Epidemiology of cannabis poisoning : Data from the toxicology laboratory of the Poison Control and Pharmacovigilance Centre of Morocco (2013–2015) Narjis.

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Epidemiology of cannabis poisoning : Data from the toxicology laboratory of the Poison Control and Pharmacovigilance Centre of Morocco (2013–2015) Narjis Badrane a,b , Omaima Elbouazzi a,b , Mouna Bentafrita , Mohamed Ghandia , Abdelmajid Soulaymanib , Naima Aitdaoud a,b and Rachida Soulaymani Bencheikh c ,a a Poison Control and Pharmacovigilance Centre of Morocco, Rabat, Morocco; b Genetics and Biometry Laboratory, Faculty of Sciences, University Ibn Tofail, Kenitra, Morocco; c Faculty of Medicine and Pharmacy of Rabat, Rabat, Morocco INTRODUCTION Cannabis is the most prevalent illicit drug found in routine clinical and medico-legal drug testing. Urine is the easiest biological fluid for identifying recent cannabis use. Immunoassay is currently the most common approach for urine drug screening (1). In this study, we aimed to assess harm associated with cannabis use and to describe the epidemiological features of cannabis poisoning cases. METHODS Data was collected retrospectively from the requests of urine detection of cannabis sent to the toxicology laboratory of the Poison Control and Pharmacovigilance Centre of Morocco (CAPM-LAB) from January 2013 to September 2015. The qualitative determination of 11-norD9-tetrahydrocannabinol-9-carboxylic acid (11-nor-D9-THC-9- COOH) in urine was performed by chromatographic rapid test. The cut-off level was 50 ng/mL or higher. The data included circumstances of poisoning, sex, age distribution and symptomatology of the positive cases. RESULTS 224 requests for urine detection of cannabis were received at CAPM-LAB, 121 (54%) were positive for cannabis; no deaths were reported Tableau 1: Epidemiological characteristics of the positive urine detection of cannabis, toxicology laboratory of the Poison Control and Pharmacovigilance Centre of Morocco, 2013-2015 Epidemiological characteristic Results Average age 21.1 ± 6.8 Sex ratio 11 (110 males, 10 females) Circumstances Chronic use 99 (81. 8%) Acute accidental poisoning 6 (5%) Acute overdose in users 16 (13.2%) Symptomatic cases (neurological symptoms) 22 (18.2%) Association with other drugs 24 (19.8%) Benzodiazepines 10 Nicotine 6 Methadone 2 Ethanol 1 Other drugs* 5 Figure 1: Number of positive cannabis detection cases by age and circumstances , toxicology laboratory of the Poison Control and Pharmacovigilance Centre of Morocco, 2013-2015 * Morphine : 1, Amphetamine : 1, Metamphetamine : 1, Cocaine : 1, Sertraline : 1 CONCLUSION Cannabis use is common in Morocco and affects young people. Although cases of chronic use were most common, there were also cases of acute poisoning in children. REFERENCE 1-Sundström M, Pelander A, Ojanperä I. Comparison between drug screening by immunoassay and ultra-high performance liquid chromatography/high-resolution time-of-flight mass spectrometry in post-mortem urine. Drug Test Anal. 2015 May;7(5):420-7.