Children's Hospital Colorado

Experts Research Pediatric Exposure to Marijuana Since Legalization

JAMA Pediatrics | July 25, 2016
Dr. Wang at Children's Hospital Colorado.

Retrospective study that finds significant increase in unintentional exposures

A recent study published in the The Journal of the American Medical Association (JAMA) Pediatrics by researchers at Children’s Hospital Colorado demonstrates an association between the legalization of recreational marijuana and the rate of unintended marijuana exposure in children. Led by Dr. G. Sam Wang, Pediatric Emergency Medicine and Medical Toxicology at Children’s Colorado and the CU Anschutz Medical Campus, the researchers looked at incidences of pediatric marijuana exposures seen in the hospital’s emergency department, urgent cares, and inpatient units, as well as related calls to regional poison control centers between 2009 and 2015.  

The study looked specifically at the electronic medical records of children between zero and nine years of age. Researchers found that only one child was evaluated at the Children’s Colorado’s emergency department with accidental marijuana exposure in 2009, while 16 such cases were seen at the hospital in 2015. Similarly, regional poison control centers reported only nine unintentional marijuana exposure cases in 2009, but saw a fivefold increase – to 47 cases – in 2015. Looking at the same time period, these increases were significantly higher in Colorado than those seen across the rest of the U.S.

How the legalization of recreational marijuana has played a part

When researchers looked at the two years before and after recreational marijuana became legal in Colorado, they again saw a notable increase in emergency department visits (from 1.2 per 100,000 population two years prior to legalization to 2.3 per 100,000 population two years after legalization) and regional poison control center calls due to unintentional marijuana exposure in children. Almost half of the patients seen for marijuana exposure at Children’s Colorado’s in the two years after legalization had been exposed to recreational marijuana, suggesting that legalization did affect the incidence of exposures.

“Unintentional pediatric exposures to marijuana have undoubtedly increased since the legalization of recreational marijuana,” said Dr. Wang. “Many exposures involve edible products – things like brownies and gummy bears that would naturally appeal to children – and in most cases, the product belonged to a parent, grandparent, neighbor, friend, babysitter or other family member.”

The average age of the children involved in the exposure cases was 2.4 years. Most exposures occurred in the home, many as a result of poor child supervision or because marijuana products weren’t in child-resistant containers or were otherwise not stored in a safe manner.

Symptoms and treatment of accidental exposure

Typical symptoms following exposure included sleepiness and lethargy. However, rarely, children were hospitalized in the intensive care unit and required intubation (breathing assistance) due to coma or respiratory depression.

“As more states decide to legalize marijuana, we must be cognizant of the related public health impacts and carefully consider the rules and regulations that should be put in place to help prevent exposures and accidental ingestions,” stated Dr. Wang. “As for next steps in this field of research, we also need to examine the other ways that legalizing marijuana may impact the pediatric population, including exposure in the womb, via breastfeeding or from secondhand smoke, along with adolescent use and related impacts on adolescents’ mental and physical health.”

Learn more about the effects of recreational marijuana and the laws surrounding it.


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