At the end of 2019, the staff at IPC had planned to focus on surveillance of pediatric cannabis exposures to see if Illinois would experience the same uptick in cases that other states have experienced after legalizing recreational cannabis.  However, 2020 had other ideas of what the IPC and the rest of the country was going to focus on.  Now, after a full year of recreational sales in Illinois, coupled with a worldwide pandemic that has required children to spend more time in their homes, IPC has reviewed the trends in pediatric cannabis exposures.

In other states, after legalization of cannabis for recreational use, there have been clear increases in pediatric ingestions, mainly due to edible products. Because of a toddler’s small size, the amount of tetrahydrocannabinol (THC)—the principal psychoactive compound of cannabis—ingested by weight is very high and can lead to more severe symptoms. IPC and University of Chicago researchers presented national data at the Society of Academic Emergency Medicine 2020 annual meeting showing that, in states with legal cannabis, children ages five and under were 2.25 times more likely to have an unintended exposure compared to states that have not legalized cannabis.

This is a key chart from the presentation per 100,000 population of children:

 

 

 

 

 

 

 

 

 

There are many published articles showing that pediatric cannabis edible ingestions is an unintended consequence of legalized cannabis and cannabis products. With the 2020 legalization of cannabis in Illinois, IPC examined its cases on pediatric edible ingestions for 2019 (pre-legalization) and 2020 (post-legalization). In 2019 there were 37 total reported cannabis edible ingestions in children five years and under; in 2020 there were 150 cases—a 305% increase.

Here are IPC data trends for 2019 and 2020 with a month-to-month comparison:

 

 

 

 

 

 

 

 

Here are IPC case data on showing monthly trending across 2019 through 2020:

 

 

 

 

 

 

 

 

As with other products that unintentionally harm children (e.g., alcohol, chemicals and cleaners, over-the–counter, and prescription medications), adults are the gatekeepers to prevent pediatric poisoning. This is especially true of tempting cannabis products that look like candy or baked goods like cookies and brownies.

Here are some home safety recommendations from the American College of Medical Toxicology:

• Do not use cannabis products in front of 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) immediately after use. Safe storage up high and out of sight can prevent exploratory pediatric ingestions.
• 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 from regular use.
• 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.

These tips are more critical than ever, as children are spending more time at home due to the COVID-19 pandemic.

Due to the increasing number of calls regarding pediatric cannabis edible ingestions, IPC developed online information in English and Spanish for caregivers..

As always, if you have any questions, let us know in the comment box below or contact us at IPCadmin@team-iha.org.