In medicine one of the ways information is shared among healthcare professionals is by publishing interesting, unusual or emerging case reports in peer reviewed medical journals. While this is not a case managed by the Illinois Poison Center, I thought it was important to share this real life situation!
Case Report:
A 2 year old female with no past medical history presented to the local emergency department 45 minutes after ingesting Cannabidiol (CBD) edibles. The patient was minimally responsive and put on a ventilator due to her serious symptoms. It was eventually discovered that the patient had actually gotten into a package of Delta-8-THC gummies her father had recently purchased from a gas station.
What the heck is Delta-8-THC?
Some sort of new drug? Well yes, but actually, no… Delta-8 is short for Delta-8-Tetrahydrocannabinol (Delta-8-THC). If that names sounds familiar it’s because Tetrahydrocannabinol (THC) is the psychoactive drug found in the various cannabis plant species Cannabis sativa, Cannabis indica, and Cannabis ruderalis. But the THC everyone knows has a full scientific chemical name – Delta-9-Tetrahydrocannabinol. But we will be referring to it as THC from here on out just to make things a little less confusing.
The cannabis plants used recreationally can contain over sixty different chemicals called cannabinoids, with THC and CBD being the most well-known. Cannabis can also contain Delta-8 THC but the amount found naturally in the plant is negligible, so all the psychoactive properties of marijuana are generally attributed to THC.
Delta-8-THC and THC are remarkably similar chemicals and only differ by the position of a single double bond. Don’t believe me? Just look at the chemical structures below (my apologies for any terrifying flashbacks to the days of high school chemistry).
Because of the almost near identical chemical structures of THC and Delta-8-THC, the two drugs produce similar effects when consumed, though some Delta-8-THC users claim it gives a more mellow high with less side effects. The symptoms of Delta-8-THC intoxication can include drowsiness, confusion, slurred speech, stumbling, rapid heart rate, decreased blood pressure, difficulty breathing and coma. The similarities don’t stop there; just like THC, there are a variety of different products that contain Delta-8-THC including plant material intended to be smoked, vape pens or cartridges, tinctures, and just about any type of edible you could possibly imagine! And if you were thinking of switching to Delta-8-THC to avoid your urine testing positive for THC, I wouldn’t recommend it. Your standard urine drug screen doesn’t actually test for THC but rather one of its metabolites created by the body. The metabolites from Delta-8-THC are near copycats of those from THC, so the drug screen will still be positive for THC.
Is Delta-8-THC Legal?
The Agriculture Improvement Act of 2018 (Farm Bill) amended the Controlled Substances Act to remove Cannabis (also called Hemp) plants and their derivatives containing <0.3% THC as scheduled substances. There was no mention of Delta-8-THC or other cannabinoids, which some manufacturers interpreted as a legal loop hole. This led to the increased creation of products containing synthetic Delta-8-THC and have been aggressively marketed as a “legal” high. The Drug Enforcement Agency (DEA) was not pleased with this attempted exploitation of the law and released a memo stating that synthetically derived cannabinoids are still considered Schedule I controlled substances. Several states have banned or restricted the sale of Delta-8-THC and others are considering enacting similar legislation in the future.
Human Research Involving Delta-8-THC
Unfortunately, the medical literature has not kept up with the current enthusiasm for Delta-8-THC. Only a few studies on the effect of Delta-8-THC have been performed in humans, and the majority are from the 1970’s and 1980’s. These studies suggest that Delta-8-THC is about 33% less potent than the equivalent amount of THC. A clinical trial from 1995 studied the use of Delta-8-THC to treat nausea and vomiting in children receiving chemotherapy. It was an incredibly small study with only 8 patients so it is difficult to make any sweeping generalizations from the results, but Delta-8-THC appeared to be fairly well tolerated with only 2 patients having symptoms of euphoria and irritability.
Final Thoughts
Delta-8-THC is similar to other recreational drugs in that you never really know what you’re dealing with. Due to shady manufacturers trying to skirt laws, there’s always the possibility a product labeled Delta-8-THC may actually contain other substances such as THC. Even though Delta-8-THC is thought to be less potent, some individuals, especially children, can become quite sick from it, just like in the case described in the introduction.
Trends in recreational drug use are constantly changing but the one thing that won’t change is the fact that the IPC 1-800-222-1222 Helpline will always be here to answer your questions, every minute of every day (free, confidential call)! Click here for a free Complimentary Safety Packet (includes a sticker, magnet and first-aid recommendations) and here for the IPC’s free online Poison Prevention Education Course.
