Unintentional Cannabis Ingestion in Children: A Systematic Review

Richards, John R.; Smith, Nishelle E.; Moulin, Aimee

doi:10.1016/j.jpeds.2017.07.005

Cited by 132 publications

(98 citation statements)

References 44 publications

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“…Increases in maternal cannabis use, during the preconception, prenatal, and postpartum periods, in combination with increasing THC potency and product concentrations, elicit concern about potential adverse health consequences for both women and children [10][11][12][16][17][18]. In the US, prevalence estimates of past-month prenatal cannabis use have escalated from 3.4% in 2002 to 7.0% in 2016 [3].…”

Section: Introductionmentioning

confidence: 99%

“…THC crosses the human placenta, introducing the drug to the fetus in utero [13]. Children may be exposed to cannabis through additional mechanisms beyond in utero exposure, including breast milk consumption [32], second-hand smoke exposure [16] and accidental ingestion of cannabis products [11,17]. THC is a highly lipophilic compound that is readily transferred to breast milk and takes a substantial amount of time to be cleared, the estimated half-life of THC in breast milk to be roughly 27 hours [32].…”

Section: Introductionmentioning

confidence: 99%

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Recreational Cannabis Legalization in the US and Maternal Use during the Preconception, Prenatal, and Postpartum Periods

Skelton

Hecht

Benjamin‐Neelon

2020

IJERPH

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In the United States (US), recreational cannabis use is on the rise. Since 2011, 11 states and the District of Columbia have legalized cannabis for adult recreational use. As additional states consider legalizing, there is an urgent need to assess associations between recreational cannabis legalization and maternal use in the preconception, prenatal, and postpartum periods—all critical windows for maternal and child health. Using cross-sectional data from the 2016 Pregnancy Risk Assessment Monitoring System, we assessed associations between state cannabis legalization and self-reported maternal cannabis use. Using logistic regression, we estimated the adjusted prevalence ratio (PR) of cannabis use during the preconception, prenatal, and postpartum period for women delivering a live-born infant in three states that had legalized recreational cannabis (Alaska, Colorado, and Washington) and three states that had not legalized (Maine, Michigan, and New Hampshire) by 2016. Our final sample size was 7258 women. We utilized 95% confidence intervals (CI) and a significance level of alpha = 0.05. After adjustment for potential confounders, women who resided in states with legalized recreational cannabis were significantly more likely to use cannabis during the preconception (PR 1.52; 95%CI ranging from 1.28–1.80; p < 0.001), prenatal (PR 2.21; 95% CI ranging from 1.67–2.94; p < 0.001), and postpartum (PR 1.73; 95%CI ranging from 1.30–2.30; p < 0.001) periods, compared to women who resided in states without legalized recreational cannabis. Although evidence about the effect of marijuana use during these periods is nascent, these findings show potential for increased incidence of child exposure to cannabis. Longitudinal research is needed to assess immediate and sustained impacts of maternal use before and after state legalization of recreational cannabis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recreational Cannabis Legalization in the US and Maternal Use during the Preconception, Prenatal, and Postpartum Periods

Skelton

Hecht

Benjamin‐Neelon

2020

IJERPH

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“…A review of pediatric cases from 1975 to 2015 found more unintentional cannabis ingestion by children in US states that had legalized medical and recreational cannabis use 97 . This increase prompted limits on package and serving sizes of edible cannabis products in 2017 98 .…”

Section: Health Effects Of Legalizing Recreational Cannabis Use In Thmentioning

confidence: 99%

Assessing the public health impacts of legalizing recreational cannabis use: the US experience

2020

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The sale of cannabis for adult recreational use has been made legal in nine US states since 2012, and nationally in Uruguay in 2013 and Canada in 2018. We review US research on the effects of legalization on cannabis use among adults and adolescents and on cannabis‐related harms; the impact of legalizing adult recreational use on cannabis price, availability, potency and use; and regulatory policies that may increase or limit adverse effects of legalization. The legalization of recreational cannabis use in the US has substantially reduced the price of cannabis, increased its potency, and made cannabis more available to adult users. It appears to have increased the frequency of cannabis use among adults, but not so far among youth. It has also increased emergency department attendances and hospitalizations for some cannabis‐related harms. The relatively modest effects on cannabis use to date probably reflect restrictions on the number and locations of retail cannabis outlets and the constraints on commercialization under a continued federal prohibition of cannabis. Future evaluations of legalization should monitor: cannabis sales volumes, prices and content of tetrahydrocannabinol; prevalence and frequency of cannabis use among adolescents and adults in household and high school surveys; car crash fatalities and injuries involving drivers who are cannabis‐impaired; emergency department presentations related to cannabis; the demand for treatment of cannabis use disorders; and the prevalence of regular cannabis use among vulnerable young people in mental health services, schools and the criminal justice system. Governments that propose to legalize and regulate cannabis use need to fund research to monitor the impacts of these policy changes on public health, and take advantage of this research to develop ways of regulating cannabis use that minimize adverse effects on public health.

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“…Various effects of unintentional cannabis ingestion in children have been described such as lethargy, ataxia, hypotonia, mydriasis, tachycardia, hypoventilation and even respiratory insufficiency [47]. Despite these adverse effects, would cannabis be a potential treatment option in pediatric IBD?…”

Section: Cannabis For Medical Purposes In Childrenmentioning

confidence: 99%

Cannabis, a potential treatment option in pediatric IBD? Still a long way to go

Halbmeijer

Groeneweg

Ridder

2019

Expert Review of Clinical Pharmacology

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Introduction: The onset of inflammatory bowel disease (IBD) in children is rising. Current treatment options are based on immunomodulatory therapy. Alternative treatment options are upcoming since they appear to be effective in individual patients. Cannabis might relief IBD symptoms in these cases and improve quality of life. Recent evidence suggests a potential anti-inflammatory effect of cannabis. Areas covered: This review presents an overview of recent literature on the use of cannabis in IBD focussing on pediatric IBD patients. Background information on the role of the endocannabinoid system within the gastrointestinal tract is presented. Other modalities of cannabis and its purified ingredients will be discussed as well, with attention to its applicability in children with IBD. Expert opinion: More research is needed on the efficacy and safety of cannabis in pediatric IBD. Studies are well underway, but until then the use of cannabis in pediatric IBD cannot be recommended. ARTICLE HISTORY

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Unintentional Cannabis Ingestion in Children: A Systematic Review

Cited by 132 publications

References 44 publications

Recreational Cannabis Legalization in the US and Maternal Use during the Preconception, Prenatal, and Postpartum Periods

Recreational Cannabis Legalization in the US and Maternal Use during the Preconception, Prenatal, and Postpartum Periods

Assessing the public health impacts of legalizing recreational cannabis use: the US experience

Cannabis, a potential treatment option in pediatric IBD? Still a long way to go

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