Abstract
Introduction: Synthetic cannabinoids abuse is a global concern, creating new challenges for treatment services. Strox is a version of synthetic cannabinoids that emerged and became increasingly popular in Egypt. Aim: To study socio-demographic and clinical characteristics in addition to causes of deaths in patients with acute Strox toxicity who presented to Poison Control Center Ain Shams University Hospitals (PCCA). Methods: a cross-sectional hospital-based observational study was carried out on 92 patients with Strox toxicity during a 3 year period from 2018 to 2020. Recorded data included: age, gender, route, mode of exposure and vital data. Investigation including arterial blood gases (ABG), liver function tests (LFT) and renal function tests (RFT) and ECG were done. Outcome data including duration of hospital stay, intensive care unit (ICU) admission and mortality rate were recorded. Results: Cases were mainly in the age group between 13-40 years (82.6%), males (93.5%) and due to addiction (90.2 %). Coma and agitation were the main recorded presentations (63% and 34% respectively). Shock and respiratory failure were recorded in 12% and 22% respectively, while liver and renal impairment were recorded in 5% and 3% respectively. Sever intoxication was diagnosed in 78.3% with mortality rate 11%. Deaths were due to cardiac insults in 50% of the patients. Conclusion: The incidence of strox toxicity has recently increased in Egypt with high mortality rate. Cardiac and respiratory complication are the most common causes of death. Until now little is known about the pattern of acute poisoning by strox poisoning, so early recognition of sever cases and close observation in ICU with early resuscitation could help in lowering the mortality rate.
Highlights
Synthetic cannabinoids abuse is a global concern, creating new challenges for treatment services
This study included 92 patients presented to Poison Control Center Ain Shams University Hospitals (PCCA) with Strox toxicity over 3 years period from beginning of the year 2018 to end of the year 2020
Statistical analysis revealed no significant differences between survivors and nonsurvivors as regard age, sex, and mode/route of poisoning
Summary
Synthetic cannabinoids abuse is a global concern, creating new challenges for treatment services. Until now little is known about the pattern of acute poisoning by strox poisoning, so early recognition of sever cases and close observation in ICU with early resuscitation could help in lowering the mortality rate. Synthetic cannabinoids (SCs) are either sprayed on dried plant material so they can be smoked or sold as liquids to be vaporized and inhaled in electronic cigarettes. Their types are variable from country to another and their constituents are subjecting to continues renewing by their creators to escape legal prohibition (Farquhar et al, 2018). An emerging novel synthetic cannabinoid that named Strox is representing great medical and legal challenges in Egypt. As with tetra-hydrocannabinol (THC), prolonged exposure to SCs results in tolerance to agonist effects, decreased CB1 receptor expression and signaling in specific brain regions (Tai et al, 2015)
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