{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:48:09Z","timestamp":1790952489336,"version":"4.1.0"},"reference-count":75,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Psychopharmacol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cannabis is the most widely used illegal drug but is rarely considered a causal factor in death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>This study aimed to understand trends in deaths in England where cannabinoids were detected at post-mortem, and to evaluate the clinical utility of post-mortem cannabinoid concentrations in coronial investigations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Deaths with cannabinoid detections reported to the National Programme on Substance Abuse Deaths (NPSAD) were extracted and analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From 1998 to 2011, on average 7% of all cases reported to NPSAD had a cannabinoid detected ( n\u2009=\u2009110 deaths per year), rising to 18% in 2020 ( n\u2009=\u2009350). Death following cannabis use alone was rare (4% of cases, n\u2009=\u2009136\/3455). Traumatic injury was the prevalent underlying cause in these cases (62%, n\u2009=\u200984\/136), with cannabis toxicity cited in a single case. Polydrug use was evident in most cases (96%, n\u2009=\u20093319\/3455), with acute drug toxicity the prevalent underlying cause (74%, n\u2009=\u20092458\/3319). Cardiac complications were the most cited physiological underlying cause of death (4%, n\u2009=\u2009144\/3455). The median average \u03949-tetrahydrocannabinol post-mortem blood concentrations were several magnitudes lower than previously reported median blood concentrations in living users (cannabis alone: 4.3\u2009\u00b5g\/L; cannabis in combination with other drugs: 3.5\u2009\u00b5g\/L).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Risk of death due to cannabis toxicity is negligible. However, cannabis can prove fatal in circumstances with risk of traumatic physical injury, or in individuals with cardiac pathophysiologies. These indirect harms need careful consideration and further study to better elucidate the role cannabis plays in drug-related mortality. Furthermore, the relevance of cannabinoid quantifications in determining cause of death in coronial investigations is limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02698811221115760","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T07:18:49Z","timestamp":1660115929000},"page":"1362-1370","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Can cannabis kill? Characteristics of deaths following cannabis use in England (1998\u20132020)"],"prefix":"10.1177","volume":"36","author":[{"given":"Kirsten L","family":"Rock","sequence":"first","affiliation":[{"name":"Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Englund","sequence":"additional","affiliation":[{"name":"Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London, South London and Maudsley NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9715-8936","authenticated-orcid":false,"given":"Stephen","family":"Morley","sequence":"additional","affiliation":[{"name":"Toxicology Unit, Leicester Royal Infirmary, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5328-5295","authenticated-orcid":false,"given":"Kathleen","family":"Rice","sequence":"additional","affiliation":[{"name":"Toxicology Unit, Leicester Royal Infirmary, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-1402","authenticated-orcid":false,"given":"Caroline S","family":"Copeland","sequence":"additional","affiliation":[{"name":"Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Sciences, King\u2019s College London, London, UK"},{"name":"National Programme on Substance Abuse Deaths, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"bibr1-02698811221115760","first-page":"18","volume":"13","author":"Akhgari M","year":"2021","journal-title":"Addict Health"},{"key":"bibr2-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.21218"},{"key":"bibr3-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.02.016"},{"key":"bibr4-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.195503"},{"key":"bibr5-02698811221115760","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.42.2.01"},{"key":"bibr6-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-200304000-00020"},{"key":"bibr7-02698811221115760","first-page":"168","volume":"41","author":"Bourget D","year":"2013","journal-title":"J Am Acad Psychiatry Law"},{"key":"bibr8-02698811221115760","doi-asserted-by":"publisher","DOI":"10.3390\/toxins13020117"},{"key":"bibr9-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1007\/s00414-009-0403-2"},{"key":"bibr10-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.01.035"},{"key":"bibr11-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjco.2020.09.001"},{"key":"bibr12-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1186\/s40621-020-00276-9"},{"key":"bibr13-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1186\/s40621-017-0105-z"},{"key":"bibr14-02698811221115760","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2013.00079"},{"key":"bibr15-02698811221115760","volume-title":"Pharmacology Condensed","author":"Dale MM","year":"2009"},{"key":"bibr16-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00437.x"},{"key":"bibr17-02698811221115760","volume":"10","author":"Desai R","year":"2018","journal-title":"Cureus"},{"key":"bibr18-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2013.01.002"},{"key":"bibr19-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2013.216507"},{"key":"bibr20-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkv012"},{"key":"bibr21-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30048-3"},{"key":"bibr22-02698811221115760","unstructured":"EMCDDA (2012) Driving under the influence of drugs, alcohol and medicines in Europe\u2014findings from the DRUID project. Available at: https:\/\/www.emcdda.europa.eu\/publications\/thematic-papers\/druid_en (accessed February 2022)."},{"key":"bibr23-02698811221115760","unstructured":"EMCDDA (2021) Trends and developments European monitoring centres for drugs and drug addiction [Online]. Available at: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/13838\/TDAT21001ENN.pdf (accessed February 2022)."},{"key":"bibr24-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(17)30075-5"},{"key":"bibr25-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1177\/0269881112460109"},{"key":"bibr26-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.4500"},{"key":"bibr27-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2019.12.001"},{"key":"bibr28-02698811221115760","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2013.07.2684"},{"key":"bibr29-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2018.299727"},{"key":"bibr30-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.194381"},{"key":"bibr31-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02141-3"},{"key":"bibr32-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2011.06.028"},{"key":"bibr33-02698811221115760","unstructured":"Home Office (2015) Drug misuse: Findings from the 2014\/15 crime survey for England and Wales, 2nd edn. Statistical Bulletin 03\/15. Available at: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/462885\/drug-misuse-1415.pdf (accessed February 2022)."},{"key":"bibr34-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1992.100"},{"key":"bibr35-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2010.04.019"},{"key":"bibr36-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2021.103391"},{"key":"bibr37-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2010.03897.x"},{"key":"bibr38-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-017-0663-0"},{"key":"bibr39-02698811221115760","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000681"},{"key":"bibr40-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.05.047"},{"key":"bibr41-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/33.8.469"},{"key":"bibr42-02698811221115760","first-page":"294","volume":"10","author":"Kendall DA","year":"2016","journal-title":"Front Cell Neurosci"},{"key":"bibr43-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2019.10.012"},{"key":"bibr44-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12345"},{"key":"bibr45-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.06.005"},{"key":"bibr46-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1093\/anatox\/35.7.394"},{"key":"bibr47-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291713001438"},{"key":"bibr48-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxr017"},{"key":"bibr49-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2019.106142"},{"key":"bibr50-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.05.013"},{"key":"bibr51-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1375\/twin.9.4.523"},{"key":"bibr52-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.4037"},{"key":"bibr53-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187320"},{"key":"bibr54-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2021.01.003"},{"key":"bibr55-02698811221115760","unstructured":"Ministry Of Housing, Communities & Local Government (2019) English indicies of deprivation 2019 [Online]. Available at: http:\/\/imd-by-postcode.opendatacommunities.org\/imd\/2019 (Accessed February 2022)."},{"key":"bibr56-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61162-3"},{"key":"bibr57-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20341"},{"key":"bibr58-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1097\/00000433-199603000-00002"},{"key":"bibr59-02698811221115760","unstructured":"ONS (2020). Drug misuse in England and Wales: year ending March 2020 [Online]. Available: https:\/\/www.ons.gov.uk\/peoplepopulati-onandcommunity\/crimeandjustice\/articles\/drugmisuseinenglandandwales\/yearendingmarch2020 (accessed February 2022)."},{"key":"bibr60-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14819"},{"key":"bibr61-02698811221115760","unstructured":"PHE (2021) United Kingdom drug situation 2019: Focal Point annual report. Available at: https:\/\/www.gov.uk\/government\/publications\/united-kingdom-drug-situation-focal-point-annual-report (accessed February 2022)."},{"key":"bibr62-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1111\/j.1556-4029.2007.00603.x"},{"key":"bibr63-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1002\/dta.2368"},{"key":"bibr64-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.03.015"},{"key":"bibr65-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109118"},{"key":"bibr66-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2018.11.011"},{"key":"bibr67-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2010.05.006"},{"key":"bibr68-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.08.010"},{"key":"bibr69-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/32.7.470"},{"key":"bibr70-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1992.tb02692.x"},{"key":"bibr71-02698811221115760","unstructured":"UK Government (2021) United Kingdom drug situation 2019: Focal Point annual report. Available at: https:\/\/www.gov.uk\/government\/publications\/united-kingdom-drug-situation-focal-point-annual-report\/united-kingdom-drug-situation-focal-point-annual-report-2019#cannabis (accessed February 2022)."},{"key":"bibr72-02698811221115760","unstructured":"www.gov.uk (2020) When a death is reported to a coroner [Online]. Available at: https:\/\/www.gov.uk\/after-a-death\/when-a-death-is-reported-to-a-coroner (accessed February 2022)."},{"key":"bibr73-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-58950"},{"key":"bibr74-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1007\/s40429-017-0149-8"},{"key":"bibr75-02698811221115760","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-014-9899-y"}],"container-title":["Journal of Psychopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02698811221115760","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02698811221115760","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02698811221115760","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:11:07Z","timestamp":1777507867000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02698811221115760"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,10]]},"references-count":75,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1177\/02698811221115760"],"URL":"https:\/\/doi.org\/10.1177\/02698811221115760","relation":{},"ISSN":["0269-8811","1461-7285"],"issn-type":[{"value":"0269-8811","type":"print"},{"value":"1461-7285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,10]]}}}