More kids hospitalized for cannabis poisonings after edibles legalized, study finds

The average number of kids hospitalized for unintentional cannabis poisonings spiked in some provinces after they legalized edibles, according to a new study published Wednesday in the New England Journal of Medicine.

The Ontario-based researchers also found that three such provinces — Alberta, B.C. and Ontario — saw twice the increase in pediatric hospitalizations than Quebec, which prohibited edibles at the time of the study. 

"Unlike adults where they would mostly get high, maybe a little bit drowsy, when young children ingest edibles, they may become very, very sick. We've seen kids with seizures, kids who stopped breathing," said Dr. Yaron Finkelstein, a senior author of the study and staff physician at SickKids Hospital in Toronto. 

"Their symptoms, especially in young children, can be more severe and can be life-threatening."

Federal law requires cannabis-infused edibles — including gummy candies, chocolate or baked goods — to be sold in plain packaging, so as not to appeal to children, and with no more than 10 milligrams of the psychoactive compound THC.

But even those precautions "are not enough," Finkelstein said. "Those kids are still at risk." 

That's why Finkelstein and other pediatricians say parents and guardians should store edibles away from kids. Kids are affected differently by such products and could get very sick, pediatricians say. How much was eaten, the type of edible, the age and size of the child are all factors.

"They are made to be yummy and it can be very tempting for a young person to try one of these things thinking that it's a yummy cookie or brownie or gummies or other edible products," said Dr. Dina Kulik, a Toronto-based pediatrician who was not involved in the study.

What the study shows

As part of the research, Finkelstein and colleagues wanted to see how having more cannabis products on the market after legalization affected the number of kids hospitalized for poisonings. 

They compared provincial hospital data over three time periods: 

• Before legalization of cannabis in Canada (January 2015 to September 2018). 
• After cannabis first became legal (October 2018 to December 2019).
• After the legalization of edibles (January 2020 to September 2021).

In the first period, they found that 581 kids between one and nine years old had been hospitalized for cannabis poisoning. 

There were an average of two such hospitalizations per month in Alberta, B.C. and Ontario, according to data provided to CBC News. 

The number grew to 5.2 on average per month after cannabis became legal, according to the data.

After edibles were legalized in those provinces, it increased again to 14.9.

In Quebec, the increase was smaller. That province averaged about 0.7 monthly hospital visits due to cannabis poisonings before legalization. But that tripled after edibles were legalized, to about 2.1. 

The researchers did not specify if any kids died during the study period.

"It is concerning that with legalization led to more kids having accidental ingestion and toxicity from marijuana products," said Kulik, adding that she has seen a rise in cases at her practice. 

Deborah Friedman, the trauma director at the Montreal Children's Hospital and McGill University Health Centre and an associate professor of pediatrics at McGill, said the study points to what she and her colleagues are seeing in their emergency departments. 

"Certainly the cases we saw were a result of gummies, chocolate and cookies, but certainly the numbers did not increase as they did apparently in Alberta, Ontario and B.C.," she said, adding that it's still early in legalization and that more monitoring of the trend is needed. 

Finkelstein says some parents and guardians don't know their child has ingested an edible, making diagnosis challenging sometimes. Other times, parents choose not to disclose that to doctors.

"When that happens … we have an unconscious kid where we don't know the reason and we start to do a lot of investigations," he said.

"Some of those kids undergo many more painful examinations … until we identify the reason, especially if we're not told about the exposure to cannabis."

Friedman says guardians should watch for common symptoms like vomiting, drowsiness, increased heart rate, trouble breathing, anxiety and agitation. She says that parents should take their children to the nearest hospital if cannabis poisoning is suspected. 

Finkelstein says more needs to be done to stop kids from ingesting edibles.

He, Kulik and Friedman agree that if parents are bringing edibles into the home, they should be safely stored away from kids.   

"We do want to make sure that these products are very, very far away from curious eyes and curious hands and locked away like other medicines should be," Kulik said.