Wednesday, April 16, 2014

Which is more deadly - water or marijuana?

Posted by Marc Abrahams in Improbable Research

high animated GIFThere’s news about the literally grave danger that a feared drug might pose for someone somewhere someday. Details are in a new study. The study describes two persons who died from no obvious cause, and who—the doctors conclude — therefore must have died from the unknown amounts of marijuana that they are likely to have consumed at some point in the minutes, hours or days prior to their death:

Sudden unexpected death under acute influence of cannabis,” Benno Hartung, Silke Kauferstein, Stefanie Ritz-Timme, Thomas Daldrup, Forensic Science International, vol. 237, April 2014, pp. e11-e13.

“We describe the cases of two young men who died unexpectedly under the acute influence of cannabinoids. To our knowledge, these are the first cases of fatal cannabis smoking where full postmortem investigations were carried out…. 

After exclusion of other causes of death we assume that the young men experienced fatal cardiovascular complications evoked by smoking cannabis….The absolute risk of cannabis-related cardiovascular effects can be considered to be low…. Nevertheless, it is impossible to predict….”

The marijuana danger is comparable, in some ways, to the danger-of-death posed by another feared drug. This study describes four persons who died after ingesting extremely large amounts of water in a very short time:

Forensic aspects of water intoxication: four case reports and review of relevant literature,” Nemanja Radojevic, Bojana Bjelogrlic, Vuk Aleksic, Nemanja Rancic, Mira Samardzic, Stojan Petkovic, Slobodan Savic, Forensic Science International, vol. 220, nos. 1-3, July 2012, pp. 1-5.

“Water intoxication (WI) is a rare condition that originates from over-consumption of water, with a potentially fatal outcome. Increased water intake (polydipsia) is followed by urination of high amount of diluted urine (polyuria) which are the main initial symptoms of WI. We present four case reports of WI.”

BONUS: A New Scientist report about the marijuana report: “Cannabis can kill without the influence of other drugs“. Also, a Daily Mail report.

BONUS (possibly related):
Acute water intoxication during military urine drug screening,” M.A. Tilley, C.L. Conant, Military Medicine, vol. 176, no. 4, April 2011, pp. 451-3.

“Random mandatory urine drug screening is a routine practice in the military. The pressure to produce a urine specimen creates a temptation to consume large volumes of water, putting those individuals at risk of acute water intoxication. This occurs when the amount of water consumed exceeds the kidney’s ability to excrete it, resulting in hyponatremia owing to excess amount of water compared to serum solutes. 

The acute drop in serum osmolality leads to cerebral edema, causing headaches, confusion, seizures, and death. There has been increasing awareness of the danger of overhydration among performance athletes, but dangers in other groups can be underappreciated. 

We present the case of a 37-year-old male Air Force officer who developed acute water intoxication during urine drug screening. Our case demonstrates the need for a clear Air Force policy for mandatory drug testing to minimize the risk of developing this potentially fatal condition.”