Fatal Toxicity of Synthetic Cannabinoid: Case Report

Introduction Synthetic cannabinoids (SC) are chemicals that interact with cannabinoid receptors in the body and can cause mild to fatal toxicity, including respiratory depression, sedation, vomiting, convulsions, and psychosis [1,2]. This case highlights the severe, unpredictable toxicity of synthetic cannabinoids and related clinical challenges. Case Presentation A 42-year-old man was admitted to the Intensive Care Unit (ICU) from prison after two days of shortness of breath and poor general condition following inhalation of the synthetic cannabinoid SPICE. Suspecting acute respiratory distress syndrome and pneumothorax, a chest X-ray and computed tomography scan were performed, revealing lung congestion and pleural effusion, which was drained, releasing greenish foamy fluid. Despite treatment, his condition remained severe, with respiratory acidosis, agranulocytosis, lower respiratory tract infection complicated by sepsis, and respiratory failure. On the second day of hospitalization, multi-organ toxicity was observed, including toxic pneumonitis, acute liver failure, acute kidney injury, and ischemic gastrointestinal damage. Despite intensive care, the patient’s condition worsened, and he died on the fourth day due to progressive acute renal failure and lifethreatening hyperkalemia. Discussion Synthetic cannabinoids (SC) like SPICE are more potent and unpredictable than cannabis, acting as CB1 and CB2 receptor agonists [3]. SC carry a higher risk of severe neurological and cardiovascular effects, including seizures, consciousness disturbances, tachycardia, and psychosis. Toxic effects may include respiratory depression, pulmunory damage, and even death. Chronic use can lead to cannabinoid hyperemesis syndrome, rhabdomyolysis, and acute renal failure. SPICE use in e-cigarettes is linked to respiratory complications such as pneumothorax and pneumonia [4]. Due to the varying chemical composition of SC, there is no specific antidote, and treatment focuses primarily on intensive monitoring and supportive care [5]. Conclusions This case presents significant health dangers associated with synthetic cannabinoids, highlighting their potent and unpredictable toxicity. Further study is needed to understand their effects on different organ systems and to improve strategies for early detection and treatment of intoxication.