Abstract
Background
Legalization of medical and recreational cannabis is a major contributor to pediatric
cannabis exposures. The trends and magnitude of pediatric cannabis exposures in Michigan
after medical cannabis legalization in 2008 have not been assessed.
Objective
To describe the temporal trends of pediatric cannabis exposures reported to the Michigan
Poison Center (MiPC) after medical cannabis was legalized in 2008 and 1 year after
legalization of recreational cannabis in 2018.
Methods
Retrospective electronic chart review of pediatric (<18 years old) single-substance
cannabis exposures reported to the MiPC from January 1, 2008 to December 31, 2019.
Routes of cannabis exposure were reported as ingestion, inhalation, and unknown. Types
of ingested cannabis products were also documented.
Results
Between 2008 and 2019, 426 pediatric cannabis single exposures were reported. The
median patient age was 6.0 years (interquartile range 2–15 years). Age distribution
was bimodal. A total of 327 (76.8%) exposures were from cannabis ingestion, 79 (18.5%)
from inhalation, 2 (0.5%) from both ingestion and inhalation, and 18 (4.2%) from unknown
route. The doubling time for number of cases was 2.1 years, and the total number of
annual reported cases increased after 2016. Teenagers (13–17 years) had the highest
number of inhalational exposures, whereas young children (0–5 years) had the highest
number of ingestions.
Conclusion
Single-substance pediatric cannabis exposures reported to the Michigan Poison Center
increased after medical cannabis was legalized in 2008 through recreational legalization
in 2018.
Keywords
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References
- Results from the 2018 National Survey on Drug Use and Health.(Available at:)https://www.samhsa.gov/data/report/2018-nsduh-detailed-tablesDate accessed: April 15, 2020
- 1991-2017 High School Youth Risk Behavior Survey.(Available at:)http://nccd.cdc.gov/YouthOnline/App/Default.aspxDate accessed: April 15, 2020
- Drug scheduling.(Available at:)https://www.dea.gov/drug-schedulingDate accessed: May 5, 2020
- 2020 marijuana legalization and marijuana-related ballot measures.(Available at:)https://ballotpedia.org/2020_marijuana_legalization_and_marijuana-related_ballot_measuresDate accessed: November 30, 2020
- Association of unintentional pediatric exposures with decriminalization of marijuana in the United States.Ann Emerg Med. 2014; 63: 684-689
- Highlights of the 2011 DAWN findings on drug-related emergency department visits.(Available at:)www.samhsa.gov/data/sites/default/files/DAWN127/DAWN127/sr127-DAWN-highlights.pdfDate accessed: April 17, 2020
- Incidence of pediatric cannabis exposure among children and teenagers aged 0 to 19 years before and after medical marijuana legalization in Massachusetts.JAMA Netw Open. 2019; 2: e199456
- Unintentional pediatric marijuana exposures prior to and after legalization and commercial availability of recreational marijuana in Washington State.J Emerg Med. 2019; 56: 398-404
- Unintentional pediatric exposures to marijuana in Colorado, 2009–2015.JAMA Pediatr. 2016; 170: e160971
- Marijuana and acute health care contacts in Colorado.Prev Med. 2017; 104: 24-30
- US epidemiology of cannabis use and associated problems.Neuropsychopharmacology. 2018; 43: 195-212
- The design of medical marijuana laws and adolescent use and heavy use of marijuana: analysis of 45 states from 1991 to 2011.Drug Alcohol Depend. 2017; 170: 1-8
- Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: results from annual, repeated cross-sectional surveys.Lancet Psychiatry. 2015; 2: 601-608
- Impact of marijuana legalization in Colorado on adolescent emergency and urgent care visits.J Adolesc Health. 2018; 63: 239-241
- The continued impact of marijuana legalization on unintentional pediatric exposures in Colorado.Clin Pediatr (Phila). 2019; 58: 114-116
- Adult-use marihuana establishments: Emergency Rules. State of Michigan Department of Licensing and Regulatory Affairs.(Available at:)https://www.michigan.gov/documents/lara/Adult_Use_Marihuana_Establishments_659804_7.pdfDate accessed: April 15, 2020
- Marijuana tax data.(Available at:)https://www.colorado.gov/pacific/revenue/colorado-marijuana-tax-dataDate accessed: June 15, 2020
- Monthly report: March 2020. State of Michigan Department of Licensing and Regulatory Affairs.(Available at:)https://www.michigan.gov/documents/lara/Monthly_Report_March_2020_687859_7.pdfDate accessed: June 9, 2020
- Monthly report: April 2020. State of Michigan Department of Licensing and Regulatory Affairs.(Available at:)https://www.michigan.gov/documents/mra/Monthly_Report_-_April_2020_690574_7.pdfDate accessed: June 9, 2020
- The impact of marijuana policies on youth: clinical, research, and legal update.Pediatrics. 2015; 135: e769-e785
- NORML. State laws.(Available at:)https://norml.org/statesDate accessed: April 17, 2020
- Understanding the limitations of retrospective analyses of poison center data.Clin Toxicol (Phila). 2007; 45: 943-945
Article info
Publication history
Published online: February 02, 2021
Accepted:
December 23,
2020
Received in revised form:
December 9,
2020
Received:
September 14,
2020
Identification
Copyright
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