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A cannabis 'overdose' death in Louisiana? Experts don't buy it.

Posted on June 17th, 2019 by Bill Weinberg and tagged , , , , , .

LouisianaA Louisiana coroner declared a local woman's death to be the first on record attributed to a cannabis overdose, winning lurid national headlines. But medical experts and even federal officials as well as advocates are skeptical of the claim.


When the first ever reported death from THC in the United States was declared by a local coroner in Louisiana earlier this month, media reports across the country jumped on the claim.

Fox News, predictably, ran the most gullible headline, merely parroting: "Louisiana coroner says woman died of THC overdose." Other mainstream sources, thankfully, aired skepticism from experts in the field—whose voices carry far more weight than that of Christy Montegut, coroner of St. John the Baptist Parish, some 30 miles up the Mississippi River from New Orleans.

The unnamed 39-year-old woman was found dead in her apartment in the town of La Place in February, and the autopsy determined that she had healthy organs, no evident illnesses, and no elevated levels of alcohol or other drugs in her body—just high levels of THC.

"It looked like it was all THC because her autopsy showed no physical disease or afflictions that were the cause of death," Montegut told the New Orleans Advocate. "There was nothing else identified in the toxicology—no other drugs, no alcohol. There was nothing else."

Based on an interview with her boyfriend, Montegut said the THC in the woman's system likely came through use of a vaping device with highly concentrated THC oil—even though no such device was actually found. The toxicology report said she had 8.4 nanograms of THC per milliliter of blood—about 15 times the detection level. In the absence of the vape pen, Montegut went on the Internet to try to determine what the concentrate level of the oil may have been, and came up with a surmised 80% THC.

"I'm thinking this lady must have vaped this THC oil and got a high level in her system and [it] made her stop breathing, like a respiratory failure," he said.

Montegut asserted to local CBS affiliate 4WWL that "at high levels, marijuana can cause respiratory depression, which means a decrease in breathing, and if it's a high enough level it can make you stop breathing."

Don't believe the hype
Montegut's claim was met with skepticism even from the highest levels of prohibitionist officialdom.

Keith Humphreys, a former senior policy adviser at the White House Office of National Drug Control Policy, told the Advocate that with the huge quantities of cannabis consumed across the United States each year, more overdose deaths would logically be occurring if THC were really toxic at consumable levels.  

"We know from really good survey data that Americans use cannabis products billions of times a year, collectively. Not millions of times, but billions of times a year," Humphreys said. "So, that means that if the risk of death was one in a million, we would have a couple thousand cannabis overdose deaths a year."

Even the generally reactionary New York Post noted that the federal government's National Institute on Drug Abuse admits that there have been no recorded deaths attributable to a cannabis overdose.

States the NIDA website: "Can a person overdose on marijuana? An overdose occurs when a person uses enough of the drug to produce life-threatening symptoms or death. There are no reports of teens or adults dying from marijuana alone." It goes on to warn (of course) of "symptoms such as anxiety and paranoia, and in rare cases, an extreme psychotic reaction" (this latter a dubious enough claim) that can lead to an emergency room visit (theoretically).  

Go higher up the rungs of officialdom, to the global level, and the notion is dismissed more forthrightly. The World Health Organization's Expert Committee on Drug Dependence (ECDD) stated in a 2018 report on cannabis toxicology: "Cannabis is a relatively safe drug, which is not associated with acute fatal overdoses... Lethality studies in animals show the doses needed to induce mortality are well beyond what could possibly be consumed by a human."

Even Fox News, after their credulous headline, did cite Bernard Le Foll, an addiction specialist at the University of Toronto. He estimated that any dangerous threshold would likely fall between 100 and 1,000 times higher than the THC level found in the woman's blood.

The cannabis industry trade journal MG Retailer spoke to Bonni Goldstein, a pediatrician who treats conditions such as epilepsy with cannabis medicines, and was featured in the 2018 documentary Weed the People. "There is no known fatal overdose with cannabinoids," she said. "It is physiologically impossible, as there are no cannabinoid receptors in the area of the medulla oblongata [brain stem] that controls respiration,"

And indeed the woman's boyfriend told investigators that she had three weeks before her death visited an emergency room over a chest infection, and was given over-the-counter medication. Complications related to this infection may be a far more likely culprit in her death than use of cannabis oil—but would have certainly failed to grab headlines.

As Humphreys, the former advisor to the Drug Czar, told the Advocate, perhaps somewhat understatedly: "There's always some imperfection in these kinds of assessments."

But reason for caution with extracts
Nonetheless, there is cause for caution where use of highly concentrated extracts is concerned. In a 2012 commentary for O’Shaughnessy’s, the San Francisco-based "Journal of Cannabis in Clinical Practice," California NORML’s longtime leader Dale Gieringer related numerous cases of fainting (sometimes causing injury) due to over-indulgence in "dabbing" concentrates such as butane hash oil. He warned that "increased use of BHO has led to an increase in hospitalizations for cannabis overdose."

Advocates of good old fashioned marijuana bud have a point when they diss the current concentrate craze as making possible a cannabis "overdose," the very notion of which was rightly dismissed as ludicrous when smoking in the herbaceous form was ubiquitous. That said, use of the term "overdose" even in regard to dabbing is inherently misleading, as it inevitably invokes the deadly OD from heroin or cocaine. The possibility that the unfortunate La Place woman died due to THC is vanishingly small.

Cross-post to Cannabis Now

Image from Greenwich Mean Time

 

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