. State officials in Colorado are now scrambling to create regulations regarding dosages of THC in the products, while more marijuana business owners are encouraging new users to “start low, go slow.”
After Colorado voted to legalize marijuana in 2012, doctors in Denver noticed a surprising trend. Most people who visited the emergency room for cannabis-related complaints had smoked the drug. But those who ingested the drug were more likely to suffer more severe effects, including psychiatric symptoms and heart problems.
Out of 2,567 marijuana-linked visits to the ER in 2012–2016 at the University of Colorado Hospital in Denver, only about 9 percent — or 238 cases — involved edibles. But those cases involved proportionally more short-term psychiatric conditions, with 18 percent of edible users suffering symptoms such as anxiety and psychosis compared with about 11 percent of cannabis smokers, researchers report March 25 in Annals of Internal Medicine.
Heart issues were also more prevalent among ER visitors who had eaten edibles: Eight percent of those patients were diagnosed as having symptoms such as an irregular heartbeat, or even heart attacks. By comparison, only 3.1 percent of marijuana smokers in the ER had such heart symptoms.
An overdose from edibles can involve:
heart issues like tachycardia or heart attacksIt’s unclear why different ailments are associated with different methods of getting high on THC, the psychoactive drug in marijuana. “These are new phenomena” for clinicians, says emergency physician Andrew Monte at the University of Colorado Hospital who led the research.
There are no federal regulations on what a single dose of marijuana should be, with the drug still illegal at the federal level and in 40 states (SN: 6/14/14, p. 16). Some states, including Colorado and Washington, recommend a single edible serving to have no more than 10 milligrams of THC, and require that edible products be labeled to show both the total amount of THC in a product as well as how many servings are included. Still, the production of those products is not well monitored. So a single chocolate bar could contain almost no THC, or it might contain 100 milligrams — the maximum dose those states allow in a single edible — and that difference might not be clear to a consumer.
Edibles that have that much disparity in their THC concentrations are going to have significantly different effects on a person, Monte says. “That’s a recipe for disaster.”
Monte and his colleagues argue that the U.S. Food and Drug Administration should issue appropriate health warnings and guidelines for standard doses and packaging. “This is sort of a brave new world we’re living,” Monte says. Though edibles make up only a small part of Colorado’s cannabis market, accounting for only 0.32 percent of sales in 2014–2016, edibles are leading to more ER visits each year, the researchers say. (The study could not account for edibles that were homemade, purchased on the black market or brought in from overseas.)
Edibles and other forms of cannabis can interact with alcohol and some medications, such as blood thinners. These interactions may intensify the effects of THC, or interfere with the actions of the medicines.
Marijuana allergies have also become more common in recent years. Although the plant is known for anti-inflammatory properties, cannabis can cause a number of symptoms if it’s inhaled. If you smoke and you have a weed allergy, you may experience:
red eyeswatery eyeshay feverrunny nosecongestionsneezingnauseavomitingCannabis allergies can also resemble contact dermatitis if the plant is tampered with or handled. In a 2007 study evaluating marijuana allergy symptoms, a skin prick test revealed that cannabis can cause specific skin irritation. Some of the most common irritations include:
itchinessinflamed, red skinhivesdry, scaly skinIn more severe cases, an allergic reaction to cannabis can cause anaphylactic shock, a life-threatening condition that causes your blood pressure to suddenly drop and your airways to close. If left untreated, a marijuana allergy of this severity could be fatal.
Marijuana allergies can become more prevalent if you’re allergic to a food or substance with similar protein properties. This is also called allergy cross-reaction. Some foods with similar allergen properties as the cannabis plant are:
grapefruitalmonds and chestnuts
Volkow agrees that the FDA should weigh in on these issues. Without standardization, “you’re just jeopardizing the health of these individuals imbibing or using edible marijuana,” she says.
If you are experiencing an overdose of marijuana or any type of substance, call 911 and seek medical attention immediately. Once stabilized, limiting your cannabis use and seeking further treatment for your cannabis use disorder are both options to help prevent future overdoses.
Treatment for cannabis use disorder varies depending on the person. It may include varying degrees of inpatient or outpatient care, mutual support groups, therapy, or treatment for co-occurring disorders (having a substance use disorder and mental health disorder at the same time).
With ingestible marijuana use on the rise across the spectrum combined with the increasing number of deleterious effects found after you ingest marijuana, as well as a growing list fatal outcomes, I just cannot recommend this use of THC. When its use is combined with the chance for allergic reactions, it seems to be an additional reason to steer clear of this chemical whether it is smoked or ingested. Call me an old fuddy-duddy, but rolling the dice with your physical and mental health just doesn't seem worth the risk to me.
I recall that immortal line from 'The Good, The Bad and The Ugly', uttered by the half soldier, "...hand me down a whiskey."