A case of panic attack developing after THC-O acetate inhalation using an e-cigarette device.

AIM: Tetrahydrocannabinol acetate (THC-O) is a cannabinoid-based product, and few medical studies have evaluated the effects of THC-O on humans. Recently, e-cigarettes have become popular among teenagers and young adults worldwide. However, there have been reports of people misusing this device as a delivery system for drugs of abuse.

CASE PRESENTATION: We herein report a case of panic attack after THC-O inhalation using an e-cigarette device in an 18-year-old male with no history of psychiatric disorders. Although he started smoking both regular cigarettes and e-cigarettes in junior high school, he had never vaped delta-9 THC or THC-O until the present episode. A total of 20 min after his first inhalation of THC-O, he experienced a sudden attack that lasted 2 h. After this episode, he did not inhale THC-O. Throughout the subsequent 6 months of follow-up, he maintained improvement with no panic attacks.

CONCLUSION: In this case, we intend to emphasize that THC-O is not safe, even if the substance is regarded as loophole drug. The use of e-cigarette devices might accelerate substance abuse.