A surge in availability and popularity of designer drugs and cannabinoids, natural and synthetic, has led to increasing numbers of users who require emergency care. With presentations ranging from somnolence to sociability, depression to euphoria, agitation to hallucination, and hyperemesis to hyperthermia, acute intoxication and synthetic drug use should be included in the differential for a wide spectrum of possible diagnoses. Complicating such cases, many of these patients have multiple substances on board, the chemical structure of which is ever-changing as manufacturers seek to outpace the development of tests to detect designer drugs and fly under the radar of legal authorities. This multimedia resource will give you the low-down on “legal highs” by reviewing the evaluation and management of intoxication emergencies associated with cannabinoids, synthetic cannabinoids, cathinones, phenethylamines, methoxetamine, kratom, and salvia. It includes 9 AMA PRA Category 1 Credits™. Included as part of the 9 credits, this CME activity is eligible for 7 Pharmacology CME credits. CME expires on 06/01/2021.
Course 1: Cannabinoids: Emerging Evidence in Use and Abuse
As the use of cannabinoids increases, so have ED presentations of patients with acute intoxication and cannabinoid hyperemesis syndrome. This course reviews the latest evidence on recognizing and managing patients with emergent conditions related to cannabinoid use, including an overview of the pathophysiology of cannabinoids; the common and uncommon clinical findings associated with cannabinoid use; and the current evidence on cannabinoid hyperemesis syndrome. This course also includes an episode of the EMplify podcast for audio review.
CME Credits: 4.5 (includes 3.5 Pharmacology credits)
Course 2: Synthetic Drug Intoxication in Children: Recognition and Management in the Emergency Department
Due to the constantly changing chemical formulations of synthetic drugs and the prevalence of polysubstance abuse, diagnosing patients with intoxication from these substances is often challenging. This course reviews the basic terminology and background information on synthetic cannabinoids, synthetic cathinones, and phenethylamines; the common presentations of synthetic drug intoxication in children and adolescents; and the best practices for managing pediatric patients with synthetic drug intoxication.
CME Credits: 4 (includes 3 Pharmacology credits)
Audio Presentation: What’s in the Street and What’s in Your ED
In this audio presentation, Andrew C. Schmidt, DO, MPH, of the University of Florida College of Medicine – Jacksonville, reviews the presentation and management of intoxication with so-called “designer” synthetic drugs, including synthetic cannabinoids, methoxetamine, cathinones, kratom, and salvia. Mechanisms of use and action, symptoms of intoxication, potential complications, and treatment options are discussed.
Audio length: 25 minutes
CME Credits: 0.5 (includes 0.5 Pharmacology credits)
Publication Date: September 1, 2020
CME Expiration Date: June 1, 2021
CME Information: Included as part of the 9 credits, this CME activity is eligible for 7 Pharmacology CME credits, subject to your state and institutional approval. Accreditation: EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the ACCME. Credit Designation: EB Medicine designates this enduring material for a maximum of 9 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The “Cannabinoids: Emerging Evidence in Use and Abuse” journal issue of Cannabinoids and “Legal Highs”: Recognition and Management in the Emergency Department is approved by the American College of Emergency Physicians for 4 hours of Category I credit. Cannabinoids and “Legal Highs”: Recognition and Management in the Emergency Department is eligible for 8 Category 2-A or 2-B credit hours by the American Osteopathic Association.