Medical marijuana

A Colorado study finds that more of the state’s children have accidentally ingested marijuana since medical marijuana was legalized. Suzan Mazor, MD, a pediatric emergency medicine physician at Seattle Children’s and a medical toxicologist at Children’s and the Washington Poison Center, says parents and doctors can expect to see similar effects in Washington state.

The study, published May 27 in JAMA Pediatrics, was conducted at a children’s hospital in Colorado, where medical marijuana was legalized in June 2001 and recreational use of marijuana was decriminalized in November 2012. The researchers saw a sharp increase in emergency department visits for marijuana ingestion after October 2009, when the federal government stopped prosecuting medical marijuana users who were conforming to their state’s laws.

Fourteen children between 8 months and 12 years old were evaluated and treated for accidental ingestions between October 2009 and December 2011. By comparison, there were no accidental marijuana ingestions between January 2005 and September 2009.

Mazor says it makes sense that as marijuana became more available in the community, children’s exposures to the drug increased. She suspects that researchers would see the same results in Washington state, which has similar laws. “More availability of any poison usually translates to more unintentional poisonings in kids.”

The emergency team at Children’s has already seen several cases of unintentional marijuana ingestion. “One child in particular was quite sedated, and was admitted to the pediatric intensive care unit after eating a homemade product containing marijuana,” says Mazor.

Effects of marijuana on kids

Of the 14 unintentional ingestions in the Colorado study, eight of the cases involved medical marijuana, and seven of those patients had eaten food products containing marijuana. Eight children had to be admitted to the hospital’s intensive care unit for symptoms ranging from lethargy to breathing problems.

In an editorial accompanying the study, Mazor and William Hurley, MD, of the University of Washington and Washington Poison Center, note, “The medical marijuana industry provides attractive and palatable marijuana-infused solid and liquid products, including cookies, candies, brownies, and beverages.” The access to foods and drinks containing marijuana will continue to increase as recreational marijuana laws are implemented in Washington and Colorado.

Mazor warns that children can have serious reactions to marijuana. They typically experience stimulation with hallucinations and illusions, followed by sedation. Some may even require ventilator support to help with their breathing, and some cases have resulted in a coma.

“Today’s marijuana contains more of the active ingredient than it did ‘when we were kids,’” says Mazor. Over the past 40 years, the level of delta-9-tetrahydrocannibinol (THC) in marijuana in the United States has risen from around 2 percent to nearly 8 percent.
In their editorial, Mazor and Hurley note that there is no treatment to reverse the toxic effects of marijuana in children. Doctors can only provide support for patients’ anxiety and panic, and help support their breathing if necessary.

Preventing marijuana poisoning in children

Mazor says parents and the medical community should learn from past experience when it comes to preventing unintentional marijuana ingestions. When doctors started prescribing opioid pain medication like oxycodone more frequently, there were more children unintentionally poisoned. More recently, children have accidentally ingested “laundry pods,” which are used in many households and come in attractive packages. Even prenatal iron, frequently prescribed for expecting women, can be harmful to children.

“Prenatal iron used to be one of the biggest killers in kids,” says Mazor. “Now, because of changes in packaging and increased warnings and community education, we see iron poisoning much less frequently.”

Mazor and Hurley support increased education for families and the medical community about the effects of marijuana on children. They also suggest that more control of marijuana-infused products is needed to protect children. “We need to advocate for child-resistant packaging on marijuana and products made with it,” Mazor says.

For parents, Mazor’s advice is simple: “Keep these products away from kids!” If your child is exposed to marijuana, she encourages parents to call the Poison Center in addition to seeking medical attention. Real-time tracking of accidental marijuana exposures in children will help physicians recognize and treat the symptoms of marijuana ingestion. The lessons learned will also inform lawmakers as they implement and adjust marijuana legislation.

Additional resources for parents of teens:

For more information or to arrange interviews with Dr. Mazor, contact the public relations team at 206-987-4500 or press@seattlechildrens.org.