The Hidden Danger Of Marijuana Edibles

By Robert Glatter MD
The death of 19 year old Levy Thamba Pongi, a Wyoming exchange student from the Republic of Congo visiting Colorado in March of 2014, who ate a marijuana cookie, deserves special mention in light of the growing trend toward legalization of recreational marijuana in the U.S.
It offers a stark reminder about the potential risks associated with consuming edibles rapidly, serving as a reminder of its delayed effects (1-2 hours), as opposed to smoking it (5-10 minutes).

The story goes like this: After consuming the remainder of a cookie (total THC content =60 mg) about 30-60 minutes after he initially did not feel any effects after a single serving size (10 mg), he proceeded–2.5 hours after finishing the cookie—and 3.5 hours later to jump off a building, subsequently falling to his death.
He was initially given the cookie by a friend, and was apparently aware that there were 6 servings contained in the single cookie. He was instructed to eat one serving, which contained 10 mg.

According to a report this week by the CDC, he had never used marijuana, alcohol or illicit drugs, and had no previous history of mental illness.
The chief contributing factor to his death based on the autopsy, was marijuana intoxication—with a blood level of 7.2 ng/ml. Any level greater than 5 ng/ml constitutes impairment, and is above the legal limit for driving set forth in Colorado.

This was the first reported death in Colorado linked to marijuana use since the state approved recreational use in 2012, without evidence of polysubstance abuse.
First and foremost, it’s important that the public understands the delayed effects of marijuana edibles. Any user of such a product must realize that it takes at least 1-2 hours to experience the “high,” or euphoria, compared with smoking it. Consuming multiple servings, especially at one sitting, has an additive effect for potential psychological effects, not to mention possibility for oversedation, anxiety or psychosis.

Ingesting multiple servings in a short amount of time, such as the decedent did, can also lead to paradoxical or unusual reactions that can trigger intense anxiety, paranoia, or even frank psychosis–seen more frequently among first time users (marijuana-naïve).
It’s possible in this case that consuming the higher than recommended amount may have provoked an acute psychotic state that lead to distortion and perception of reality leading to such erratic behavior.

Another issue is quality control when you purchase marijuana edibles. The label of the product consumed by the decedent read as follows: “This marijuana product has not been tested for contaminants or potency.”

The safety of edibles could be compromised by potential adulteration with other illicit substances or drugs of abuse. With legalization and subsequent regulation, the goal is make consumers feel safe that they are consuming pure unadulterated THC.

As other states (Alaska, Washington, Oregon) have legalized recreational marijuana, it’s important to reinforce the need for packaging and labeling rules that edibles contain no more than 10 mg of THC, or “have clear demarcation of each 10 mg serving.”

With this report, the CDC clearly recognizes the danger of marijuana edibles by suggesting, “a need for improved public health messaging to reduce the risk for overconsumption of THC.”