Marijuana Exposures in Children

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for a poison emergency

Poison centers in states that have decriminalized marijuana have reported a significant increase in poison exposures in children involving marijuana and marijuana products. Children are more susceptible to adverse effects from the ingestion of marijuana products. Edible products are of special concern because they are likely to be more attractive to small children. While the number of exposures to marijuana products in children less than 6 years of age reported to the Utah Poison Control Center is relatively small, about ½ of the cases involved edible products.

What is Marijuana?

  • Marijuana refers to the dried leaves, flowers, stems, seeds from the Cannabis sativa plant
  • ∆-9 tetrahydrocannabinol (THC) is the main psychoactive component

Marijuana Adverse and Toxic Effects

  •  Physiologic: tachycardia, postural hypotension
  • Central nervous system depressant
    • drowsiness, confusion, ataxia
    • respiratory depression, coma, seizures
  • Hyperemesis syndrome: chronic use

Pediatric Exposures Reported to Poison Centers

  • Significant increase in pediatric exposures in states that allow medical marijuana
  • Neurologic effects (drowsiness and lethargy) were most common
  • Ingestion most common route of exposure
    • edibles the most common type ingested
  • Majority evaluated in a health care facility
    • hospital admissions increased
    • highest proportion of hospital admissions in children < 2 years of age
    • 7% required admission to an intensive care unit

Edible Challenges

  • Attractive to small children
  • More than one serving size per package even when a single brownie or cookie
  • No standard dosing
  • Child resistant packaging – but this is negated when the package contains more than one serving size

References

1. Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana exposure among children younger than 6 years in the United States. Clinical Pediatrics. 2016;55 (5); 428-36.

2. Wang GS, Roosevelt G, Le Lait MC, et. Al. Association of unintentional pediatric exposures with decriminalization of marijuana in the United States. Ann Emerg Med. 2014;63:684-9