OBJECTIVE: To describe a case of marijuana-induced delirium and the techniques used to detect psychoactive agents and metabolites in urine. METHODS: A case of delirium following involuntary ingestion of cannabis is described. A urine sample was analyzed applying various chemical procedures, using high-resolution gas chromatography coupled with mass spectrometry technique. 11-Nor-delta9-tetrahydrocannabinol-9-carboxylic acid was quantified by the methodology for steroids and cannabis. RESULTS: A 26-year-old man was hospitalized with severe agitation and psychotic behavior 36 hours after suspected involuntary ingestion of cannabis contained in a brigadeiro, a typical Brazilian cookie, consumed during a party. Treatment with neuroleptics resulted in complete regression of the symptoms over 2 weeks. The urine sample revealed marijuana ingestion, demonstrated by the presence of its metabolite, 11-nor-delta9-tetrahydrocannabinol-9-carboxylic acid in high concentration. No other investigated substance was found in the patient's urine. CONCLUSION: Severe delirium can follow oral ingestion of cannabis integrated into homemade cookies.
OBJECTIVE: To describe a case of marijuana-induced delirium and the techniques used to detect psychoactive agents and metabolites in urine. METHODS: A case of delirium following involuntary ingestion of cannabis is described. A urine sample was analyzed applying various chemical procedures, using high-resolution gas chromatography coupled with mass spectrometry technique. 11-Nor-delta9-tetrahydrocannabinol-9-carboxylic acid was quantified by the methodology for steroids and cannabis. RESULTS: A 26-year-old man was hospitalized with severe agitation and psychotic behavior 36 hours after suspected involuntary ingestion of cannabis contained in a brigadeiro, a typical Brazilian cookie, consumed during a party. Treatment with neuroleptics resulted in complete regression of the symptoms over 2 weeks. The urine sample revealed marijuana ingestion, demonstrated by the presence of its metabolite, 11-nor-delta9-tetrahydrocannabinol-9-carboxylic acid in high concentration. No other investigated substance was found in the patient's urine. CONCLUSION: Severe delirium can follow oral ingestion of cannabis integrated into homemade cookies.
Authors: Erin L Karschner; David M Schwope; Eugene W Schwilke; Robert S Goodwin; Deanna L Kelly; David A Gorelick; Marilyn A Huestis Journal: Drug Alcohol Depend Date: 2012-03-29 Impact factor: 4.492
Authors: David A Gorelick; Robert S Goodwin; Eugene Schwilke; David M Schwope; William D Darwin; Deanna L Kelly; Robert P McMahon; Fang Liu; Catherine Ortemann-Renon; Denis Bonnet; Marilyn A Huestis Journal: J Anal Toxicol Date: 2012-10-16 Impact factor: 3.367