September 16, 2019

Michigan Poison Center at Wayne spots increase in pediatric exposure to edibles

Nine months into 2019, more than half of calls made to the Michigan Poison Center at Wayne State University concerning marijuana exposure through edibles like brownies, chocolate bars, candy and gummies involved children as young as 6 years old.

The uptick is likely due to the November 2018 legalization of marijuana in Michigan, leading to a higher availability of substances in homes, said School of Medicine Associate Professor of Emergency Medicine and Toxicology Fellowship Program Director Andy King, M.D.

Since the beginning of the year, the Michigan Poison Center at WSU has received 420 calls related to marijuana exposure, 104 of them involving children under 18 years old. More than half of the pediatric calls – 59 – involved edibles, according to data collected by the center’s Medical Director Cynthia Aaron, M.D., the bulk under 6 years old, and another peak in calls regarding adolescents. In comparison, in 2017, the center fielded six calls of the same nature. In 2014, one.

“Wherever you start seeing legalization, kids are going to have more access to it by sheer numbers and probability to it,” Dr. King said. “A lot of the edibles are so desirable to children. This is the age that really can’t read, and they’re going to (sneak) a cookie or steal a gummy bear.”

Children don’t just have a bad trip, the physicians explained. Smaller children (2 or 3 years old), become unresponsive and may stop breathing, requiring a breathing tube and ventilator.

Results from a decade-long study of children in France who ingested marijuana showed 80 having neurologic symptoms such as drowsiness, loss of balance, dizziness, floppiness, agitation, seizures and coma.

The result of exposure to edibles is drastically different in children compared to an adult smoking THC or eating THC-laced products for several reasons. Children can weigh less than one-third of an average adult. The effects of edibles can also take several hours to show up, unlike smoking marijuana.

Dr. King recommends all edibles and substances, including prescription drugs, be kept in a locked box to ensure safety.

He noted that the laced edibles don’t always belong to the parent. Children often find something at a friend or family member’s house and think it’s a regular treat.

“A typical marijuana cigarette holds about 10 mg of THC, Dr. King said. “That’s what you see in a gummy bear. That’s a dose for a novice person to take to get the psychedelic or enjoyable effects of THC. These edibles can go up to 10 times that amount.”

And, dosing in THC-laced edibles isn’t regulated, Dr. Aaron added.

“You may be told that the rice cereal treat has 50 mg of THC in it, but because there is no oversight you have no idea how well-distributed that 50 mg is within the treat. If you read the package, the dose is half of a treat, one square of a chocolate bar or one or two gummies. What child is going to stop at half the treat or one square of chocolate? So overall the kids get a higher dose of THC than the adult would due to smaller size,” she added.

These can be up to 20 times more than a typical dose equivalent for an adult.

“They can get really sick from the adult products. They can have pretty scary and profound dramatic presentations,” said Dr. King, who divides his time between the Michigan Poison Center and the emergency department. “Some can be so sleepy they have to be intubated. It can last for a long time. They don’t hit you right away like smoking does, they take a long time. It’s such a long-acting drug. They can be pretty sick for a day or two. And then lingering sick for two days. There’s no antidote for it,” he said.

The center fields calls and exposures from across the state.

“We get calls from the hospitals when the children are brought in acting strangely, are unresponsive or aren’t breathing. If we get calls from the home on young children, we send them into the hospital,” Dr. Aaron said.

The center also gets calls regarding adult exposure.

“Smoking gives you a fairly rapid effect, but edibles can take several hours, and by that time many have eaten more than recommended because they ‘didn’t feel anything,’” Dr. Aaron. “We get called on the adults because they have a dysphoric trip or are dizzy, lightheaded, don’t feel good. We’ve fielded several calls where older adults thought they were having a stroke.”

Visit www.mipoisonhelp.org for more information on the Michigan Poison Center at Wayne State University. Call 1-800-222-1222 for free expert poison help 24/7.