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July 28, 1975, Vol 233, No. 4 >
ARTICLE | July 28, 1975

The Toxicity of Intravenously Used Marihuana FREE

LTC Ronald J. Payne, MCMAJ ; Stanley N. Brand, MC
[+] Author Affiliations

Reprint requests to Gastroenterology Service, US Army Medical Department Activity, Fort Carson, CO 80913 (LTC Payne).


JAMA. 1975;233(4):351-354. doi:10.1001/jama.1975.03260040045023
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References

While no unanimity of opinion exists regarding the risk to physical health from smoking marihuana, we have seen four cases that demonstrate clearly that intravenous usage is hazardous. The severity of the multisystemic involvement is dose-related. On initial examination, signs of most severe overdosage included fulminant gastroenteritis, hypoalbuminemia, toxic hepatitis confirmed by serial biopsy, acute renal failure, electrolyte disturbances, leukocytosis, anemia, and a relative thrombocytopenia. In three patients who shared a common needle, gingivostomatitis also developed.

(JAMA 233:351-354, 1975)

REFERENCES

1 +
Lieberman CM, Lieberman BW:  Marihuana: A medical review . N Engl J Med 284:88-91, 1972;.
2 +
Ames FA:  Clinical and metabolic study of acute intoxication with Cannabis sativa and its role in the model psychoses . J Mental Sci 104:972-999, 1958;.
3 +
Henderson AH, Pugsley DJ:  Collapse after intravenous injection of hashish . Br Med J 3:229-230, 1968;.
4 +
King AB, Cowen DL:  Effect of intravenous injection of marihuana . JAMA 210:724-725, 1969;.
5 +
King AB, Pechet GS, Pechet L:  Intravenous injection of crude marihuana . JAMA 214:1711, 1970;.
6 +
Gary NE, Keylon V:  Intravenous administration of marihuana . JAMA 211:501, 1970;.
7 +
Lundberg GD, Adelson J, Prosnitz EH:  Marihuana-induced hospitalization . JAMA 215:121, 1971;.
8 +
Adams R:  Marihuana . Bull NY Acad Med 18:705-729, 1942;.
9 +
Miras CJ: Some aspects of cannabis action in hashish: Its chemistry and pharmacology , Ciba Foundation Study Group No. 21. Boston, Little Brown and Co, 1965;, p 37.
10 +
Lemberger L, Axelrod J, Kopin IJ:  Metabolism and disposition of δ-nine tetrahydrocannabinol in man . Pharm Rev 23:371-380, 1971;.
11 +
Kew MC, Bershon J, Siew S:  Possible hepatotoxicity of cannabis . Lancet 1:578-579, 1969;.
12 +
Rees KR, Shotlander VL:  Fat accumulation in acute liver failure . Ann NY Acad Sci 104:905-915, 1963;.
13 +
Popper H, Schaffner F, Rubin E, et al:  Mechanisms of intrahepatic cholestasis in druginduced hepatic injury . Ann NY Acad Sci 104:988-1013, 1963;.
14 +
Dagirmanjian R, Boyd ES:  Some pharmacological effects of two tetrahydrocannabinols . J Pharm Exp Ther 125:25-33, 1962;.
15 +
Hardman HF, Donimo EF, Seever MH:  General pharmacological actions of some synthetic tetrahydrocannabinol derivatives . Pharm Rev 23:295-315, 1971;.
16 +
Perez-Reyes M, Timmons MC, Lipson MA, et al:  Intravenous injection in man of δ-nine tetrahydrocannabinol and 11-OH δ-nine tetrahydrocannabinol . Science 177:633-635, 1972;.
17 +
Tennant FS, Preble M, Prendergast TJ, et al:  Medical manifestations associated with hashish . JAMA 216:1965-1969, 1971;.
18 +
Juel-Jensen BE:  Cannabis and recurrent herpes simplex . Br Med J 4:296, 1972;.
19 +
Nahas GG, Suciu-Focu N, Armand JP, et al:  Inhibition of cellular mediated immunity in marihuana smokers . Science 183:419-420, 1974;.

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1 +
Lieberman CM, Lieberman BW:  Marihuana: A medical review . N Engl J Med 284:88-91, 1972;.
2 +
Ames FA:  Clinical and metabolic study of acute intoxication with Cannabis sativa and its role in the model psychoses . J Mental Sci 104:972-999, 1958;.
3 +
Henderson AH, Pugsley DJ:  Collapse after intravenous injection of hashish . Br Med J 3:229-230, 1968;.
4 +
King AB, Cowen DL:  Effect of intravenous injection of marihuana . JAMA 210:724-725, 1969;.
5 +
King AB, Pechet GS, Pechet L:  Intravenous injection of crude marihuana . JAMA 214:1711, 1970;.
6 +
Gary NE, Keylon V:  Intravenous administration of marihuana . JAMA 211:501, 1970;.
7 +
Lundberg GD, Adelson J, Prosnitz EH:  Marihuana-induced hospitalization . JAMA 215:121, 1971;.
8 +
Adams R:  Marihuana . Bull NY Acad Med 18:705-729, 1942;.
9 +
Miras CJ: Some aspects of cannabis action in hashish: Its chemistry and pharmacology , Ciba Foundation Study Group No. 21. Boston, Little Brown and Co, 1965;, p 37.
10 +
Lemberger L, Axelrod J, Kopin IJ:  Metabolism and disposition of δ-nine tetrahydrocannabinol in man . Pharm Rev 23:371-380, 1971;.
11 +
Kew MC, Bershon J, Siew S:  Possible hepatotoxicity of cannabis . Lancet 1:578-579, 1969;.
12 +
Rees KR, Shotlander VL:  Fat accumulation in acute liver failure . Ann NY Acad Sci 104:905-915, 1963;.
13 +
Popper H, Schaffner F, Rubin E, et al:  Mechanisms of intrahepatic cholestasis in druginduced hepatic injury . Ann NY Acad Sci 104:988-1013, 1963;.
14 +
Dagirmanjian R, Boyd ES:  Some pharmacological effects of two tetrahydrocannabinols . J Pharm Exp Ther 125:25-33, 1962;.
15 +
Hardman HF, Donimo EF, Seever MH:  General pharmacological actions of some synthetic tetrahydrocannabinol derivatives . Pharm Rev 23:295-315, 1971;.
16 +
Perez-Reyes M, Timmons MC, Lipson MA, et al:  Intravenous injection in man of δ-nine tetrahydrocannabinol and 11-OH δ-nine tetrahydrocannabinol . Science 177:633-635, 1972;.
17 +
Tennant FS, Preble M, Prendergast TJ, et al:  Medical manifestations associated with hashish . JAMA 216:1965-1969, 1971;.
18 +
Juel-Jensen BE:  Cannabis and recurrent herpes simplex . Br Med J 4:296, 1972;.
19 +
Nahas GG, Suciu-Focu N, Armand JP, et al:  Inhibition of cellular mediated immunity in marihuana smokers . Science 183:419-420, 1974;.

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