Cannabis poisonings in young children have increased in Canadian provinces where they legalized the sale of cannabis edibles, such as gummies, chocolates and baked goods, a new study suggests.
The research, published Jan. 13 in the journal JAMA Health Forum (opens in new tab), evaluated rates of pediatric hospitalizations for poisonings in four provinces: Ontario, Alberta, British Columbia and Quebec.
Dried cannabis flower use and sale were legalized across Canada in October 2018, but individual provinces could then decide whether additional cannabis products could be sold in their jurisdictions. Quebec chose to prohibit the sale of sweets, candies, desserts and chocolates that contain THC (tetrahydrocannabinol), the psychoactive ingredient in cannabis, but Ontario, Alberta and British Columbia legalized such edibles in 2020.
The study authors wanted to see if the provinces that legalized edibles saw significant spikes in hospitalizations for cannabis poisoning among kids; such pediatric poisonings can cause excessive sleepiness, dizziness, trouble walking, trouble breathing and, in very severe cases, seizures. To do so, the team compiled hospitalization records from children ages 9 and younger who were hospitalized between January 2015 and September 2021.
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In the seven-year study period, the four provinces reported 581 total hospitalizations for pediatric cannabis poisoning. Prior to 2018, 120 poisonings occurred; 105 happened in the window between the legalization of flowers and that of edibles; and 356 occurred after the legalization of edibles in Ontario, Alberta and British Columbia.
Pediatric poisoning hospitalizations due to cannabis represented a greater proportion of child poisoning hospitalizations over time, the researchers found.
Prior to the legalization of cannabis flowers, cannabis accounted for about 4% to 7% of the pediatric poisonings in each province. After flower legalization, the four provinces saw that proportion increase 2.6-fold to 3.1-fold. And after legalizing edibles, Ontario, Alberta and British Columbia saw that proportion jump an additional 2.2-fold, while Quebec's rates did not change.
"In provinces with legal edibles, approximately one-third of pediatric hospitalizations for poisonings were due to cannabis," the researchers wrote in their report. Specifically, after the legalization of edibles, about 318 out of every 1,000 poisonings were attributable to cannabis.
"The overall increases in unintentional pediatric poisonings occurred despite regulations by Canadian authorities aimed at reducing the incidence and severity of unintentional pediatric poisonings," the authors added. These regulations involved capping the amount of THC in edibles and mandating consumer education campaigns and child-resistant packaging.
Similar trends are occurring in the U.S. as more states legalize edibles. A report published Jan. 3 in the journal Pediatrics (opens in new tab) found that U.S. poison control centers received nearly 15 times more calls about kids younger than age 6 accidentally ingesting edibles in 2021 than they did in 2017. That's 3,054 calls compared with 207.
"Our findings suggest that placing restrictions on the sale of visually attractive and palatable commercial cannabis edibles is a key strategy and policy consideration for preventing unintentional pediatric cannabis poisonings for the U.S. and other countries considering legalization of recreational cannabis," the authors of the JAMA study concluded.