Tetrahydrocannabinol (Δ9-THC) is a psychoactive substance
that is found in Cannabis sativa L., which has been globally linked with
acute toxicity cases. Finding the best biological sample for quick and
accurate THC detection is essential for medical and forensic oversight.
This study aimed to evaluate the most precise sample type for rapidly and
accurately determining cannabis levels. We conducted a case-control
study at Benha Poisoning Control Unit. Benha University Hospital, from
December 1, 2023, to April 30, 2024. One hundred sixty-eight
participants were recruited, comprising 84 with acute cannabis toxicity
and 84 controls who matched in age and sex. Sociodemographic
information, vital signs, clinical symptoms (neurological,
gastrointestinal, and respiratory), and THC levels in blood, urine, and oral
fluid using immunoassay (cutoff: 50 ng/mL) were all evaluated. The
majority of cases were male (71.4%), aged 19-59; 52.4% were inhaled,
while 83.3% were intentionally exposed. Common symptoms included
tachycardia (47.5% when compared to controls), anxiety (40.8%),
decreased consciousness (59.5%), vomiting (23.8%) and nausea (11.9%).
THC levels (ng/mL) after 30 hours of exposure varied from 66 to 90
(blood), 59 to 77 (urine), and 400 to 700 (oral fluid/saliva). Three hours
for blood and urine Cmax, and five to nine hours for oral fluid. The
maximum AUC (0–9h: 3977.08 mcg/mL.hr) and a positive correlation
with blood (r=0.9, p |
