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Correction to: The Potential Proconvulsant Effects of Cannabis: a Scoping Review (Journal of Medical Toxicology, (2022), 18, 3, (223-234), 10.1007/s13181-022-00886-3)

  • Eric E. Kaczor
  • , Kevin Greene
  • , Jennifer Zacharia
  • , Laura Tormoehlen
  • , Mark Neavyn
  • , Stephanie Carreiro
  • University of Massachusetts Medical School
  • Tufts University
  • Indiana University Bloomington

Research output: Contribution to journalComment/debate

Abstract

References #53 and #59 in this article contain errors. The correct references are as follows: 53. Wang GS, Le Lait MC, Deakyne SJ, Bronstein AC, Bajaj L, Roosevelt G. Unintentional Pediatric Exposures to Marijuana in Colorado, 2009–2015. JAMA Pediatr. 2016;170(9):e160971. 59. Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clin Pediatr (Phila). 2016;55(5):428–36. 53. Wang GS, Le Lait MC, Deakyne SJ, Bronstein AC, Bajaj L, Roosevelt G. Unintentional Pediatric Exposures to Marijuana in Colorado, 2009–2015. JAMA Pediatr. 2016;170(9):e160971. 59. Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clin Pediatr (Phila). 2016;55(5):428–36. In addition, the Table 1 citation numbering became mismatched during the final submission. The numbering has been updated to match the reference list. (Table presented.) Data Abstracted from Included Articles Exposure Chronicity Author(s); Year, Type Study Goal/ Description Data Source Location Clinical Setting Timeframe Cohort Age Range (y) (Mean/Median), % Male, % Female Routes of Exposure Biomarker Testing Description of Cannabis Exposure Group Seizure Incidence (N); n = # of Cannabis Exposures (single: poly-substance) Other Relevant Findings/Takeaways Acute Cannabis Exposures Anderson, et al. (57); 2019, RC Characterize neuropsychiatric presentation of cannabinoid exposures to the ED ToxIC Registry U.S., 23 states ED'10-'18 13–19 y 74% M, 26% F NR No Adolescents presenting to the ED for synthetic or traditional cannabis exposure 5.8% (5^);n = 348 (86: 262) SC-only & SC-polydrug exposures had higher rates of seizures than cannabis-only & cannabis-polydrug exposures, respectively Heizer, et al. (49); 2018, RC Explore dose–response relationship in THC-naïve vs. non-naïve children after THC exposure Medical charts CO, U.S., 1 hospital Inpatient '09-'14 0—20 y (9.5 y) 60.5% M, 39.5% F Oral = 30 (39%), INH = 35 (46%), U/O = 11 (14%) Yes 2 Hospital presentations related to acute THC toxicity, excluding co-ingestions 3.9% (3^); n = 76 (76: 0) Clinical effects differed for naïve vs. non-naïve patients. Naïve patients exhibited more CNS effects & a direct relationship between dose ingested, hospital disposition & level of medical intervention required Noble (52); 2019, RC Describe clinical effects of acute recreational cannabis exposures during early legalization period Oregon/ Alaska Poison Center OR & AL, U.S PCC '15-'17 0—96 y (20 y) 54.2% M, 45.8% F Oral = 187 (74%), INH = 57 (23%), U/O = 9 (3.6%) Yes 3 PCC calls for acute exposure to cannabis, excluding co-ingestions 3.6% (9^); n = 253 (253: 0) Neurotoxicity is common after acute cannabis exposures Concentrated products such as resins & liquid concentrates were associated with greater toxicity than other cannabis products Onders, et al. (56); 2015, RC Provide information about pediatric exposures to MJ NPDS U.S., 50 states PCC '00-'13 0–6 y (1.81 y) 50.7% M, 49.3% F Oral = 1477 (75%), INH = 286 (14.5%), U/O = 206 (10.4%) NR All single substance MJ exposures involving children < 6 years old 0.51% (10^); n = 1,969 (1,969: 0) N/A Schmid, et al. (51); 2020, RC Characterize the acute toxicity of cannabis with & without co-substances Euro-DEN Plus Switzerland, 3 hospitals ED '12-'18 14–68 y (26 y) 77.4% M, 22.6% F Oral = 40 (6%), INH = 356 (50%), U/O = 321 (45%) Yes 4 ED presentations due to acute toxicity related to self-reported cannabis recreational use 4.8% (9^); n = 717 (186: 531) No significant difference found in rate of seizures with cannabis alone vs. cannabis combined with other substances Wang, et al. (53); 2016, RC Compare incidence of pediatric MJ exposures before & after recreational MJ legalization Medical charts CO, U.S PCC'09-'15 0–9 y (2 y) 48% M, 52% F Oral = 121 (74%), INH = 18 (11%), U/O = 24 (15%) Yes 5 ED/Urgent Care presentations, inpatient hospitalizations, & RPC cases for single-substance MJ exposures 3% (5^); n = 163 (163: 0) N/A Wolfe, et al. (50); 2019, RC ID the recreational substances most implicated in seizures, their RR & differences in presentations with & without seizure Euro-DEN Plus Europe, 21 countries ED '14-'17 NR (31 y) 76% M, 23% F NR No ED presentations with acute recreational drug toxicity & self-reported cannabis use 3.1% (61^); n = 22,919 (1,954: 20,965) Drugs associated with higher seizure incidence include fentanyl & synthetic cannabinoids Heroin, clonazepam, & cannabis were associated with a lower seizure incidence than other drugs Claudet, et al. (54); 2017, RC Assess characteristics of cannabis exposure in young children admitted from the ED Medical charts France, 1 hospital ED '04-'14 0–3 y (15.1 m) NR Oral = 23 (79%), U/O = 6 (21%) Yes6 Children admitted to a pediatric ED due to unintentional cannabis exposure 14% (4); n = 29 (NR) N/A Graham, et al. (58); 2020, RC Describe trends of illicit drug exposures in young children, their incidence & outcomes NPDS U.S., 50 states PCC '06-'16 0–10 y (2 y) 52% M, 48% F NR NR Pediatric exposure calls to all US Poison Centers that include acute cannabis exposure 2.3% (76); n = 3,365 (NR) N/A Guidet, et al. (47); 2020, RC Present bio-concentrations of THC & metabolites in infants after cannabis intoxication Medical charts France, 1 hospital ED '16-'18 0–3 y (16 m) 20% M, 80% F Oral = 8 (80%), U/O = 2 (20%) Yes 1 ED presentations for cannabis poisoning with available data on [THC] & [metabolites] in plasma &/or urine 20% (2); n = 10 (10: 0) No correlation between plasma concentrations & symptoms, but [THC-COOH] in the 2 patients who experienced seizures was > 3000 (ng/mL) Liakoni, et al. (55); 2015, RC Describe the acute toxicity of recreational drugs Medical charts Switzerland, 1 hospital ED '13-'14 > 16 y (31 y) 69% M, 31% F NR Yes7 ED presentations with acute toxicity due to self-reported recreational cannabis use 4.4% (3); n = 68 (NR) N/A Non-Acute Cannabis Exposures Desai, et al. (48); 2018, RC Assess the most frequently identified causes of hospitalization & independent predictors of in-hospital mortality in recreational MJ users NIS U.S., > 40 states Inpatient '10-'14 18–44 y (37 y) 63.2% M, 36.8% F NR NR All hospitalizations in patients with a history of recreational MJ usage * 1.8% (41,972) +; n = 465,959 (NR) Hospital presentation for epilepsy among MJ users increased in recent years Epilepsy & convulsions were the most common primary presentations at the time of MJ-related admission Patel, et al. (60); 2019, RC Investigate the relationship between CUD & hospitalization for epilepsy NIS U.S., > 40 states Inpatient '10-'14 15–54 y 50.2% M, 49.8% F NR NR All hospitalizations with a primary diagnosis of epilepsy & an ICD-9 diagnosis of CUD 5.77% ϕ; n = 37,945 (NR) CUD is independently associated with a 56% increased likelihood of epilepsy hospitalization. Odds of epilepsy hospitalization were higher in cannabis, tobacco, & alcohol use disorders, but lower with cocaine, amphetamine, & opioid use disorders ToxIC Registry Toxicology Investigators Consortium Registry; NPDS National Poison Data System; Euro-DEN European Drug Emergencies Plus Network; NIS National Inpatient Sample; RC Retrospective Cohort; PC Prospective Cohort; SC Synthetic Cannabinoids; CUD Cannabis Use Disorder; RPC Regional Poison Center; UDS Urine Drug Screen; THC Tetrahydrocannabinol; MJ Marijuana; RR = Relative Risk; NR Not Reported; ID Identify; y Years; PCC Poison Center Calls; INH Inhaled; U/O Unknown or Other; N/A Not Applicable; 1only included cases with quantifiable serum &/or urine THC levels; 2Positive THC was part of inclusion criteria. Also used to rule out co-ingestions 323 (9%) had a positive UDS immunoassay; 4used in 54% (n = 387) of the cases; among these, THC was detected in 294/387 cases; 5Subjects were identified either by a positive UDS for THC or having one of a list of ICD-9 codes; 6UDS, positive in all; 783% confirmed with immunoassays & liquid chromatography/mass spectrometry (LC–MS/MS) *only 13 subjects identified themselves as 'active cannabis users.' +rate (n = total #) of admissions due to epilepsy in recreational cannabis users; ϕCUD incidence in epilepsy patients ^seizure events (N) come from the single-substance ingestion group [] concentration The authors respectfully apologize for this error.

Original languageEnglish
Pages (from-to)54-60
Number of pages7
JournalJournal of Medical Toxicology
Volume19
Issue number1
DOIs
StatePublished - Jan 2023

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