An observational study of cannabis exposures reported to the poisons information helpline of the Western Cape

Abstract

Background: Cannabis has gained popularity as a medicinal and recreational drug and has recently been decriminalised for private use in South Africa. Previous publications indicate an association between increased popularity and increased reports of cannabis exposures. We aim to study this association indirectly by conducting a secondary analysis of cannabis exposures reported to the Poison Information Helpline of the Western Cape in South Africa. Objectives: To describe the demographics and characteristics of reported cannabis exposure cases from June 2015 to June 2019. Methods: This was a retrospective, observational, cross-sectional study of reported cannabis exposures recorded in the AfriTox TeleLog Database. The following variables were collected: demographics; circumstances of exposure; route of exposure; symptom profile and management advice. Changes in reports made to the poison helpline from June 2015 to June 2019 were also noted as was the comparison between monosubstance exposure and polysubstance exposure. Results: A total of 106 database entries were identified. Monosubstance use was reported in 70.8% of cases. Both genders were equally represented. The most common age groups were 20–59 years old (52.8%) followed by under 12 years old (27.3%). From June 2015 to June 2019 there was a 3 threefold increase in reported cases. Accidental overuse (40.6%), substance abuse (26.4%) and intentional self-harm (19.8%) were the most reported circumstances of exposure. The most common route of exposure was oral (66.0%) followed by inhalation (26.4%). Adverse effects are commonly reported after accidental versus nonaccidental (p<0.001), oral ingestion versus inhaled (p<0.001) of monosubstance cannabis use. The most common symptoms reported were central nervous system-related (75.5%), followed by gastrointestinal symptoms (20.8%). Central nervous system involvement was more commonly reported in children 12 years and younger (p=0.001) compared to those over 12 years. Conclusion: We provide a South African perspective on the changes in cannabis exposures reported to the Poison Information Helpline of the Western Cape from June 2015 to June 2019. Monosubstance cannabis exposures, accidental exposures, and oral ingestions are more likely to lead to reports of undesired effects. Children 12 years and younger are more likely to report neurological symptoms.