Emergency departments nationwide are documenting a surge in cannabis-related medical presentations, creating an urgent need for evidence-based treatment protocols that many physicians lack. This comprehensive clinical review addresses a critical knowledge gap as cannabis legalization expands and synthetic variants proliferate in the market.
The analysis identifies distinct pathophysiological mechanisms between natural cannabis compounds and synthetic alternatives, revealing different toxicity profiles that require tailored interventions. Emergency physicians now encounter everything from acute intoxication episodes to cannabinoid hyperemesis syndrome—a condition characterized by severe, cyclical vomiting that can lead to dangerous dehydration and electrolyte imbalances. The review establishes diagnostic criteria for these presentations and outlines specific management strategies, including emerging treatments for the most severe cases.
This clinical guidance arrives at a pivotal moment in cannabis medicine. While research on therapeutic applications continues, the reality is that emergency departments serve as unintended laboratories for understanding cannabis toxicity patterns. The distinction between natural and synthetic cannabinoids proves particularly crucial, as synthetic variants often produce more severe and unpredictable reactions. For health-conscious adults, this research underscores the importance of understanding that legal status doesn't eliminate medical risks. The documentation of hyperemesis syndrome as a legitimate clinical entity—once dismissed or misdiagnosed—validates patient experiences and provides physicians with concrete treatment frameworks. This represents a maturation in cannabis medicine, moving beyond advocacy or prohibition debates toward practical clinical reality.