United Nations Office on Drugs and Crime , 2022. World Drug. Vienna, Austria: United Nations. Available at: https://www.unodc.org. Accessed August 21, 2023.
Australian Institute of Health and Welfare , 2022. Alcohol, Tobacco & Other Drugs in Australia. Available at: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/cannabis. Accessed August 21, 2023.
Butt J, Wilson M, Jones J, Lenton S, 2022. Review of cannabis use among Aboriginal and Torres Strait Islander people. HealthInfoNet 3, doi: 10.14221/aihjournal.v3n3.1.
Yayan J, Rasche K & Pokorski M Advancements in Clinical Research. Advances in Experimental Medicine and Biology, Vol. 952. Cham: Springer.
Ribeiro L, Ind PW, 2018. Marijuana and the lung: hysteria or cause for concern? Breathe (Sheff) 14: 196–205.
Schauer GL, King BA, Bunnell RE, Promoff G, McAfee TA, 2016. Toking, vaping, and eating for health or fun: marijuana use patterns in adults, U.S., 2014. Am J Prev Med 50: 1–8.
Australian Institute of Health and Welfare , 2020. National Drug Strategy Household Survey 2019. Cat. No.: PHE 270. Available at: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data. Accessed August 21, 2023.
Wikipedia , 2007. Gravity Bong. Available at: https://en.wikipedia.org/wiki/Gravity_bong. Accessed August 21, 2023.
Moore D, 1995. Drug Use and Western Selfhood: An Ethnography of Urban Paths in Perth. Dissertation, University of Western Australia, Perth Australia.
Tashkin DP, Roth MD, 2019. Pulmonary effects of inhaled cannabis smoke. Am J Drug Alcohol Abuse 45: 596–609.
Tashkin DP, 2013. Effects of marijuana smoking on the lung. Ann Am Thorac Soc 10: 239–247.
Aldington S, Williams M, Nowitz M, Weatherall M, Pritchard A, McNaughton A, Robinson G, Beasley R, 2007. Effects of cannabis on pulmonary structure, function and symptoms. Thorax 62: 1058–1063.
Haddad I, Al-Ghzawi F, Karakattu SM, Musa R, Hoskere G, 2021. Dabbing-induced hypersensitivity pneumonitis. Cureus 13: e16333.
McMahon MJ, Bhatt NA, Stahlmann CG, Philip AI, 2016. Severe pneumonitis after inhalation of butane hash oil. Ann Am Thorac Soc 13: 991–992.
Gill A, 2005. Bong lung: regular smokers of cannabis show relatively distinctive histologic changes that predispose to pneumothorax. Am J Surg Pathol 29: 980–982.
Weiss ZF, Gore S, Foderaro A, 2019. Pneumomediastinum in marijuana users: a retrospective review of 14 cases. BMJ Open Respir Res 6: e000391.
Hancox RJ, Gray AR, Zhang X, Poulton R, Moffitt TE, Caspi A, Sears MR, 2022. Differential effects of cannabis and tobacco on lung function in mid-adult life. Am J Respir Crit Care Med 205: 1179–1185.
Ghasemiesfe M, Ravi D, Vali M, Korenstein D, Arjomandi M, Frank J, Austin PC, Keyhani S, 2018. Marijuana use, respiratory symptoms, and pulmonary function: a systematic review and meta-analysis. Ann Intern Med 169: 106–115.
Gracie K, Hancox RJ, 2021. Cannabis use disorder and the lungs. Addiction 116: 182–190.
Marcus HSL, Hancox RJ, 2011. Effects of smoking cannabis on lung function. Expert Rev Respir Med 5: 537–547.
Ribeiro LIG, Ind PW, 2016. Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review. NPJ Prim Care Respir Med 26: 16071.
Murtha L, Sathiadoss P, Salameh JP, Mcinnes MDF, Revah G, Chest CT, 2023. Findings in marijuana smokers. Radiology 307: e212611.
Leb JS, D’Souza B, Steiner RM, 2018. Images in COPD: marijuana lung. Chronic Obstr Pulm Dis (Miami) 5: 81–83.
Wilgus M-L, 2022. Bong Lung: A Case of Massive Lower Lobe Lung Bullae Associated with Cannabis Smoking. 26. Available at: https://proceedings.med.ucla.edu/index.php/2022/09/29/bong-lung-a-case-of-massive-lower-lobe-lung-bullae-associated-with-cannabis-smoking/. Accessed August 21, 2023.
Warner MA, Patel B, 2013. Mechanical ventilation. Hagberg CA, Benumof J, ed. Benumof and Hagberg’s Airway Management. Philadelphia, PA: Elsevier/Saunders, 981–997.
Ioannidis G et al., 2015. Barotrauma and pneumothorax. J Thorac Dis 7 (Suppl 1): S38–S43.
Kruavit A, Fox M, Pearson R, Heraganahally S, 2017. Chronic respiratory disease in the regional and remote population of the Northern Territory Top End: a perspective from the specialist respiratory outreach service. Aust J Rural Health 25: 275–284.
Heraganahally SS, Wasgewatta SL, McNamara K, Eisemberg CC, Budd RC, Mehra S, Sajkov D, 2019. Chronic obstructive pulmonary disease in Aboriginal patients of the Northern Territory of Australia: a landscape perspective. Int J Chron Obstruct Pulmon Dis 14: 2205–2217.
Mehra S, Chang AB, Lam CK, Campbell S, Mingi JJ, Thomas I, Harwood S, Maguire G, Heraganahally S, 2021. Bronchiectasis among Australian Aboriginal and non-Aboriginal patients in the regional and remote population of the Northern Territory of Australia. Rural Remote Health 21: 6390.
Heraganahally SS, Wasgewatta SL, McNamara K, Mingi JJ, Mehra S, Eisemberg CC, Maguire G, 2020. Chronic obstructive pulmonary disease with and without bronchiectasis in Aboriginal Australians – a comparative study. Int Med J 50: 1505–1513.
Heraganahally S, Digges M, Haygarth M, Liyanaarachchi K, Kalro A, Mehra S, 2019. Pulmonary AL – amyloidosis masquerading as lung malignancy in an Australian Indigenous patient with Sjogren’s syndrome. Respir Med Case Rep 26: 94–97.
Heraganahally SS, Howarth TP, Lloyd A, White E, Veale A, Ben Saad H, 2022. The prevalence of bronchodilator responsiveness “asthma” among adult Indigenous Australians referred for lung function testing in the Top End Northern Territory of Australia. J Asthma Allergy 15: 1305–1319.
Heraganahally SS, Timothy TP, Sorger L, 2022. Chest computed tomography findings among adult Indigenous Australians in the Northern Territory of Australia. J Med Imaging Radiat Oncol 66: 337–344.
Schubert J, Kruavit A, Mehra S, Wasgewatta S, Chang AB, Heraganahally S, 2019. Prevalence and nature of lung function abnormalities among Indigenous Australians referred to specialist respiratory outreach clinics in the Northern Territory. Int Med J 49: 217–224.
Heraganahally SS, Howarth T, White E, Sorger L, Biancardi E, Ben Saad H, 2020. Lung function parameters among Australian Aboriginal “apparently healthy” adults: an Australian Caucasian and Global Lung Function Initiative (GLI-2012) various ethnic norms comparative study. Expert Rev Respir Med 23: 1–11.
Sze DFL, Howarth TP, Lake CD, Ben Saad H, Heraganahally SS, 2022. Differences in the spirometry parameters between Indigenous and non-Indigenous patients with COPD: a matched control study. Int J Chron Obstruct Pulmon Dis 17: 869–881.
Heraganahally SS, Ponneri TR, Howarth TP, Saad HB, 2021. The effects of inhaled airway directed pharmacotherapy on decline in lung function parameters among Indigenous Australian adults with and without underlying airway disease. Int J Chron Obstruct Pulmon Dis 16: 2707–2720.
Howarth T, Gahreman D, Ben Saad H, Ng L, Heraganahally SS, 2023. Correlation of spirometry indices to chest radiology in the diagnosis of chronic airway disease among regional and rural Indigenous Australians. Int Med J. doi: 10.1111/imj.16023.
Heraganahally SS, Howarth T, Mo L, Sorger L, Ben Saad H, 2021. Critical analysis of spirometric patterns in correlation to chest computed tomography among adult Indigenous Australians with chronic airway diseases. Expert Rev Respir Med 15: 1229–1238.
Heraganahally SS, Rajaratnam B, Silva SAAS, Robinson N, Oguoma VM, Naing P, Kangaharan N, Ilton M, 2021. Obstructive sleep apnoea and cardiac disease among Aboriginal patients in the Northern Territory of Australia. Heart Lung Circ 30: 1184–1192.
Heraganahally SS, Kruavit A, Oguoma VM, Gokula C, Mehra S, Judge D, Sajkov D, 2020. Sleep apnoea among Australian Aboriginal and non-Aboriginal patients in the Northern Territory of Australia – a comparative study. Sleep (Basel) 43: zsz248.
Howarth T, Ben Saad H, Heraganahally SS, 2023. The impact of lung function parameters on sleep among Aboriginal Australians – a polysomnography and spirometry relationship study. Nat Sci Sleep 15: 449–464.
Heraganahally SS, Mortimer N, Howarth T, Messenger R, Issac S, Thomas I, Brannelly C, 2021. Utility and outcomes among Indigenous and non-Indigenous patients requiring domiciliary oxygen therapy in the regional and rural Australian population. Aust J Rural Health 29: 918–926.
Heraganahally SS, Ghimire RM, Howarth T, Kankanamalage OM, Palmer D, Falhammar H, 2022. Comparison and outcomes of emergency department presentations with respiratory disorders among Australian Indigenous and non-Indigenous patients. BMC Emerg Med 22: 11.
Heraganahally S, Howarth TP, Issac S, Lloyd A, Ravichandran SJ, Abeyaratne A, Patel B, 2023. Exploring the appropriateness of prescribing practice of inhaled pharmacotherapy among Aboriginal Australians in the Top End Northern Territory of Australia: a retrospective cohort study. BMJ Open Respir Res 10: e001508.
Howarth TP, Jersmann HPA, Majoni SW, Mo L, Ben Saad H, Ford LP, Heraganahally SS, 2023. The “ABC” of respiratory disorders among adult Indigenous people – asthma, bronchiectasis and COPD among Aboriginal Australians – a systematic review. BMJ Open Respir Res 10: e001738.
Howarth T, Heraganahally S, Heraganahally S, 2023. Bronchiectasis among adult First Nations Indigenous people – a scoping review. Curr Respir Med Rev 19: 36–51.
Kaplan AG, 2021. Cannabis and lung health: does the bad outweigh the good? Pulm Ther 7: 395–408.
Pal A, Howarth TP, Rissel C, Messenger RL, Issac S, Ford L, Connors C, Heraganahally SS, 2022. COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort – a study to explore preventable hospitalization. BMJ Open Respir Res 9: e001295.
Past two years | Past Year | Past 30 Days | |
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Abstract Views | 2217 | 2217 | 74 |
Full Text Views | 176 | 176 | 9 |
PDF Downloads | 42 | 42 | 5 |
The prevalence of cannabis usage is increasing worldwide, including among both Indigenous and non-Indigenous Australians. The long-term effects of cannabis use on the lungs are well-known. However, the acute adverse effects on the lungs are sparsely reported. There are different ways in which cannabis can be inhaled, such as smoking or through a water vaporizing method known as a “bong.” An improvised innovative bong device that is commonly used in Northern Australia, called a “bucket bong,” uses water and air pressure to assist in cannabis inhalation. In this report, we describe three patients from remote and rural Northern Australian communities presenting with near–life-threatening events (acute pneumonitis and massive pneumothorax) immediately after the use of cannabis via bucket bong.
Author’s addresses: Subash S. Heraganahally, Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Australia, E-mail: subash.heraganahally@nt.gov.au. Ellen Monsi, College of Medicine and Public Health, Flinders University, Darwin, Australia, E-mail: mons0023@flinders.edu.au. Eden Gadil, Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Australia, E-mail: eden.gadil@nt.gov.au. David Maze, Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Australia, E-mail: david.maze@nt.gov.au. Steven Lynch, Aboriginal Support Division, Royal Darwin Hospital, Darwin, Australia, E-mail: steven.lynch@nt.gov.au.
United Nations Office on Drugs and Crime , 2022. World Drug. Vienna, Austria: United Nations. Available at: https://www.unodc.org. Accessed August 21, 2023.
Australian Institute of Health and Welfare , 2022. Alcohol, Tobacco & Other Drugs in Australia. Available at: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/cannabis. Accessed August 21, 2023.
Butt J, Wilson M, Jones J, Lenton S, 2022. Review of cannabis use among Aboriginal and Torres Strait Islander people. HealthInfoNet 3, doi: 10.14221/aihjournal.v3n3.1.
Yayan J, Rasche K & Pokorski M Advancements in Clinical Research. Advances in Experimental Medicine and Biology, Vol. 952. Cham: Springer.
Ribeiro L, Ind PW, 2018. Marijuana and the lung: hysteria or cause for concern? Breathe (Sheff) 14: 196–205.
Schauer GL, King BA, Bunnell RE, Promoff G, McAfee TA, 2016. Toking, vaping, and eating for health or fun: marijuana use patterns in adults, U.S., 2014. Am J Prev Med 50: 1–8.
Australian Institute of Health and Welfare , 2020. National Drug Strategy Household Survey 2019. Cat. No.: PHE 270. Available at: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data. Accessed August 21, 2023.
Wikipedia , 2007. Gravity Bong. Available at: https://en.wikipedia.org/wiki/Gravity_bong. Accessed August 21, 2023.
Moore D, 1995. Drug Use and Western Selfhood: An Ethnography of Urban Paths in Perth. Dissertation, University of Western Australia, Perth Australia.
Tashkin DP, Roth MD, 2019. Pulmonary effects of inhaled cannabis smoke. Am J Drug Alcohol Abuse 45: 596–609.
Tashkin DP, 2013. Effects of marijuana smoking on the lung. Ann Am Thorac Soc 10: 239–247.
Aldington S, Williams M, Nowitz M, Weatherall M, Pritchard A, McNaughton A, Robinson G, Beasley R, 2007. Effects of cannabis on pulmonary structure, function and symptoms. Thorax 62: 1058–1063.
Haddad I, Al-Ghzawi F, Karakattu SM, Musa R, Hoskere G, 2021. Dabbing-induced hypersensitivity pneumonitis. Cureus 13: e16333.
McMahon MJ, Bhatt NA, Stahlmann CG, Philip AI, 2016. Severe pneumonitis after inhalation of butane hash oil. Ann Am Thorac Soc 13: 991–992.
Gill A, 2005. Bong lung: regular smokers of cannabis show relatively distinctive histologic changes that predispose to pneumothorax. Am J Surg Pathol 29: 980–982.
Weiss ZF, Gore S, Foderaro A, 2019. Pneumomediastinum in marijuana users: a retrospective review of 14 cases. BMJ Open Respir Res 6: e000391.
Hancox RJ, Gray AR, Zhang X, Poulton R, Moffitt TE, Caspi A, Sears MR, 2022. Differential effects of cannabis and tobacco on lung function in mid-adult life. Am J Respir Crit Care Med 205: 1179–1185.
Ghasemiesfe M, Ravi D, Vali M, Korenstein D, Arjomandi M, Frank J, Austin PC, Keyhani S, 2018. Marijuana use, respiratory symptoms, and pulmonary function: a systematic review and meta-analysis. Ann Intern Med 169: 106–115.
Gracie K, Hancox RJ, 2021. Cannabis use disorder and the lungs. Addiction 116: 182–190.
Marcus HSL, Hancox RJ, 2011. Effects of smoking cannabis on lung function. Expert Rev Respir Med 5: 537–547.
Ribeiro LIG, Ind PW, 2016. Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review. NPJ Prim Care Respir Med 26: 16071.
Murtha L, Sathiadoss P, Salameh JP, Mcinnes MDF, Revah G, Chest CT, 2023. Findings in marijuana smokers. Radiology 307: e212611.
Leb JS, D’Souza B, Steiner RM, 2018. Images in COPD: marijuana lung. Chronic Obstr Pulm Dis (Miami) 5: 81–83.
Wilgus M-L, 2022. Bong Lung: A Case of Massive Lower Lobe Lung Bullae Associated with Cannabis Smoking. 26. Available at: https://proceedings.med.ucla.edu/index.php/2022/09/29/bong-lung-a-case-of-massive-lower-lobe-lung-bullae-associated-with-cannabis-smoking/. Accessed August 21, 2023.
Warner MA, Patel B, 2013. Mechanical ventilation. Hagberg CA, Benumof J, ed. Benumof and Hagberg’s Airway Management. Philadelphia, PA: Elsevier/Saunders, 981–997.
Ioannidis G et al., 2015. Barotrauma and pneumothorax. J Thorac Dis 7 (Suppl 1): S38–S43.
Kruavit A, Fox M, Pearson R, Heraganahally S, 2017. Chronic respiratory disease in the regional and remote population of the Northern Territory Top End: a perspective from the specialist respiratory outreach service. Aust J Rural Health 25: 275–284.
Heraganahally SS, Wasgewatta SL, McNamara K, Eisemberg CC, Budd RC, Mehra S, Sajkov D, 2019. Chronic obstructive pulmonary disease in Aboriginal patients of the Northern Territory of Australia: a landscape perspective. Int J Chron Obstruct Pulmon Dis 14: 2205–2217.
Mehra S, Chang AB, Lam CK, Campbell S, Mingi JJ, Thomas I, Harwood S, Maguire G, Heraganahally S, 2021. Bronchiectasis among Australian Aboriginal and non-Aboriginal patients in the regional and remote population of the Northern Territory of Australia. Rural Remote Health 21: 6390.
Heraganahally SS, Wasgewatta SL, McNamara K, Mingi JJ, Mehra S, Eisemberg CC, Maguire G, 2020. Chronic obstructive pulmonary disease with and without bronchiectasis in Aboriginal Australians – a comparative study. Int Med J 50: 1505–1513.
Heraganahally S, Digges M, Haygarth M, Liyanaarachchi K, Kalro A, Mehra S, 2019. Pulmonary AL – amyloidosis masquerading as lung malignancy in an Australian Indigenous patient with Sjogren’s syndrome. Respir Med Case Rep 26: 94–97.
Heraganahally SS, Howarth TP, Lloyd A, White E, Veale A, Ben Saad H, 2022. The prevalence of bronchodilator responsiveness “asthma” among adult Indigenous Australians referred for lung function testing in the Top End Northern Territory of Australia. J Asthma Allergy 15: 1305–1319.
Heraganahally SS, Timothy TP, Sorger L, 2022. Chest computed tomography findings among adult Indigenous Australians in the Northern Territory of Australia. J Med Imaging Radiat Oncol 66: 337–344.
Schubert J, Kruavit A, Mehra S, Wasgewatta S, Chang AB, Heraganahally S, 2019. Prevalence and nature of lung function abnormalities among Indigenous Australians referred to specialist respiratory outreach clinics in the Northern Territory. Int Med J 49: 217–224.
Heraganahally SS, Howarth T, White E, Sorger L, Biancardi E, Ben Saad H, 2020. Lung function parameters among Australian Aboriginal “apparently healthy” adults: an Australian Caucasian and Global Lung Function Initiative (GLI-2012) various ethnic norms comparative study. Expert Rev Respir Med 23: 1–11.
Sze DFL, Howarth TP, Lake CD, Ben Saad H, Heraganahally SS, 2022. Differences in the spirometry parameters between Indigenous and non-Indigenous patients with COPD: a matched control study. Int J Chron Obstruct Pulmon Dis 17: 869–881.
Heraganahally SS, Ponneri TR, Howarth TP, Saad HB, 2021. The effects of inhaled airway directed pharmacotherapy on decline in lung function parameters among Indigenous Australian adults with and without underlying airway disease. Int J Chron Obstruct Pulmon Dis 16: 2707–2720.
Howarth T, Gahreman D, Ben Saad H, Ng L, Heraganahally SS, 2023. Correlation of spirometry indices to chest radiology in the diagnosis of chronic airway disease among regional and rural Indigenous Australians. Int Med J. doi: 10.1111/imj.16023.
Heraganahally SS, Howarth T, Mo L, Sorger L, Ben Saad H, 2021. Critical analysis of spirometric patterns in correlation to chest computed tomography among adult Indigenous Australians with chronic airway diseases. Expert Rev Respir Med 15: 1229–1238.
Heraganahally SS, Rajaratnam B, Silva SAAS, Robinson N, Oguoma VM, Naing P, Kangaharan N, Ilton M, 2021. Obstructive sleep apnoea and cardiac disease among Aboriginal patients in the Northern Territory of Australia. Heart Lung Circ 30: 1184–1192.
Heraganahally SS, Kruavit A, Oguoma VM, Gokula C, Mehra S, Judge D, Sajkov D, 2020. Sleep apnoea among Australian Aboriginal and non-Aboriginal patients in the Northern Territory of Australia – a comparative study. Sleep (Basel) 43: zsz248.
Howarth T, Ben Saad H, Heraganahally SS, 2023. The impact of lung function parameters on sleep among Aboriginal Australians – a polysomnography and spirometry relationship study. Nat Sci Sleep 15: 449–464.
Heraganahally SS, Mortimer N, Howarth T, Messenger R, Issac S, Thomas I, Brannelly C, 2021. Utility and outcomes among Indigenous and non-Indigenous patients requiring domiciliary oxygen therapy in the regional and rural Australian population. Aust J Rural Health 29: 918–926.
Heraganahally SS, Ghimire RM, Howarth T, Kankanamalage OM, Palmer D, Falhammar H, 2022. Comparison and outcomes of emergency department presentations with respiratory disorders among Australian Indigenous and non-Indigenous patients. BMC Emerg Med 22: 11.
Heraganahally S, Howarth TP, Issac S, Lloyd A, Ravichandran SJ, Abeyaratne A, Patel B, 2023. Exploring the appropriateness of prescribing practice of inhaled pharmacotherapy among Aboriginal Australians in the Top End Northern Territory of Australia: a retrospective cohort study. BMJ Open Respir Res 10: e001508.
Howarth TP, Jersmann HPA, Majoni SW, Mo L, Ben Saad H, Ford LP, Heraganahally SS, 2023. The “ABC” of respiratory disorders among adult Indigenous people – asthma, bronchiectasis and COPD among Aboriginal Australians – a systematic review. BMJ Open Respir Res 10: e001738.
Howarth T, Heraganahally S, Heraganahally S, 2023. Bronchiectasis among adult First Nations Indigenous people – a scoping review. Curr Respir Med Rev 19: 36–51.
Kaplan AG, 2021. Cannabis and lung health: does the bad outweigh the good? Pulm Ther 7: 395–408.
Pal A, Howarth TP, Rissel C, Messenger RL, Issac S, Ford L, Connors C, Heraganahally SS, 2022. COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort – a study to explore preventable hospitalization. BMJ Open Respir Res 9: e001295.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 2217 | 2217 | 74 |
Full Text Views | 176 | 176 | 9 |
PDF Downloads | 42 | 42 | 5 |