Portal de Periódicos da CAPES

An Antidote for THC Overdose?

2023; Lippincott Williams & Wilkins; Volume: 45; Issue: 9A Linguagem: Inglês

10.1097/01.eem.0000978628.45757.4e

1552-3624

Sherry Yafai,

Cannabis and Cannabinoid Research

FigureFigureAre you tired of the partygoer who didn't know his THC limit and just took too big an edible and landed in your ED? Panic stricken and thinking he was going to die, only to take up a bed for hours and fall asleep until a friend picked him up? Now, thanks to the latest harebrained invention of a weed aficionado, say hello to HIBEGONE. (https://www.hibegone.com.) That's right, high-be-gone, the smartest name for an antidote since Digibind, brought to you by the makers of other brand names such as OG-Kush, Wedding Crashers, and Gorilla Glue (not made by the same people). Seriously, though, this new product aims to help those who have taken too much avoid the unintentional, nonlethal overdose that can land people in the ED. You have to hand it to the marijuana user community: They noticed a lack of treatment and devised their own. Proof of this is in increasing ED visits in Colorado and poison control calls in states with recreational laws in place. We have had more negative outcomes, but the seriousness of those visits and calls has still been relatively mild and often easily managed with good old-fashioned Ativan. (This is not to be confused with a discussion on Cannabis hyperemesis syndrome, which is more akin to long-term subclinical overdose from THC.) Cannabis lore holds that individuals can employ some home remedies when too much THC causes panic and anxiety instead of the intended pleasant high, including, according to social media and the dark web, biting into a peppercorn, taking CBD, and waiting it out. We in the ED have access to Ativan, which is the mainstay for the typical overdose leading to anxiety. But most people don't have Ativan laying around. From this paucity of an antidote available to laypeople comes the people's solution to the THC OD, HIBEGONE, chemically known as THCV (tetrahydrocannabivarin). One article noted that THCV is a nonpsychoactive neutral CB1 antagonist/reverse agonist and may act as an agonist or antagonist at the CB2 receptor depending on dose. (J Cannabis Res. 2020;2[1]:6; https://bit.ly/3YVq0Q9.) THCV is thought to block the psychological effects of THC, but the process is unknown. It is also referred to as “diet weed” or “weederall” after an article reported on THCV decreasing fasting plasma glucose. (Diabetes Care. 2016;39:1777. https://bit.ly/45P4E9d.) Interestingly, most states won't allow it to be placed in a dispensary alongside the medications that would lead to its use because it is derived from hemp. The same law that allows it to be legal in all 50 states also makes it illegal to sell THCV in a dispensary in certain states. The last question I hope you are asking yourself is whether it works. I have no idea. THCV has been notoriously difficult to access. This makes it difficult to formulate an opinion on it from a clinical perspective, and the paucity of literature on it makes it difficult to decide on a scientific perspective, leaving us in the dark. I would love to hear from anyone who has seen a patient who has tried it as an antidote. Please send me your experiences at [email protected]. DR. YAFAI is an emergency physician, the medical director of the ReLeaf Institute, an adjunct assistant professor at the John Wayne Cancer Institute, and a vice president of the Society of Cannabis Clinicians. Find more information at https://thereleafinstitute.com. Read her past columns at http://bit.ly/CaseforCannabis. Share this article on Twitter and Facebook. Access the links in EMN by reading this on our website: www.EM-News.com. Comments? Write to us at [email protected].