Issued “to alert public health departments, healthcare professionals, first responders, poison control centers, laboratories, and the public to the increased availability of cannabis products containing delta-8 tetrahydrocannabinol (THC) and the potential for adverse events due to insufficient labeling of products containing THC and cannabidiol (CBD).”
Delta-8 THC exists naturally in the cannabis plant in only small quantities and is estimated to be about 50-75% as psychoactive as delta-9 THC. CBD can be synthetically converted into delta-8 THC, as well as delta-9 THC and other THC isomers, with a solvent, acid, and heat to produce higher concentrations of delta-8 THC than those found naturally in the cannabis plant. This conversion process, used to produce some marketed products, may create harmful by-products that presently are not well-characterized.
Products that contain delta-8 THC but are labeled with only delta-9 THC content rather than with total THC content likely underestimate the psychoactive potential of these products for consumers. Labeling deficiencies may also lead consumers to think that they are purchasing hemp or CBD products that are not intoxicating. Because testing methods for products like synthetically derived delta-8 THC are still being developed, delta-8 THC products may not be tested systematically for contaminants such as heavy metals, solvents, or pesticides that may have adverse health effects. Poison control centers and intensive care units have reported cases of adverse events related to the use of delta-8THC products in adults and children. After the American Association of Poison Control Centers began monitoring these events, 660 delta-8 THC exposures were recorded between January 1 to July 31, 2021, of which, 18% (119 of 661 cases) required hospitalization, and 39% (258 of 661 cases) involved pediatric patients less than 18 years of age.
The rise in popularity of delta-8 THC has increased the availability of psychoactive cannabis products, even in states, territories, and tribal nations where non-medical adult cannabis use is not permitted under law. Variations in product content, manufacturing practices, labeling, and potential misunderstanding of the psychoactive properties of delta-8 THC may lead to unexpected effects among consumers. Other cannabis-derived products of potential concern have emerged recently, such as those containing delta-10 THC and THC-O acetate. Increased reports of adverse events as well as the continued emergence of similarly produced cannabis-derived products, warrants the continued monitoring and research.
The CDC provides several recommendations for retailers selling cannabis products such as providing consumers with information regarding the psychoactive qualities of delta-8-THC and reporting total THC content on labels (including ingredients like delta-8).
Additionally, the CDC also provides several recommendations for healthcare providers, including being vigilant in observing patients presenting with THC-like intoxication symptoms and questioning patients about their use of CBD of delta-8-THC products. There is no specific antidote for THC intoxication. Treatment is largely symptomatic and supportive care. The ability to detect delta-8 THC with laboratory tests that hospitals use to detect delta-9 THC currently is not fully characterized yet, therefor it is best to contact the hospital toxicologist with any concerns.
