Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes

Kaczor, Eric E.; Mathews, Bonnie; LaBarge, Kara L.; Chapman, Brittany P.; Carreiro, Stephanie

doi:10.1007/s13181-021-00849-0

Cited by 15 publications

(6 citation statements)

References 20 publications

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“…In addition, the dosing/strength of each incident is unknown. If the patients were using edibles, some products contain as much as 500mg of THC per package [ 12 ]. Therefore, a single serving taken by a child could result in more severe symptoms and toxicity.…”

Section: Discussionmentioning

confidence: 99%

Varied Presentations of Pediatric Patients With Positive Cannabinoid Tests

Harvey¹,

Gomez²,

Wolk³

et al. 2022

Cureus

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Background: Cannabis (marijuana) is one of the most abused drugs worldwide. The increasing availability of cannabis has been associated with increased emergency department (ED) visits. There is a wide range of presentations documented in the recent literature, and the full scope of symptoms in young children is not fully known. Objective: The primary objectives were to gather information regarding the characteristics in the presentation of the children with positive cannabinoid urine drug screen (UDS) results in the ED and to determine if there are certain common presentations with cannabinoid ingestion or inhalation. Design/methods: This study was a descriptive retrospective chart review from March 2013 to June 2020 of pediatric patients <18 years old with positive UDS for cannabinoids. Data collected included age, gender, chief complaint, history, review of systems, vital signs, physical exam findings, laboratory studies, imaging findings, and disposition. Four hundred and twenty-two charts were included in the study. Analysis was done using Stata 13 (College Station, TX). Results: The data showed that there was a significant increase in the number of pediatric patients with a positive UDS after cannabis legalization. Using cases from November 2013 to November 2019 showed 71% of cases presented after legalization on November 8, 2016 (Z=7.72, p<.01). The majority of cases were patients between the ages of 15 and 17 (78%). 43% (n=182) of patients presented with chief complaints of suicidal ideation. The other most common chief complaints were vomiting (8%, n=33), nausea (5%, n=22), trauma (5%, n=21), and altered mental status (AMS) (5%, n=20). The most common vital sign abnormalities included tachycardia (27%, n=115) and hypertension (18%, n=74). Forty-two percent of patients had tests ordered during their visit with 7% undergoing head computerized tomography. On the UDS, 28% of patients were positive for at least one other drug with amphetamine being the most common (13%, n=55). Conclusion: Our data showed a significant increase in the number of cases since the legalization of cannabis in 2016, supporting the need for ED physicians to become more familiar with cannabis intoxication and its complications. The presentations of these patients can vary greatly. Common presentations include suicidal ideation, nausea/vomiting, AMS, and trauma with vital sign abnormalities including tachycardia and hypertension. Physicians should continue to consider cannabis use when evaluating these pediatric complaints. It may decrease the number of tests ordered in this patient population.

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Section: Discussionmentioning

confidence: 99%

Varied Presentations of Pediatric Patients With Positive Cannabinoid Tests

Harvey¹,

Gomez²,

Wolk³

et al. 2022

Cureus

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“…Legalization of cannabis in Colorado was accompanied by a 5-fold increase in exposures in children less than 9 years of age from 2009 to 2015, with 35% of cases presenting requiring hospitalization [16]. In other jurisdictions, the legalization of medical and/or recreational cannabis has likewise been accompanied by significant increases in poison control calls, emergency department (ED) visits, and inpatient and intensive care unit (ICU) admissions for accidental ingestions of cannabis in children [11,17–19,22 ▪▪ ,23,24,25 ▪▪ ,26,27,28 ▪ ]. Of particular concern for unintentional pediatric cannabis intoxications is edible forms of cannabis.…”

Section: Cannabismentioning

confidence: 99%

“…The main psychoactive compound in cannabis, tetrahydrocannabinol (THC), is commonly found in high concentrations in these edible forms; however, children may also ingest other cannabis products including resins, oils, and vaping fluid [6,8,9]. A single edible item can contain 400 mg or more of THC, while the toxic dose for a child can range from 5-300 mg [10,11]. The concentration of THC in edible products has also increased over the last several years, with average concentrations of 4% in 1995 and 12% in 2015 [12,13].…”

Section: Introductionmentioning

confidence: 99%

“…The concentration of THC in edible products has also increased over the last several years, with average concentrations of 4% in 1995 and 12% in 2015 [12,13]. In addition to the risks to children conferred by cannabis being available in edible forms and at high concentrations, some cannabis products are purposely packaged and labeled to mimic non-THC food items that children are familiar with, which further increases the risk of accidental overdose [10,11,14,15]. Studies have found that most poison control calls and hospital visits for cannabis intoxication in children are from edible products, with the vast majority of products being from the child's own home [9,[16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Evolving threat of pediatric ingestions: a discussion of cannabis and button batteries and their implications for children

Lorenzo

Beno

2023

Current Opinion in Pediatrics

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Purpose of ReviewPediatric button battery and cannabis ingestions are rising in incidence and have the potential for significant harm. This review will focus on the clinical presentation and complications of these two common inadvertent ingestions in children, as well as recent regulatory efforts and advocacy opportunities. Recent FindingsThe rising incidence of cannabis toxicity in children has corresponded with its legalization across several countries in the last decade. Inadvertent pediatric cannabis intoxication is most commonly due to the ingestion of edible forms discovered by children in their own home. The clinical presentation can be nonspecific, therefore clinicians should have a low threshold for including it on their differential diagnosis. Button battery ingestions are also increasing in incidence. While many children are asymptomatic at presentation, button battery ingestions can quickly cause esophageal injury and lead to several serious and potentially life-threatening complications. Prompt recognition and removal of esophageal button batteries is essential for reducing harm.

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“…This event represents a deleterious and noxious issue for children and adolescents who may be exposed passively or actively to cannabis or marijuana smoke. Also, a harmful effect may be associated with the spread of edible cannabis products (14)(15)(16).…”

mentioning

confidence: 99%

Translational pediatrics: reflections for the 21st century and beyond

Sergi¹

2022

Transl Pediatr

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Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes

Cited by 15 publications

References 20 publications

Varied Presentations of Pediatric Patients With Positive Cannabinoid Tests

Varied Presentations of Pediatric Patients With Positive Cannabinoid Tests

Evolving threat of pediatric ingestions: a discussion of cannabis and button batteries and their implications for children

Translational pediatrics: reflections for the 21st century and beyond

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