UNINTENTIONAL IMPACT ON CHILDREN BY MARIJUANA

A 9-year-old girl unwittingly ate, and handed out to other classmates, THC-laced candy, school officials said.

The girl brought the candies to school last Thursday and said she could not see; another girl ate them and started to feel dizzy, Albuquerque School of Excellence Dean of Elementary School Students Kristy Del Curto told KRQE.

“We noticed the student who initially brought the edible to our school was acting strange. She started saying she couldn’t see,” Del Curto said.

Three students shared one gummy and the student who handed it out had three or four pieces, Del Curto said.

Paramedics were called and monitored the students, who eventually recovered.

The student who brought them to school did not know they were medicinal, THC-laced gummies, Del Curto said.

“As marijuana becomes legal in each state, it’s going to become more and more of an issue, I believe,” Del Curto said.  [Girl, 9, unknowingly hands out THC-laced candy to classmates, school says by Jared Leone, Cox Media Group, Jan. 20, 2018  National/World News ALBUQUERQUE, N.M]

The 3 research studies that follow illustrate the unintentional Pediatraic Population affected by increased popularity and legalization of Marijuana.

For example, annual Colorado Regional Poison Center (RPC) pediatric marijuana cases increased more than 5-fold from 2009 (9) to 2015 (47). Colorado had an average increase in Pediaatric RPC cases of 34% (P < .001) per year.

1.“CONCLUSIONS: Children are collateral victims of changing trends in cannabis use and a prevailing THC concentration. Intoxicated children are more frequent, are younger, and have intoxications that are more severe. This raises a real issue of public health.

“BACKGROUND AND OBJECTIVES: In France, cannabis consumption is illegal. The health impact of its increasing use and higher tetrahydrocannabinol (THC) concentrations is still poorly documented, particularly that of unintentional pediatric intoxications. We sought to evaluate the French national trend of admissions for unintentional cannabis intoxication in children over an 11-year period (2004–2014).

“RESULTS: Twenty-four PEDs participated in our study; 235 children were included, and 71% of the patients were 18 months old or younger. Annual admissions increased by a factor of 13. Hashish resin was the main form ingested (72%). During the study period, the evolution was characterized by a national increase in intoxications, younger intoxicated children (1.28 ± 0.4 vs 1.7 ± 0.7 years, P = .005), and more comas (n = 38) (P = .05, odds ratio 3.5 [1.02–11.8]). Compared with other intoxications, other PED admissions, and the same age population, cannabis-related admissions were greater. There was a potential link between the increased incidence of comas and increased THC concentration in resin seized in France over the period.

[Unintentional Cannabis Intoxication in Toddlers, by Isabelle Claudet, et al, for the Marie-Jeanne Study Group, J of Pediatrics, Sept 2017, VOLUME 140 / ISSUE 3]

2. IMPORTANCE:
As of 2015, almost half of US states allow medical marijuana, and 4 states allow recreational marijuana. To our knowledge, the effect of recreational marijuana on the pediatric population has not been evaluated.

OBJECTIVE:
To compare the incidence of pediatric marijuana exposures evaluated at a children’s hospital and regional poison center (RPC) in Colorado before and after recreational marijuana legalization and to compare population rate trends of RPC cases for marijuana exposures with the rest of the United States.

RESULTS:
Eighty-one patients were evaluated at the children’s hospital, and Colorado’s RPC received 163 marijuana exposure cases between January 1, 2009, and December 31, 2015, for children younger than 10 years of age. The median age of children’s hospital visits was 2.4 years (IQR, 1.4-3.4); 25 were girls (40%) . The median age of RPC marijuana exposures was 2 years (IQR, 1.3-4.0), and 85 patients were girls (52%). The mean rate of marijuana-related visits to the children’s hospital increased from 1.2 per 100 000 population 2 years prior to legalization to 2.3 per 100,000 population 2 years after legalization (P = .02). Known marijuana products involved in the exposure included 30 infused edibles (48%). Median length of stay was 11 hours (interquartile range [IQR], 6-19) and 26 hours (IQR, 19-38) for admitted patients. Annual RPC pediatric marijuana cases increased more than 5-fold from 2009 (9) to 2015 (47). Colorado had an average increase in RPC cases of 34% (P < .001) per year while the remainder of the United States had an increase of 19% (P < .001). For 10 exposure scenarios (9%), the product was not in a child-resistant container; for an additional 40 scenarios (34%), poor child supervision or product storage was reported. Edible products were responsible for 51 exposures (52%).

CONCLUSIONS AND RELEVANCE:
Colorado RPC cases for pediatric marijuana increased significantly and at a higher rate than the rest of the United States. The number of children’s hospital visits and RPC case rates for marijuana exposures increased between the 2 years prior to and the 2 years after legalization. Almost half of the patients seen in the children’s hospital in the 2 years after legalization had exposures from recreational marijuana, suggesting that legalization did affect the incidence of exposures. [Unintentional Pediatric Exposures to Marijuana in Colorado, 2009-2015. By Wang GS1, Le Lait MC2, Deakyne SJ3, Bronstein AC2, Bajaj L4, Roosevelt G5. JAMA Pediatr. 2016 Sep 6;170(9)]

3. Abstract

“An “unintended consequence” of marijuana legalization is the impact on the pediatric population. From prenatal exposure to unintentional childhood exposures, through concerns of adolescence abuse and marijuana use for medicinal indications in children, marijuana exposure can affect pediatric patients at every stage in childhood. Regardless of the stage or reason of exposure, concerns exist about short-term and long-term consequences in a child’s physical and mental health. The use of cannabidiol (CBD) may have some benefit for the treatment of epilepsy, but emphasis needs to be on rigorous clinical trials to evaluate efficacy and safety. As more states allow both medical and recreational marijuana, availability and prevalence of use will likely increase and more surveillance and research is needed to evaluate the consequences on the pediatric population.”

[Pediatric Concerns Due to Expanded Cannabis Use: Unintended Consequences of Legalization by Wang GS1 J Med Toxicol. 2017 Mar;13(1):99-105. doi: 10.1007/s13181-016-0552-x. Epub 2016 May 2]

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