Intravenous marijuana syndrome

Overview

Intravenous marijuana syndrome is a rare and dangerous condition resulting from the attempt to inject marijuana extracts or solutions directly into the bloodstream. Unlike the typical inhalation or oral ingestion of cannabis, intravenous (IV) use is highly unsafe and not a recognized or sanctioned method of administration. This behavior is often associated with severe complications, including systemic infection, cardiovascular collapse, and toxic reactions, as the body is not equipped to handle plant-based materials or oils injected into the veins.

Causes

The syndrome is caused by the intravenous injection of substances derived from cannabis, including:

• Homemade cannabis oil extracts: Often containing impurities or solvents not meant for IV use.

• Infused solutions or suspensions: Crude attempts to dissolve or emulsify cannabis products in water or alcohol for injection.

• Recreational experimentation or substance abuse: Some individuals may attempt IV use seeking a faster or more intense effect.

• Misinformation: Belief that injecting cannabis might offer medicinal benefits or stronger psychoactive effects without understanding the risks.

Symptoms

Symptoms of intravenous marijuana syndrome can appear rapidly and vary based on the substance used and individual response. Common symptoms include:

• Severe pain, redness, or swelling at the injection site

• Fever and chills: Signs of systemic infection or sepsis

• Shortness of breath and chest pain: Possible pulmonary embolism or chemical pneumonitis

• Nausea, vomiting, or confusion: Due to toxic reactions or contamination

• Altered mental status: Anxiety, hallucinations, or agitation

• Rapid heartbeat or low blood pressure: Cardiovascular instability or shock

In severe cases, symptoms can escalate to life-threatening complications such as multi-organ failure, septicemia, or cardiac arrest.

Diagnosis

Diagnosis is based on clinical evaluation and disclosure of injection behavior. Healthcare providers may perform the following:

• Medical history: Questioning about substance use, particularly IV drug use.

• Physical examination: Evaluation of injection sites for infection, abscess, or thrombophlebitis.

• Blood cultures and laboratory tests: To detect systemic infection, inflammation, or organ dysfunction.

• Toxicology screening: To identify other substances that may have been used or mixed with the injection.

• Imaging studies: Chest X-ray or CT scan if respiratory symptoms are present.

Treatment

Treatment for intravenous marijuana syndrome is emergency-based and supportive, focusing on managing complications:

• Hospitalization: Often required for close monitoring and treatment.

• Antibiotics: Administered if infection or sepsis is suspected.

• IV fluids and vasopressors: For stabilizing blood pressure in cases of shock.

• Wound care or surgical drainage: If there is an abscess or infected injection site.

• Oxygen therapy or mechanical ventilation: For patients with respiratory distress.

• Psychiatric evaluation: To assess for underlying substance use disorder or mental health conditions.

Prognosis

The prognosis for intravenous marijuana syndrome depends on the amount and type of material injected, the promptness of medical treatment, and the presence of complications. While mild cases may resolve with supportive care, more severe cases can lead to permanent organ damage or death. Long-term consequences may include vein scarring, chronic infection, or psychological trauma. Education and prevention are critical, as there is no safe or medically approved method for injecting cannabis products.