Preventing Ingestion of Edibles

by Michelle Crowley, MD, MPH (’24)

As more states across the United States have legalized marijuana, the rate of accidental ingestions of edible marijuana and phone calls to poison control centers have risen exponentially. We have seen an increase in the number of hospitalizations of children secondary to ingestion of marijuana edibles. There are many key points that physicians can talk to parents and caregivers about to prevent these ingestions and subsequent hospitalizations from occurring. 

The Trainees for Child Injury Prevention group collected data from poison control centers around the United States and the data were staggering. The potency of cannabis edibles has increased by 5.7 over the past 25 years. Additionally, there has been a 1375% increase in calls to poison control centers since 2017 particularly regarding children <5 years old who have consumed edible cannabis. The reasons for this are varied however include increased access and appealing packaging that mimics candy and products designed for children. Adults and teenagers can tell the difference between candy and marijuana edibles, but children cannot. 

52% of patients reported to Regional Poison Centers were girls and the median age of children visiting hospitals for edible ingestions is between 2-3 years. In children 6 and under, 97.7% of edible ingestions occurred at home and a child resistant container was not present in 9% of cases. Inadequate supervision or storage of the edibles was reported in 34% of cases. Of children under 6 years with known cannabis ingestions, 22.7% were admitted to the hospital, and 8.1% were admitted to the ICU. 

It is important to counsel parents and caretakers that children’s bodies react differently to marijuana and to educate them on signs and symptoms of marijuana ingestion in children. Children can become sleepy and confused and can develop vomiting, difficulty breathing, and seizures.

Recommendations for parents include:

  •  Keep edibles separate from food
  •  Store edibles in secure and locked storage locations
  •  Treat edibles like medications and store them as you would medications
  •  If possible, keep THC-containing products out of the home
  • Keep edibles locked up, away and out of sight 
  • Avoid consuming THC-containing products in front of children
  • Ask other caregivers about safe storage of products
  •  If you think your child has swallowed marijuana edibles, call poison control 1-800-222-1222 
  • Call 911 if you are very concerned about your child- for example if they are unconscious, having trouble breathing, or experiencing other severe symptoms

As providers there are several ways we can advocate for legislation for safer packaging and labeling for marijuana edibles. The Poison Prevention Packaging Act is a law that states items including prescription drugs, over-the-counter drugs, and household cleaning chemicals must use child-resistant packaging. Providers can advocate that edible marijuana be placed under this act therefore requiring child-resistant packaging requirements. Additionally requiring manufacturers to include the symbol for cannabis, THC concentration/ content and moving towards less attractive/ colorful packaging are ways to decrease accidental ingestions. We also recommend individually wrapping edibles for an additional layer of protection and providing clear warning labels and the poison control number for the safest possible packaging. These are just a few ways to combat the increasing rates of accidental ingestions in the pediatric population and the rising number of hospitalizations. 

 

References

Bennett, Colleen E., et al. “Recent trends in marijuana-related hospital encounters in young children.”

Academic Pediatrics, vol. 22, no. 4, 2022, pp. 592–597, https://doi.org/10.1016/j.acap.2021.07.018.

Ompad, Danielle C., et al. “Copycat and lookalike edible cannabis product packaging in the United

States.” Drug and Alcohol Dependence, vol. 235, 2022, p. 109409,

https://doi.org/10.1016/j.drugalcdep.2022.109409.

Pepin, Lesley C., et al. “Toxic tetrahydrocannabinol (THC) dose in pediatric cannabis edible ingestions.”

Pediatrics, vol. 152, no. 3, 2023, https://doi.org/10.1542/peds.2023-061374.

Schauer, Gillian L. “Cannabis policy in the United States: Implications for public health.” JNCI

Monographs, vol. 2021, no. 58, 2021, pp. 39–52, https://doi.org/10.1093/jncimonographs/lgab016.

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