Definition

Marijuana ("pot") intoxication is the euphoria, relaxation, and sometimes undesirable side effects that can occur when people use marijuana. The ability to perform complex tasks may be adversely affected. Many users report excessive appetite after marijuana use.

Some states in the Unites States permit marijuana to be used legally to treat certain medical problems. Other states have also legalized its general use.

Alternative Names

Cannabis intoxication; Intoxication - marijuana (cannabis); Pot; Mary Jane; Weed; Grass; Cannabis

Symptoms

The intoxicating effects of marijuana include relaxation, sleepiness, and mild euphoria (getting high).

Smoking marijuana leads to fast and predictable signs and symptoms. Eating marijuana can cause slower, and sometimes less predictable, effects.

Marijuana can cause undesirable side effects, which increase with higher doses. These side effects include:

• Decreased short-term memory
• Dry mouth
• Impaired perception and motor skills
• Red eyes

More serious side effects include panic, paranoia, or acute psychosis, which may be more common with new users or in those who already have a psychiatric disease.

The degree of these side effects varies from person to person, as well as with the amount and strength of marijuana used.

Marijuana is often cut with hallucinogens and other more dangerous drugs that have more serious side effects than marijuana. These side effects may include:

• Sudden high blood pressure with headache
• Chest pain and heart rhythm disturbances
• Extreme hyperactivity and physical violence
• Heart attack
• Seizures
• Stroke
• Sudden collapse (cardiac arrest) from heart rhythm disturbances

Treatment

Treatment and care involves:

• Preventing injury
• Reassuring those who have panic reactions due to the drug

Sedatives, called benzodiazepines, such as diazepam (Valium) or lorazepam (Ativan), may be given. Children who have more serious symptoms or those with serious side effects may need to stay in the hospital for treatment. Treatment may include heart and brain monitoring.

In the emergency department, the person may receive:

• Activated charcoal, if the drug has been eaten
• Blood and urine tests
• Breathing support, including oxygen, tube through the mouth, and breathing machine (ventilator)
• Chest x-ray
• Computerized axial tomography (CT, or advanced imaging) scan
• ECG (electrocardiogram, or heart tracing)
• Fluids through the vein (intravenous, or IV)
• Medicines to relieve symptoms (see above)

Outlook (Prognosis)

Uncomplicated marijuana intoxication rarely needs medical advice or treatment. Recurrent anxiety attacks may occur and require medications or other ongoing treatment. Occasionally, serious symptoms occur. However, these symptoms are rare and usually associated with other drugs or compounds mixed in with marijuana.

When to Contact a Medical Professional

If someone who has been using marijuana develops any of the symptoms of intoxication, has trouble breathing, or cannot be awakened, call 911 or the local emergency number. If the person has stopped breathing or has no pulse, begin cardiopulmonary resuscitation (CPR) and continue it until help arrives.

References

Brust JCM. Effects of drug abuse on the nervous system. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff’s Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 87.

Iwanicki JL. Hallucinogens. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 150.