Rising Unintentional Marijuana Exposures in Colorado Youth since Legalization / by F. Perry Wilson

On January 1st, 2014, businesses in Colorado opened their doors to start selling recreational marijuana. Though the drug had been legalized in November of 2012, New Year's day 2014 (or "Green Wednesday" as it was called) was the beginning of more widespread availability.  And despite some crowing about state revenues, much hand-wringing has ensued, particularly when it comes to children.

But we're not talking today about kids deliberately getting their hands on pot, today we're looking at unintentional exposures.

This is relevant because pot, unlike many other drugs, comes in some really palatable forms.  In Colorado, you can get your typical cannabis for smoking:

Since this blog is located in Connecticut, this is only for medicinal use.

Since this blog is located in Connecticut, this is only for medicinal use.

But you can also get pot brownies:

The helpful leaf is not always present.

The helpful leaf is not always present.

You can get cannabis popcorn, which, really, should be called potcorn:

 

Potcorn. Trademark Pending (MM).

Potcorn. Trademark Pending (MM).

And the doses of THC in these concoctions can be really high.

So is this a recipe for disaster for Colorado youth, innocently trying to sneak a brownie from that jar that mom and dad keep on top of the refrigerator for some reason?

A study appearing in JAMA Pediatrics took a systematic look, and has raised some concerns.

Researchers examined two sources of data for this analysis.  First, they looked at emergency department visits for accidental ingestions among kids under 10 years old. Now, this was really a single-center study, so the numbers are small, but the rates did seem to tick up a bit after 2014.

On average, 6.4 out of every 1000 visits for ingestions in 2014 and 2015 were due to THC in some form. Compare that to 4.3 out of 1000 in the years prior to Green Wednesday. This change didn't meet a threshold for statistical significance on its own, though the authors make a case that THC-associated ED visits went up if you account for the total population of children in the state.

More concerning was the number of poison control center calls – increasing from 1 out of 1000 calls to 2.3 out of 1000 calls after 2014. Now, an astute epidemiologist might suspect that, as pot use became legalized and normalized, people might feel a little less nervous about calling the poison control center than they used to.  You might also point out that, if 2 out of 1000 calls are for accidental pot ingestions, there are potentially 998 other things that our little darlings are putting in their mouths.

I did some research. In 2014 in Colorado, the most common exposures among children aged 0 – 5 years looked like this:

Wait... maybe "plants" should count.

Wait... maybe "plants" should count.

You'll note that recreational drugs do not appear on that list.

So ingestion is rare, but it is not entirely benign.  Though marijuana toxicity is not nearly as life-threatening as many recreational drugs (including alcohol), the report cites cases of children suffering from drowsiness, agitation, vomiting and tachycardia.  There were 4 cases of respiratory depression and one case of death, though that was later attributed to myocarditis. There also was a fair amount of medical testing – in itself a bad experience for young kids.

The question behind the research study is, of course, whether legalization of recreational marijuana is endangering children. The answer is, probably, yes – having pot lying around the house makes it more likely that a young kid might get into it.

But the same can be said of alcohol, of bleach, of guns, of pesticides, of Nickelback albums. We accept the risk trusting people will be responsible. We'll keep an eye on this trend, but for now the best advice to parents is common-sense. Stash your stash.