2023 14th Annual NUBE Conference

Along with the legalization of marijuana throughout the U.S., there is an increase in use of delta products as well. While these delta-THCs are widely available and advertised, little information about the effects and possible risks are broadcast to the public. Marijuana is federally classified as a Schedule 1 substance; however, the Delta drugs are not regulated. According to the Farm Bill from 2018, hemp products with less than 0.3% THC can legally be bought, sold, and grown in most states in the U.S., creating a loophole for marketing of these products. For the user this means that there is no assurance of content of the purchased product, and they bear the risk of potentially containing harmful byproducts.  Delta-9-THC is one of the primary psychoactive cannabinoids of marijuana. Delta-9 is hemp derived and binds to the same cannabinoid receptors as marijuana. It can induce the same psychoactive effects which are euphoria, feeling “stoned”, anxiety or paranoia as well as aggression. Delta-8-THC is commonly called “marijuana lite” or “diet weed”. Marijuana contains Delta-8 THC only in a small percentage. The sold Delta 8 product is typically made by synthetically converting CBD or Delta 9 THC into Delta 8. Delta 8 binds to the same receptors as Delta 9; Little research is available on Delta 8, but available studies are showing side effects that are comparable to marijuana ranging from paranoia, difficulties with concentration, memory, perception of time to sedation and euphoria. Concerning are reports of accidental severe intoxication, resulting in more than 2000 calls to poison control centers between January 2021 and February 2022. Several states have started to ban the recreational sales of delta-8-THC. Delta-10-THC, however, is often reported to cause more euphoria and energy rather than sedation. Little research is available regarding its benefits and side effects, but the novelty of this substance makes it especially attractive to users. The delta-drugs are available in various forms: edibles, vaped concentrates as well as smoking bud or flower or in topical ointments. About 50% of consumers of delta-drugs also reported in surveys to use marijuana as well. It is important for emergency psychiatrist to know and understand these substances in order to be able to assess the clinical presentation correctly and to provide the effective clinical care for acute and ongoing stabilization. This presentation is a systematic review of literature looking at the available data for Delta 8,9,10 for psychiatric and medical use. Utilized sources were PubMed, Ovid, Medline, Psych Info, EMBASE.

Learning Objectives:

1. Pharmacology and toxicology of Delta-THCs.
2. Clinical presentations.
3. Treatment for use of Delta-THCs.