Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes
Division of Medical Toxicology, Department of Emergency Medicine; Division of Emergency Medicine, Department of Pediatrics
Emergency Medicine | Epidemiology | Medical Toxicology | Pediatrics | Substance Abuse and Addiction
INTRODUCTION: Pediatric exposures to cannabis edibles have been associated with serious adverse effects, such as respiratory depression. Yet, their incidence and relationship to exposure characteristics are not well defined. We attempt to describe the temporal, demographic, and clinical characteristics of pediatric patients with edible cannabis exposures and examine the relationship between these characteristics and two clinical outcomes: need for respiratory support and hospital admission.
METHODS: A retrospective chart review was conducted at a single, tertiary care academic medical center covering a 28-month period. Inclusion criteria were: evaluation in the ED, age < 18 years at the time of presentation, and physician documented exposure to edible cannabis. Exclusion criteria were: known or suspected co-ingestion of other substances.
RESULTS: Thirty-two cases of edible cannabis ingestions were identified. Age < 10 years was associated with bradypnea, hypertension, hospital admission, and respiratory support. Use of respiratory support was significantly associated with the presence of lethargy, bradypnea, hypercarbia, seizure, and hypertension. There was a five-fold increase in the number of pediatric edible cannabis exposures after recreational cannabis dispensaries opened in Massachusetts. Five patients (16%) required respiratory support and eleven (34%) required hospital admission.
CONCLUSIONS: There was a low incidence of need for respiratory support in our population, but hospital admission was more common. Severe symptoms (including lethargy and respiratory depression), need for respiratory support and hospital admission were more frequent in younger children. Exposures occurred with increasing frequency over time. Larger studies are needed to explore the relationship between THC dosage, age, and incidence of adverse outcomes.
Cannabis, Drug overdose, Epidemiology, Marijuana use, Pediatrics, Toxicity
DOI of Published Version
Kaczor EE, Mathews B, LaBarge K, Chapman BP, Carreiro S. Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes. J Med Toxicol. 2021 Jun 11. doi: 10.1007/s13181-021-00849-0. Epub ahead of print. PMID: 34117620. Link to article on publisher's site
Journal of medical toxicology : official journal of the American College of Medical Toxicology
Kaczor EE, Mathews BL, LaBarge KL, Chapman B, Carreiro S. (2021). Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes. UMass Chan Medical School Faculty Publications. https://doi.org/10.1007/s13181-021-00849-0. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/2056