Rick Bowmer, Associated Press
A law legalizing marijuana in Colorado has created an unintended consequence: an increase in cases of children ending up at area hospitals for treatment after accidentally ingesting the drug. Youngsters are attracted by pot-laced brownies and "candies," according to research published in JAMA Pediatric's Online First edition.
The study was conducted in Colorado, but the Denver-based researchers report that other states could be seeing the same thing. Several states and Washington, D.C., decriminalized medical marijuana. Colorado and Washington have legalized recreational use of marijuana. The background material on the study noted that in 2009, the Justice Department told federal prosecutors not to seek arrest of medical marijuana users and suppliers if they were complying with state laws.
The study's background data said tetrahydrocannabinol, marijuana's active chemical, is more concentrated when it's put into products intended as medical marijuana. "In addition," the researchers from the Rocky Mountain Poison and Drug Center wrote, "medical marijuana is sold in baked goods, soft drinks and candies."
"The results can be frightening to such children, who often suffer anxiety attacks when they start to feel unexpected symptoms of being high: hallucinations, dizziness, altered perception and impaired thinking," wrote Melissa Healy in the Los Angeles Times.
"Ingestion of marijuana results in the absorption of delta-9-tetrahydrocannibinol (THC) and stimulation of cannabinoid receptors in the central nervous system. This produces stimulation with hallucinations and illusions followed by sedation,” the authors said. They recommend more training for emergency medicine, pediatric emergency medicine and primary care pediatric physicians to recognize and manage toxic reactions.
The researchers analyzed emergency room visits for kids under 12 seen for any type of ingestion from 2005 to 2011, using the change in enforcement rules in the fall of 2009 as a divider.
Until the rules changed, there were no marijuana-related visits among 790 patients. Of the cases from that point until the end of 2011, 14 of 588 children were seen for marijuana exposure — eight medical marijuana and seven from food containing the drug.
"The researchers say that homemade brownies speckled with pot may not pose a significant threat to kids, but commercial products formulated for medical use — as well as loose-leaf marijuana grown for medicinal purposes — could be more concerning, since they contain concentrated amounts of THC, the chemical that induces a high," an article in Time magazine said.
“They’re sold as edible products and soft drinks that kids will eat or drink because they don’t know it’s any different,” Dr. George Wang, the study’s lead author and a medical toxicology fellow at the Rocky Mountain Poison and Drug Center, told Time. “If they’re going to eat a whole cookie with 300 mg of THC, they will get much more symptomatic and sick and have to be admitted to the hospital.”
"The trend should prompt equal concern among adult caregivers and public health authorities, since ingestion of highly potent marijuana by young children can suppress respiration and even induce coma," LA Times' Healy wrote.
“Physicians, especially in states that have decriminalized medical marijuana, need to be cognizant of the potential for marijuana exposures and be familiar with the symptoms of marijuana ingestion. This unintended outcome may suggest a role for public health interventions in this emerging industry, such as child-resistant containers and warning labels for medical marijuana,” according to the study authors.
Medical News Today said that "There is concern that parents/grandparents may not disclose their use of medical marijuana because of the perceived stigma associated with the drug."
Dr. Sharon Levy, from the Harvard Medical School and Boston Children's Hospital, wrote in an editorial that ran with the study, "The finding reignites the debate over whether and how legalized marijuana impacts children and adolescents."
More adolescents use marijuana, she said. "The skyrocketing rates of adolescent marijuana use indicate that we are losing an important public health battle and we have a lot of work to do if we want to reverse these trends. Physicians have a key role to play in educating our young patients and their families about the health consequences of marijuana use regardless of its legal status."
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