Pediatric Cannabis Intoxication: Issues After Legalization


Pediatric cannabis intoxication has become a serious public health issue in states where marijuana has been legalized. A substantial spike in emergency room visits and calls to poison control centers are an unintended consequence of the decriminalization of marijuana.

The Los Angeles Times reported that in 2017, California’s poison control centers received 588 calls regarding people under 19. More than 250 of those calls involved children ages five and under, and several were under 12 months.

The trend is similar across the nation. According to an article in U.S. News and World Report, calls to poison control centers more than doubled in Massachusetts after legalization. Maryland Poison Control reported a 30 percent hike in calls.

The effects of cannabis intoxication are usually mild to moderate and effects generally last six to 48 hours. Kids are usually evaluated, treated, and released, but some require more aggressive treatment or an overnight stay.

CBS News reported earlier this year that there has been a three-fold increase in emergency room visits related to cannabis use since legalization in 2014. As of yet, the long-term effects of pediatric cannabis intoxication haven’t been well studied, but initial research indicates the use of marijuana during adolescence can have significant negative long-term effects.

The Problem with Edibles

Pediatric cannabis intoxication can occur when children inhale marijuana smoke. However, most problems happen when kids accidentally consume cannabis in edible form.

Young children have no way of knowing treats that look like candy may contain THC.

The risks of edibles are substantial because many edible products have a very high THC content, sometimes several times higher than the safe recommended dose for normal-sized adults.

Maryland Poison Control says that a single cookie may contain up to 100 mg of THC, although the recommended dose for adults is only 10 to 30 mg. To complicate matters further, the number of servings isn’t always clearly marked. Although this uncertainty is confusing for adults, it is especially dangerous for small children.

In some cases, cannabis product packaging intentionally mimics popular and familiar candy bars, often with a similar name.

It’s also important to be aware that edible products affect the body differently than marijuana ingested by other means. For instance, edibles take time to digest, and the effects aren’t felt for 30 to 60 minutes.

Symptoms of Pediatric Cannabis Intoxication

If you notice any of the following symptoms, call the nationwide poison control hotline immediately at 1-800-222-1222. If symptoms are severe, call 911 or take your child to the nearest emergency room.

  • Difficulty walking or sitting up
  • Difficulty breathing
  • Lethargy
  • Muscle weakness
  • Unusual sleepiness
  • Agitation
  • Panic and anxiety
  • Euphoria
  • Nausea and vomiting
  • Confusion
  • Loss of coordination
  • Headache
  • Rapid heartbeat
  • Tremors
  • Slurred speech
  • Hallucinations
  • Seizures
  • Dilated pupils

Preventing Accidental Ingestion by Young Children

Whether used for medical or recreational purposes, adults with children – or who may be visited by children – who use any form of cannabis should treat it like a medication that has significant health risks if ingested by children.

Here’s a list of ways to keep cannabis away from children:

  • Talk to your kids about marijuana, especially edibles. Instruct them that they should never eat anything without asking permission first.
  • Set an example. Never use edibles or other marijuana products in front of your kids.
  • Talk to other people who spend time with your child, including family members, caregivers, or friends. Ask them to store cannabis products safely and securely. Request that they never use marijuana products when caring for your child, and never in front of your child.
  • Store all marijuana products in a locked cabinet. Treat edibles like you would treat medicine or any other substance that may be toxic for children.
  • Don’t remove edibles from the child-resistant packaging. Keep the package securely sealed.
  • Many states require an easily recognizable product symbol such as a marijuana leaf, exclamation point, and/or the letters “THC,” in black or bright red print. Teach your children not to use anything with the symbol on the label.

Advocate for Safe Packaging in Your State

Several states already require labels to be child-resistant, including Colorado, Oregon, Washington, and Alaska. It’s a good idea to check the regulations in your state.

If you’re concerned about packaging and your state is considering the legalization of marijuana or has already legalized it, contact your legislators and make your voice heard. Ask them to ensure that packages are child-resistant, resealable, and opaque even when opened, and request that packages be clearly marked and that cannabis edibles are limited to single servings. Smaller packages minimize the risk of life-threatening results if your child gets into the package. Colorado, for example, has established a rule that the standard size for one edible serving is a maximum of 10 mg.

Finally, urge them to require that edibles shouldn’t look like candy, desserts, soda, or other familiar sweet treats that kids love.

For free, expert advice, call the 24/7/365 National Poison Control Hotline at 1-800-222-1222.

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