Abstract
Question A 3-year-old girl was brought to my office by her caregiver because she was not acting like herself. She was excessively sleepy, difficult to rouse, and had poor balance. The caregiver reported cannabis products in the home in the form of gummies the caregiver takes for sleep and anxiety. What symptoms should prompt consideration of marijuana ingestion and how should accidental ingestion be managed?
Answer Cannabis is one of the most widely used drugs in the world. Many countries are decriminalizing and legalizing marijuana, but its negative impact on pediatric health is growing. Current evidence shows unintentional marijuana ingestion and severe toxicity are steadily increasing. Common symptoms of marijuana ingestion in young children are drowsiness, somnolence, nausea, and vomiting, with children being at high risk for severe symptoms of respiratory depression and seizures. Primary care providers should talk to families about issues surrounding marijuana in the home, including safe storage of products containing cannabis and when to suspect an accidental ingestion. Public health should focus on the packaging and distribution of edibles to prevent easy access and accidental ingestion by young children.
Cannabis is one of the most commonly used drugs around the world, with 16.7% of Canadians 15 years or older reporting use in the fourth quarter of 2019.1 The Cannabis Act of 2018 that decriminalized marijuana use in Canada had specific stipulations for edible formulations of cannabis that were added in 2019.2,3 In the United States, medical and recreational marijuana use is legal in 24 states and the District of Columbia; 7 states decriminalized possession of small amounts of marijuana for personal consumption.4 In Canada, 72% of individuals reported purchasing marijuana from a legal source in 2024, increasing from 37% in 2019.5 While smoking remains the most common form of cannabis use, edible use increased to 55% from 2018 to 2024.6 Despite hope further regulation of cannabis products would increase its safety and promote public health, pediatricians have voiced concerns widespread availability of legal marijuana may increase the number of children affected by unintentional cannabis exposure.7