Accidental Pediatric Intoxications of Marijuana: Update!

Dr Lee here again to touch on something that I’ve noticed in the literature about marijuana and ongoing legalization efforts. It’s about accidental pediatric intoxications!


Does Marijuana Legalization Change the Number of Kids That Get Sick?


Yes! It does seem pretty clear that legalization has been linked to an increase in accidental ingestions. 


For instance: a few studies in Colorado have shown a meaningful increase in the number of children seen in emergency departments after legalizing recreational pot in 2012 [R, R].


This has also been observed in other communities as well! Research in Washington, Pennsylvania and Canada supports those observations. More exposure to marijuana presents more opportunities for kids to have accidental ingestions [R, R, R]. 


Now there’s additional data showing that pediatric ingestions increased throughout the COVID era! New research shows that there was an uptick in poison control cases due to marijuana ingestions starting in April 2020 towards the beginning of the pandemic! It’s not a stretch to think about why- a lot of us were hanging out inside with a lot of marijuana products in 2020 [R]. 


Overall the pattern is clear. More people are using marijuana, and because of that, 


Why Do We Care About Accidental Ingestions of Marijuana? 


Most of us have felt a little over-intoxicated because of edible products. I once poisoned my freshman floor with a demonic batch of brownies when I was in undergrad, and some of them still don’t talk to me. 


Getting a little too stoned is a scary experience even for adults, but it can be life-threatening in children. Marijuana ingestion can result in severe symptoms in children, including admission to the ICU. Consequences of accidental ingestion include [R, R, R]:

  • Lethargy (78% of kids presented with this)
  • Ataxia, or difficulty walking
  • In severe cases, respiratory depression


The risk of life-threatening side effects with marijuana are most serious in kids under the age of 3. Personally I’ve seen the most ER issues with kids in the 2-3 range- they’re old enough to move and grab and still small enough to be at risk [R].


Fun fact: you’d expect gummies or chocolate to be the most likely culprit for accidental child intoxications, but it’s actually concentrates or resin! I guess it does look super sweet like honey [R]. 


What Should Parents of Children Know About Marijuana?


Great question! Having a safety plan in the house is key to preventing accidental pediatric ingestions. The vast majority of pediatric ingestions (81%) involve their products from their parents’ stash [R]. 


The most important thing is to lock up any of your marijuana goods. A lockbox that is out of sight is the gold standard [R].


Communication is also key! Even with younger children, talking to them about marijuana can help prevent issues. “Young children need to learn that parents are the only ones who should access medications. Children should know what they are and what they look like, but not be able to get them by themselves [R]”


Having the contact information for your local poison control center can help you feel more prepared. In the event that an accidental ingestion occurs, they’ll be able to help you manage it. 


What Should I Do if My Child Accidentally Consumes Marijuana?


We recommend calling poison control for all suspected pediatric intoxications. For many mild intoxications, care at home is appropriate. If symptoms are bad, call 9-1-1 or go to an emergency room.


Try to figure out how much medication your child has taken. Count the number of medications left in the package, and do your best to estimate the amount, in mg, your child has taken.


Weigh your child! Poison control will ask. With intoxications, we can sometimes predict how severe symptoms might become based on your child’s weight and the amount of medication taken.


Most accidental ingestions can be managed over the phone with help from poison control. In this case, it’s most likely that they’ll follow up with you by phone call every few hours to make sure things are okay with your kiddo.


What if I have to go to an ER? What do they do in those ERs anyway?


Most pediatric intoxications are mild and are managed with what we call observation: sitting in a dark, quiet room, and having regular periodic checkups by a doctor or nurse. Most kids that come to the ER are discharged home after they start feeling better.


Medical providers may do a urine drug screen, to confirm that marijuana, or other drugs, are present. Sometimes, marijuana isn’t the only thing the child has accidentally eaten! They may also take some blood to check for blood sugar or other tests.


In cases involving large amounts of medication, some children will need to be admitted to the hospital. In the most extreme cases, they may need help breathing with a machine called a ventilator.


How much ingested marijuana matters for kids?


It depends on the weight of the child! That’s why younger children are more at risk- they weigh less. 


If you can estimate the amount of marijuana your child has taken, you can do a rough calculation.


Low doses: 0-7 mg of THC/kg of body weight

Rarely cause serious illness. Typically treated with observation and minimal intervention.


High doses: 7-13 mg/kg

Typically results in inpatient admission to a hospital, and more serious symptoms.


Very high doses: >13 mg/kg

ICU admission, serious life-saving interventions are often required.