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Description

Synthetic cannabinoids are a chemically diverse group of psychoactive substances that target the endocannabinoid system and can cause severe, multisystem toxicity involving the neurologic, gastrointestinal, renal, and cardiovascular systems. Unlike natural cannabis, these compounds are unregulated, contributing to a growing number of emergency department visits and hospitalizations.� We present a case of synthetic cannabinoid use resulting in the constellation of seizures, encephalopathy, severe rhabdomyolysis, acute kidney injury (AKI), and refractory hyperemesis.

An 18-year-old man with a past medical history of chronic cannabis use disorder presented to the emergency department by EMS for acute confusion with intractable nausea and vomiting. Approximately 12 hours prior, he vaped an unknown substance obtained from a friend, described as "Memory Loss," believed to be a cannabis product. His father reported that the patient called him and seemed confused. During this call, the father heard periods of loud grunting and heavy breathing along with disorganized speech. On arrival, EMS found the patient in the bathroom, covered in vomit, confused, and disoriented. On arrival to the ED, the patient had no memory of these events, including how he arrived in the bathroom or calling and talking to his father. Initial labs showed creatinine 1.21 mg/dL and an anion gap of 27. Urine drug screens were positive for cannabinoids only.

This case illustrates the unpredictable multisystem toxicity associated with synthetic cannabinoid exposure, including neurologic injury, rhabdomyolysis, acute kidney injury, and hyperemesis. Given the increasing prevalence of these substances, clinicians should maintain a high index of suspicion for synthetic cannabinoids in patients presenting with unexplained toxicity. Early recognition and aggressive supportive management are essential to prevent morbidity, and awareness of emerging therapies for refractory cannabinoid hyperemesis may help improve outcomes.

Publication Date

5-8-2026

Disciplines

Internal Medicine

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1941

Synthetic Cannabinoid Use Complicated by Multiorgan Dysfunction

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