• Meghan Gilley, Jeffrey Brent, Diane P Calello, Paul Wax, Yaron Finkelstein, and Toxicology Investigators Consortium.
• From the Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
• Pediatr Emerg Care. 2021 Jan 1; 37 (1): e13e16e13-e16.

ObjectiveThe objective of this study was to characterize the clinical picture and management of synthetic cannabinoid exposure in a cohort of adolescents.MethodsUsing the 45 participating sites of the Toxicology Investigators Consortium Registry, a North American database, we conducted an observational study of a prospectively collected cohort. We identified all adolescent (12-19 years) cases of synthetic cannabinoid exposure who have received medical toxicology consultation between January 2012 and December 2016. Clinical and demographic data were collected including age, sex, circumstances surrounding exposure, coingestants, clinical manifestations, treatment, disposition, and outcome.ResultsWe identified 75 adolescents who presented to the emergency department with synthetic cannabinoid exposure. Most were male (91%) and between the ages of 16 and 19 (66%). The most common symptoms were neuropsychiatric with 50 adolescents (67%) exhibiting central nervous system (CNS) manifestations. There was no predominant toxidrome, and 9 patients (12%) were mechanically ventilated. Mainstay of treatment was supportive care. No deaths were reported.ConclusionsSynthetic cannabinoid exposure in adolescents is primarily characterized by CNS manifestations, which are varied and may be life-threatening. Frontline caregivers should maintain a high index of suspicion for synthetic cannabinoids, especially in adolescents who present with unexplained CNS manifestations, as there is no specific toxidrome or confirmatory rapid drug screen to detect them.Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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