UMEM Educational Pearls

Category: Toxicology

Title: Pediatric edible cannabis toxicity

Keywords: cannabis exposure, pediatric, toxicity, NPDS (PubMed Search)

Posted: 7/6/2023 by Hong Kim, MD (Updated: 5/21/2024)
Click here to contact Hong Kim, MD

Medical Cannabis is permitted in 39 states and Washington DC while 18 sates and Washington DC has legalized recreational cannabis use. As cannabis products become more available, pediatric exposure has also increased.

A retrospective study of National Poison Data System involving children < 6 years from 2017 and 2021 showed: Pre-COVID (2017-2019) & COVID (2020-2021)

  • 7043 exposures: (increase of 1375%)
  • 2017: 207  
  • 2021: 3054 
  • Residential exposure: 97% (n=6842)

Common Clinical effects

  • CNS depression: 70% (n=3381)
    • Pre-COVID: 61.6% --> COVID: 72.9% (p<0.05)
  • Tachycardia: 11.4% (N=548)
    • Pre-COVID: 10.3% -->COVID: 11.6% (p,0.05)
  • Vomiting: 9.5% (n=4827)
    • Pre-COVID: 7.5% -->COVID: 10.0% (p<0.05)
  • Ataxia: 7.4% (n=352)
  • Confusion: 6.1% (n=294)
  • Mydriasis: 5.9% (n=284)
  • Respiratory depression: 3.1%

Disposition

  • Admission: 22.7%
  • Critical care: 8.1% (n=533)
    • Pre-COVID: 6.6% -->COVID: 8.6% (increase of 30%) (p<0.05)
  • Non-critical care: 14.6% (n=1027)
    • Pre-COVID: 9.7% -->COVID: 16.3% (increase of 68%)(p<0.05)

Conclusion

  • Pediatric cannabis exposure has increased between 2017 and 2021. consequently, more pediatrics patients developing toxicity and being hospitalized.

References

Tweet MS, Nemanich A, Wahl M. Pediatric Edible Cannabis Exposures and Acute Toxicity: 20172021. Pediatrics. 2023;151(2):e2022057761