Poison Control Calls For Pediatric Cannabis Exposure On The Rise

U.S. poison control centers are fielding more and more calls related to pediatric cannabis exposure, and the increase appears largely fueled by unintended ingestion of edibles, a new study suggests.

Researchers examined data on all poison control center calls involving cannabis exposure for children aged 0 to 9 years from 2017 to 2019. During this three-year period, there were a total of 4,172 calls related to cannabis in children this age, and 1,906 (45.7%) cases involved edibles.

The total number of cannabis exposure cases more than doubled from 887 in the first year of the study period to 1,963 by the final year. Over this same period, the number of cases involving edibles more than quadrupled from 223 a year to 1,068 a year.

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"Cannabis use is increasing as more states legalize medical and recreational use and as social acceptance of cannabis use is increasing," said Dr. Gary Smith, president of the Child Injury Prevention Alliance and director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

"The increase of exposure to cannabis edibles among children is likely attributable to an increase in the use of these products in the home by adults, which results from the legalization of use and perhaps more adults switching from smoking to consuming edibles," Dr. Smith, who wasn't involved in the study, said by email.

Roughly half of cases involving edibles occurred in toddlers and preschoolers 3 to 5 years old, while 26.9% occurred in children 2 years and younger, and 23.6% occurred in children 6 to 9 years old.

Toddlers typically engage in exploratory behavior as their mobility increases, leading to frequent potentially poisonous ingestions in this age group, Dr. Smith said. Children may be especially attracted by edibles that look like dessert or candy, unaware that they contain marijuana or THC, Dr Smith added.

While the study wasn't designed to determine why cannabis exposure is rising or what might draw children to edibles, some previous research suggests that sweets like edible gummies appeal to youth, said lead study author Jennifer Whitehill, an associate professor of Health Promotion and Policy at the University of Massachusetts Amherst.

"Our data cannot speak directly to this question as we do not know the specific appearance of the edible products involved in the poison center calls, but it does make sense that things that look like candy or sweets would be more appealing to children than say, something that looks like a plain wafer," Whitehall said by email.

One limitation of the study is that poison control centers rely on self-reported data related to cannabis exposure, the study team notes in Pediatrics. The data from 2019 was also preliminary and might be subject to minor changes.

Even so, the results suggest that clinicians who treat parents and children should be having conversations about cannabis, said Rebekah Levine Coley, chair and professor of Counseling, Developmental & Educational Psychology at Boston College in Massachusetts.

"The results from this study suggest the need for marijuana users to engage in safe storage and labeling practices, and to be sure that marijuana products are not accessible to young children," Coley, who wasn't involved in the study, said by email. "Pediatricians, primary care doctors, and marijuana dispensaries all have a role to play in educating consumers and encouraging safe storage practices."

—Lisa Rapaport

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