Who wants chocolate, candy, cookies and brownies?
Most toddlers enjoy sweet treats, and consider them a sign of good times ahead. Yet, with the legalization and decriminalization of cannabis products in Illinois, as of Jan. 1, there is in increased risk of unintentional exposure for young children, especially with edible cannabis products that are commonly in the form of sweet treats. The THC concentration in edibles can range from 10 mg to over a gram. Ten mg of THC is generally considered to be an initial dose for adults who are not regular users, but it is a big dose for a small child. While a 10 mg gummy can be eaten whole, a rice crispy treat, which can contain up to 500 mg of THC (or more), must be portioned into doses when using the product. It is unlikely a three year old eating such a yummy, sticky treat will know that it contains a ridiculously high amount of THC that even experienced users wouldn’t eat whole.
Can you tell the difference between real and THC infused gummies?
Can a three year old tell the difference between a regular brownie and a pot brownie?
How about chocolate chip cookies?
And an IPC favorite, the large dose Rice Krispie Treat with 500 mg of THC (some brands have large bars with 1800 mg of THC)
What has happened in other states with regards to pediatric exposures after legalization?
Illinois Poison Center (IPC) staff and researchers at University of Chicago Comer’s Children’s Hospital recently partnered in the analysis of National Poison Data System (NPDS) data on pediatric cannabis exposures reported to the national poison center network. We found that compared to 2007-2008 vs 2017-2018, the eight states that legalized recreational marijuana at the time of the study (AK, CA, CO, DC, ME, MA, NV, OR, and WA) more than doubled the rate of exposures compared to states that did not have legalized recreational cannabis. This research will be presented at the Society of Academic Emergency Medicine conference in May.
How have IPC cannabis cases changed in the one month since cannabis has been legalized?
In January 2019, there were six cases of cannabis exposure, with one involving edibles, in children 0-5 years of age reported to the IPC. In January 2020, there were 11 IPC cases, with eight involving edible candies or baked treats, in children between 0-5 years of age. In one month, Illinois is quickly moving toward meeting the increased rate of pediatric poisonings experienced by other legalized recreational cannabis states, with edible products driving that increase in toddlers.
The majority of the pediatric exposures reported to the IPC in January were admitted to pediatric ICU setting until they recovered from the intoxication.
So how do we minimize pediatric cannabis injury in this new environment?
Like any other drug product, common sense measures can assist parents and other caregivers to prevent toddlers from accidentally ingesting cannabis or any other drug. Women who are pregnant or breastfeeding should not use cannabis as THC is lipid soluble and concentrates in breast milk.
The American College of Medical Toxicology has outlined some safety recommendations for cannabis use at home:
- Individuals should not use cannabis products when visible to children. Children learn from watching adults which products are safe to eat.
- Store cannabis products, including edibles, and home-prepared products in a secure place (e.g., a lockbox). Proper storage can prevent exploratory pediatric ingestion.
- Parents should not administer cannabis products to children without medical oversight and authorization. Any possible therapeutic benefit of cannabis for certain conditions must be weighed against the potential for adverse effects on the brain and development.
- Call the poison center or seek medical care (including calling 911 if necessary) for suspected exposures. Poison centers provide recommendations regarding decontamination and need for urgent medical evaluation.
What’s next for the IPC and recreational cannabis?
The IPC will continue to monitor and analyze cases reported to the center. Any new knowledge we obtain that can help to prevent cannabis poisoning, will be shared through blogs, social media, press releases, education, and other outreach activities.
As to governmental efforts, Carol DesLauriers, PharmD, DABAT, will represent the IPC on the Governor-appointed Illinois Adult Use Cannabis Health Advisory Committee and provide pharmacist and poison center insight to the efforts regarding safe cannabis use in the state.
As always, if you have any questions, let us know in the comment box below or contact us at IPCadmin@team-iha.org.