NEW ORLEANS – A local coroner claims to have discovered the first known THC overdose fatality, according to a report in the New Orleans Advocate.
Medical and cannabis experts, however, widely disagree with St. John the Baptist Parish Coroner Christy Montegut’s conclusions.
“There is no known fatal overdose with cannabinoids. It is physiologically impossible, as there are no cannabinoid receptors in the area of the medulla oblongata [brain stem] that controls respiration,” Bonni Goldstein, M.D., told mgretailer. A well-known pediatrician who treats medical conditions like cancer and epilepsy with cannabis medicines, Goldstein’s work and advocacy can be seen in 2018 documentary “Weed the People.”
Several media outlets reported that a 39-year-old LaPlace-area woman was found slumped over on her couch, dead. Montegut’s autopsy found the deceased organs were healthy, no other drugs or alcohol were in her system, and no acute medical condition was apparent. He said toxicology reports indicated a high level of THC in her blood.
“It looked like it was all THC, because her autopsy showed no physical disease or afflictions that were the cause of death,” Montegut told the Advocate. “There was nothing else identified in the toxicology—no other drugs, no alcohol. There was nothing else.”
Montegut also said in order for THC to register on toxicology tests, a THC blood level of 0.5 nanograms per milliliter of blood must be present. The deceased’s level was 8.4 nanograms per milliliter, leading him to declare cause of death as THC over-intoxication. Coroner since 1988, Montegut said he believes the case is a possible “index case in medicine.”
“I’m thinking this lady must have vaped this THC oil and got a high level in her system and [it] made her stop breathing, like a respiratory failure,” he said.
The New York Post quoted the victim’s boyfriend, who said the deceased “used a marijuana vaping pen, and had been to the ER three weeks before she died because of a chest infection and said doctors sent her home with over-the-counter medication.”
There is no clear, bright line that indicates THC over-intoxication, nor are there any documented cases of fatal cannabis overdose. Legal states have struggled to find an appropriate blood level to define “buzzed driving.” Rules can vary from jurisdiction to jurisdiction, assuming policies are in place with state or local law enforcement officials.
In 2013, Colorado set the intoxication level at 5 nanograms per milliliter of blood. Legal states Indiana, Pennsylvania, and Rhode Island prohibit any THC blood-level while driving.
“For many years, researchers, in their quest to find the lethal dose of cannabis, have given extremely high doses of cannabinoids to primates and have failed in killing them,” Dr. Goldstein explained. “The CDC [Centers for Disease Control] stopped recording ‘deaths from marijuana’ in their ‘deaths from overdoses’ because there are none. It has been extrapolated that a human would have to smoke 1,500 pounds of THC-rich cannabis in fifteen minutes to die.”
She continued, “In some parts of our country, coroners are not physicians, pathologists, or even medically trained, believe it or not, so in this article he mentions that the ‘THC caused respiratory failure.’ This can’t happen. So, I question his understanding of physiology and wonder if he is medically trained. If he is, he doesn’t know about THC or its interaction with the endocannabinoid system, which is not unusual as most doctors are still in the dark when it comes to this science.”
Media reports were unclear about whether the vaping materials of the deceased had been tested for adulterants.
Louisiana allows medical marijuana patients to consume edibles, oil, and extracts. In early June, legislators approved a bill that would allow medical marijuana patients to inhale cannabis vapors using inhalers similar to those used by asthma patients.
In his statements to The Advocate, Montegut cautioned local legislators about cannabis inhalers, saying, “If you’ve got a 30-day supply of THC in there with an inhaler, you can just keep puffing away.”