It's not a shock that as more states legalize cannabis products for recreational use, some edibles are getting into the wrong hands.
Tiny, pudgy, curious hands.
A new national study finds that the number of cases of children younger than 6 ingesting cannabis has skyrocketed as access to edibles has expanded. In 2017, there were only 207 cases reported to the national database that tracks exposures reported to regional poison control centers across the United States. Five years later, there were more than 3,000 cases. The surge, while not deadly, led to an increase in kids being hospitalized.
The biggest jump in exposures coincided with the onset of the pandemic, when kids were suddenly stuck at home due to COVID-related quarantines and school or day-care closures.
If you've ever met a toddler, it's obvious why they're getting sick.
"Kids just put things in their mouths," said Dr. Jon Cole, medical director of the Minnesota Poison Control System and a father of four. "They put things in their mouth to explore the world."
After legalizing hemp-derived products containing THC last summer, Minnesota is starting to see trend lines that jibe with the national data.
Back in 2020, only 48 pediatric cases involving exposure to edibles such as gummies and chocolates were reported to the state's poison center, which participated in the national study. Last year, cases jumped nearly fourfold to 184, as edibles overtook loose-leaf cannabis as the No. 1 cause of cannabis-related exposures for children and adults. And these numbers include only the cases that were reported to the center by parents, health care providers or others — so undoubtedly there are more incidents out there.
Cole, an emergency-department physician who is 43, is careful not to overhype the situation. Like me, he grew up in an era in which the dangers of marijuana were overstated. But children react differently to the drug than adults do, and there is some legitimate risk to them if they ingest it.
"Is it as risky as fentanyl? No. But could they be hospitalized and become seriously ill? Yes, we do see that," he told me. "A balanced message is really important. This is something you should take seriously and treat with respect. And as long as you do, everyone in your home will be safe."
He suggests that we think about having edibles in the house in the same fashion we would view high-risk heart medication pills. No need for shame or judgment about taking them, but know that they do present medical dangers to children if they're not stored properly.
The main risk faced by kids who consume cannabis is drowsiness. "Children, for reasons that are not totally clear, get much more sedate and drowsy, and can even become unconscious," Cole says. In fewer than 1% of the cases tracked by the National Poison Data System, children were so drowsy that they could not breathe on their own and had to be intubated.
Other side effects included vomiting, agitation and loss of coordination, according to the study, published this month in the journal Pediatrics.
In some cases, Cole said, parents do not know what has sickened their child when they bring them to the emergency room. It's only after a full workup and tests that cannabis is discovered in their system.
They're here, they're everywhere
You can now buy a small pack of THC gummies at your local Patina counter, rounding out purchases of scented hand lotions and embroidered kitchen towels. These potent edibles come in cute and colorful zip-top pouches that you can stash in your purse, just as you would a pack of breath mints or candy. This is what many of us wanted, right? Less stigma, more access, delightful packaging?
But you can be pro-gummy and still recognize that legalization of hemp-derived products arrived without proper regulation in Minnesota, and arguably without the necessary public education and awareness. State law requires the packaging of these products to be "child-resistant," but many children can outsmart a zip-top bag.
I called Steven Brown, owner of Nothing But Hemp and president of the advocacy group Minnesota Cannabis Association. He said his products are packaged with tricky enclosures similar to those found on containers for laundry detergent pods.
"A child would have a very difficult time opening this packaging because of the way that it locks," Brown said. "I mean, it's not very easy for an adult to open it, either."
Brown would like to see more uniform enforcement of rules already on the books. The state's law on hemp-derived edibles bans products that resemble cartoon-like characters, animals or fruit that appeal to children, or is modeled after brands, like Froot Loops or Oreos, that kids especially enjoy. (A bill that would legalize adult-use marijuana has similar protections for children.) But Brown says some smoke shops are still peddling lookalikes with THC amounts that far exceed the current limit of 5 milligrams per serving.
"It's horrible," he said. "I'm a dad. I don't want my kids getting into cannabis. I don't want somebody else's kid to get into cannabis," he said. "Let's say a 6-year-old eats a whole bag of edibles. They can get really sick. It could be horrendous for the parents to deal with that, and for the child. So it's our job, as a cannabis community, to protect all consumers, especially children, from our products."
Brown would like to see Minnesota do a better job educating parents on their obligations — and put them on the hook if their negligence leads to a child ingesting cannabis. "I'm not saying we want to put parents in jail because they make a mistake, but we need to have something in place that says the parent also has a responsibility to stow this properly."
If you're a parent, here's what you can do:
- Keep your products out of reach of children, and well out of their sight, preferably under lock and key, Cole recommends.
- Unless you can remove the labeling from childproof bottles that once carried medication or vitamins, Cole does not advise placing THC products in them. Doing so can cause confusion in the household — especially since many vitamins also come in gummy form.
- Don't consume edibles in front of your children. "Small kids like to imitate," he said. "The vast majority of children who are poisoned from this are 2- and 3-year-olds, kids who are mobile and like to explore but don't have a lot of experience of understanding what's safe around them."
- If you're concerned about your child consuming cannabis, call the Minnesota Poison Control System at 1-800-222-1222. It's free and confidential. Staff members can help you determine whether you can monitor the situation at home or if you should seek care from a hospital.
- If your child is not breathing on their own — an exceedingly rare outcome from ingestion of cannabis — call 911.
Cole said Minnesota Poison Control is not wading into Minnesota's marijuana legalization debate, where opinions are deeply entrenched. Its main priority is to keep everyone safe.
In this case, the most vulnerable who need protection are the tiniest among us, who explore their world with their mouths.