Humans have been getting high on marijuana for millennia, and there has never been a recorded case of a fatal overdose. That record appeared to be in peril earlier this week, following reports that an 11-month-old in Colorado died last year following exposure to THC, the psychoactive ingredient in weed.
Local media seized on the case report first published in March, suggesting that the two poison control doctors who wrote it had concluded the infant’s death was caused by a marijuana overdose.
Such a finding would have sent a shockwave through the marijuana advocacy and medical communities. Cannabis is associated with a low risk of harm, which advocates have long touted as a reason to relax laws that categorize weed as one of the most dangerous drugs. And although medical experts have routinely warned of certain health risks around consuming marijuana, they have largely agreed that THC alone simply doesn’t kill people.
The case from Colorado could have challenged that entire precept. But it didn’t.
“We are absolutely not saying that marijuana killed that child,” one of the doctors who authored the report told The Washington Post in a later interview.
And indeed, that’s clear after a close reading of the paper.
The doctors actually argue that marijuana exposure could have contributed to the myocarditis ― an inflammation of the heart muscle ― that was determined to have caused the death of the 11-month-old boy. The child tested positive for high levels of THC, and there have been prior reports of cannabis-associated myocarditis, according to the doctors. Because they couldn’t confirm an alternate cause for the cardiac inflammation after conducting additional testing, they concluded there may have been a “possible relationship” between the THC and the fatal episode.
“In areas where marijuana is commercially available or decriminalized, the authors urge clinicians to preventively counsel parents and to include cannabis exposure in the differential diagnosis of patients presenting with myocarditis,” they wrote.
“I’m not convinced, I have to be honest. Marijuana is a drug that’s impairing, but not one that’s known to cause issues like those described in the paper.”
At the very least, urging doctors to tell parents to be careful with their marijuana edibles and other cannabis products seems like sound advice, especially as a growing number of states ― now eight, as well as Washington, D.C. ― are legalizing marijuana for recreational use.
But to be clear, this was not a case of fatal marijuana overdose. It wasn’t even a claim of one. Such a death would be truly remarkable, as reports have found that a user would have to ingest somewhere between 20,000 to 40,000 times the amount of THC contained in a single joint ― if not more ― to approach lethal toxicity. It’s not clear if that’s even physically possible, which is probably why one Colorado doctor was quick to “call ‘BS’” on the idea that the child had been poisoned by marijuana.
But even the more accurate and less controversial conclusion ― that there could be a link between cannabis and fatal myocarditis ― has raised some eyebrows.
“I’m not convinced, I have to be honest,” Dr. Bruce Goldberger, chief of forensic medicine at the University of Florida, told HuffPost. “Marijuana is a drug that’s impairing, but not one that’s known to cause issues like those described in the paper.”
It’s crucial that medical examiners and coroners evaluate and exclude every potential cause of death in totality before attributing it to the ingestion of a drug, Goldberger said.
“I don’t know if they did any genetic testing to verify that the child was genetically OK or normal. There weren’t any details in there that I could see in the report,” he said. “You have to rule out all metabolic and genetic causes.”
The report presented a few other red flags that could have been worth further examination. For example, although the doctors claimed to have ruled out “almost every other cause” of death, the paper makes no mention of screening for a fungal infection, which can also cause myocarditis.
But ultimately, it’s not just medical professional who have to exercise caution when it comes to reporting on drugs.
“You also have to be careful about what you read on the internet,” Goldberger said.