The toxicity of intravenously used marihuana.

While no unanimity of opinion exists regarding the risk to physical health from smoking marihuana, we have seen four cases that demonstrate clearly that intravenous usage is hazardous. The severity of the multisystemic involvement is dose-related. On initial examination, signs of most severe overdosage included fulminant gastroenteritis, hypoalbuminemia, toxic hepatitis confirmed by serial biopsy, acute renal failure, electrolyte disturbances, leukocytosis, anemia, and a relative thrombocytopenia. In three patients who shared a common needle, gingivostomatitis also developed.