Intravenously Injected Marihuana Syndrome

We have recently examined two patients who suffered from the adverse effects of intravenously injected marihuana. A review of the English literature identified only four previous case reports1-3and mention of three others.4Several recent studies5-8have described the clinical effects from experimental injection of the purified marihuana components Δ9-tetrahydrocannabinol and 11-OH-Δ9-tetrahydrocannabinol; however, there are no controlled studies dealing with the clinical abnormalities induced by administration of crude marihuana extract. Our two patients shared the same broth and had almost identical clinical and laboratory findings. Their clinical course was similar to that described previously.1-3 PATIENT SUMMARIES Patient 1.— A 21-year-old man was transferred to the University of Michigan Medical Center after evaluation and treatment for hypotension at a local emergency room. Twenty-two hours prior to admission, he had added the juice squeezed from watered marihuana cuttings to opium and boiled this mixture