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Pediatric marijuana exposure.

As of April 2016, 23 states and Washington D.C. have legalized marijuana for medical use. Four of those same states and Washington D.C. have also voted to legalize marijuana for recreational use. Debates about legalizing marijuana have focused on crime rates, economic benefits, and health effects among adults. Lost In the discussion is the potential harm to young children from unintentional exposure to marijuana. A recent study by the Center for Injury Research and Policy at the Research Institute of Nationwide Children's Hospital shows that the risk to young children of swallowing, breathing in or otherwise being exposed to marijuana also needs to be considered.

The rate of marijuana exposure among children five years of age and younger rose 147.5% across the United States from 2006 through 2013. The rate increased almost 610% during the same period in states that legalized marijuana for medical use before 2000.

In states that legalized marijuana from 2000 through 2013, the rate increased almost 16% per year after legalization, with a particular jump in the year that marijuana was legalized. Even states that had not legalized marijuana by 2013 saw a rise of 63% in the rate of marijuana exposures among young children from 2000 through 2013.

More than 75% of the children who were exposed were younger than three years of age, and most children were exposed when they swallowed marijuana. The high proportion of ingestions may be related to the popularity of marijuana brownies, cookies and other foods. Young children explore their environment by putting items in their mouths, and foods such as brownies and cookies are attractive.

Marijuana exposure among young children is a growing problem. While most exposures resulted in only minor clinical effects, some children experienced coma, decreased breathing, or seizures. The main psychoactive ingredient of marijuana, THC, can be especially high in marijuana food products, and that may have contributed to some of the observed severe effects. More than 18 percent of children who were exposed were hospitalized. These hospital admissions were likely due not only to the clinical effects, but also the need to investigate the circumstances that lead to the exposure in the home.

Overall, there were almost 2,000 young children reported to Poison Control Centers in the United States because of marijuana exposure from 2000 through 2013. While that is a relatively small number of total cases, the steep rate of increase in states that have legalized marijuana is reason for concern. Any state considering marijuana legalization needs to include child protections in its laws from the very beginning. Child safety must be part of the discussion when a state is considering legalization of marijuana.

About one year ago, Colorado (one of the first states to legalize marijuana for recreational use) implemented the Packaging and Labeling Requirements of a Retail Marijuana Products Manufacturing Facility rule that requires use of child-resistant packaging with warnings and serving size information. This rule still needs to be evaluated to determine how effective it was, and whether it can be improved upon and implemented in other states and territories.

Safety experts recommend the same measures for commercially available marijuana products that are now used to protect children from medicines and dangerous household chemicals, including requirements for child-resistant packaging and packaging that is not see-through. These same precautions also need to be used for homemade marijuana products. Health care providers should educate parents and other child caregivers about the dangers of marijuana to young children, and talk to them about proper storage if marijuana is in the household. If marijuana products are in a household, they need to be kept up, away, and out of sight of children, preferably in a locked location.

By Laura Friedenberg, MA and Gary Smith, MD, DrPH

Laura Friedenberg, MA is a research writer/editor in the Center for Injury Research and Policy in the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. She works to translate research into meaningful, accurate messages to motivate the public to make positive behavior changes.

Gary Smith, MD, DrPH, is the founder and director of the Center for Injury Research and Policy in the Research Institute at Nationwide Children's Hospital and president of the Child Injury Prevention Alliance. He is a Professor of Pediatrics, Emergency Medicine, and Epidemiology at The Ohio State University. Dr. Smith has been an active researcher and advocate in the held of injury prevention for more than 30 years and has published extensively.
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Author:Friedenberg, Laura; Smith, Gary
Publication:Pediatrics for Parents
Date:Sep 1, 2014
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