Hemp seed oil may possibly (but not probably) cause cannabinoid poisoning

May 10, 2017, 1:41 am

hemp seed oil★★½☆☆

Cannabinoid Poisoning by Hemp Seed Oil in a Child. Chinello M et al. Pediatr Emerg Care 2017;33:344-345.

Abstract

This interesting but non-dispositive short case report from Italy suggests that, in rare instances, commercially marketed hemp seed oil can cause mild cannabinoid toxicity. A 2-year-7-month old male was brought to hospital with altered mental status and several hours of “decreased alertness, refusal to walk, and no verbal response.” Additional findings included: “paleness, stupor, [and] low reactivity to stimulation.” Pulse rate was 129 bpm. There was no ataxia.

The parents reported that the child had been given CANAH hemp seed oil (1 tsp twice daily) for the preceding 3 weeks, prescribed by a pediatrician to “strengthen his immune system.” There was no evidence that the child had access to other cannabinoid products, or had self-administered additional doses.The child’s initial urine drug screen was positive for cannabinoids (> 50 ng/ml), as was a second one obtained 19 hours after presentation. After several hours of hydration the child’s mental status improved. He was observed for 24 hours and then sent home.

The authors note that hemp seed oil contains a small amount of tetrahydrocannabinol (THC). (In fact, they tested the specific product involved and found that the THC content was approximately one-tenth of that allowed by law for hemp seed oil in Italy. They argue that presentation with decreased mental status was typical for toddlers with exposure to cannabinoids.

Could the child just have become dehydrated and lethargic for some other reason? Quite possibly. The authors claim that applying the Naranjo Probability scale for adverse drug reactions yielded a score of 5 (“probable” ADR). This seems to me a bit of a stretch — my interpretation is that the maximum score is 4 (“possible” ADR), which is much less compelling.

The key take-home lessons: Be aware that chronic consumption of hemp seed oil may possibly produce mild cannabinoid toxicity, with decreased mental status in a child. But be very careful to rule out other possible etiologies, such as infection, trauma, and other poisons such as ethanol.

 

 

 

 

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