Daily Dose: Pediatric Cannabis Poisoning Surges

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On January 19, 2023, we reported on a study published in JAMA Health Forum that aimed to determine the association between legalization of recreational cannabis edibles and unintentional pediatric cannabis poisoning in Canada.

The study

The investigators’ repeated, cross-sectional population-based study comprised all hospitalizations in children aged 0 to 9 years between January 1, 2015, and September 30, 2021 and was divided into 3 policy periods:

• Prelegalization period (January 2015 – September 2018)

• Period 1, representing legalized dried flower, seeds, oil only in all provinces (October 2018 – December 2019)

• Period 2, representing legalized dried flower and edibles in Ontario, British Columbia, and Alberta and restriction in Quebec (control province) (January 2020 – September 2021).

There were 581 pediatric hospitalizations for cannabis poisoning and another 4406 hospitalizations for all-cause poisonings during the 7-year study period (2015 – 2021). Among the all-cause poisoning hospitalizations, the rate per 1000 due to cannabis poisoning was 57.42 in the exposed provinces and 38.5 in the control province.

In period 1, following national legalization, the rate per 1000 more than doubled to to 149.71 in the 3 exposed provinces (incidence rate ratio [IRR], 2.55; 95% CI, 1.88 – 3.46) and to 117.52 in the control province (IRR, 3.05; 95% CI, 1.82 – 5.11).

In period 2, when the 3 exposed provinces permitted edibles but Quebec continued to restrict the sale, the rate per 1000 poisonings due to cannabis again more than doubled to 318.04 among exposed provinces (IRR, 2.16; 95% CI, 1.68 – 2.80), but remained at a similar rate of 137.93 in Quebec (IRR, 1.18; 95% CI, 0.71 – 1.97).

Clinical implications

“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 US and other countries considering legalization of recreational cannabis."

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