Pubdate: Fri, 04 Apr 2014
Source: Denver Post (CO)
Copyright: 2014 The Denver Post Corp
Author: John Ingold


ERs See More Patients As Lawmakers Review Edibles' Potency.

Throughout Dr. Scott Bentz's career in emergency medicine, marijuana 
wasn't something he much worried about.

Perhaps a person a month would come in feeling panicky after smoking 
pot. A sedative and a quiet room usually did the trick.

"It's the easiest emergency medicine case you're going to see," said 
Bentz, the medical director of emergency services at Presbyterian/St. 
Luke's Medical Center in Denver.

And then came the day a man arrived in the emergency room so sedated 
and breathing so slowly after eating a marijuana-infused edible that 
he was nearly comatose.

For the past few months, Bentz said, he's seen more and more patients 
at the hospital who have consumed marijuana-infused products. And, 
while the cases don't come close in number or severity to 
alcohol-related cases, Bentz said they show the kind of problems that 
can go along with edible marijuana-especially for those trying pot 
for the first time and who see edibles as a more appealing access point.

Potency amounts vary. It's far easier to overconsume than it is with 
smoking. And the products can affect everyone differently, from 
intense anxiety to excessive sedation.

"The edibles are just a whole different ball of wax," Bentz said. 
"You just don't know what you're going to get."

The potential risks of edibles are receiving new attention after the 
death of a Wyoming college student last month. Levy Thamba, 19, 
became agitated after eating marijuana-infused cookies and then leapt 
to his death from a hotel balcony, according to a coroner's report 
released this week. His death was classified as an accident.

Denver police are still investigating, and state law could allow for 
criminal charges against whoever gave the underage Thamba the 
cookies, though police spokesman Sonny Jackson wouldn't comment on 
the possibility of charges in the case.

"I'm not going to speculate one way or another," Jackson said Thursday.

Lawmakers this week are expected to introduce a bill that would 
further restrict the potency level of edibles. Current state law 
limits individual edible products to 100 milligrams of THC, the 
psychoactive chemical in marijuana. That amount, though, is 
equivalent to 10 servings - meaning most infused products are meant 
to be nibbled over time, not consumed all at once.

Bentz said most of the patients coming into the emergency room are 
naive users who consumed too much, too fast.

Edibles can take over an hour to kick in, leading many first-time 
users to eat more after not immediately feeling the effects. And the 
potency levels of edibles-which are not yet subject to mandatory 
testing - can differ even from what's listed on the label.

It remains unclear how much Thamba ate or how long elapsed before his death.

In 2011, 3,871 people in Denver who went to the emergency room 
mentioned recent marijuana use, according to federal data. Bentz, 
though, said he has never seen a case of extreme agitation caused by 
a marijuana edible. Patients most commonly arrive at the hospital 
over-sedated, he said.

"It's very, very rare that somebody is going to be at risk for 
serious harm," Bentz said.

Marijuana use, however, can spur psychotic episodes in people who are 
predisposed to mental health problems, said Dr. Paula Riggs, a 
professor of psychiatry at the University of Colorado School of 
Medicine. Most of the research has focused on how frequent marijuana 
use impacts the onset of psychosis. But Riggs said it is also 
possible that first-time use can lead to problems.
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MAP posted-by: Jay Bergstrom