"We have seen an increase in unintentional ingestions of marijuana by children since the modification of drugs laws in Colorado," said George Wang, MD, lead author of the study and clinical instructor in pediatrics at Children's Hospital Colorado and the University of Colorado School of Medicine. "We need to educate marijuana users, the community and medical professionals about the potential dangers."
The study, published Monday in the JAMA Pediatrics
, compared the number of young children treated at the Children's Hospital Colorado emergency department for ingesting marijuana before and after the modification of Colorado's drug laws beginning in 2009.
A total of 1,378 patients under age 12 were evaluated for unintentional ingestions - 790 before Sept. 30, 2009 and 588 after Oct. 1, 2009. The number of children treated for exposure to marijuana before Sept. 30 was zero. The number from Oct. 1 on was 14 with eight of those coming directly from consuming marijuana food products.
Wang, a fellow at the Rocky Mountain Poison & Drug Center, said today's marijuana can be much stronger, and these products can contain higher concentrations of THC, the active ingredient in the drug. Some marijuana infused candy bars, for example, contain 300 milligrams of THC. Children who ingested the drug exhibited symptoms that included respiratory problems, extreme sleepiness, difficulty in walking and lethargy. Many underwent a battery of expensive tests to diagnose their problem because the history of exposure was not given, or medical professionals were not familiar with marijuana causing these symptoms.
"Before the marijuana boom these kinds of edibles were not mass-produced and the amount of THC ingested was somewhat limited, but now we are seeing much higher strength marijuana," Wang said. "The key to this is prevention through child resistant packaging."
With that in mind, Wang and Michael Kosnett, MD, MPH, a medical toxicologist and associate clinical professor at the University of Colorado School of Medicine, recently testified before a state advisory panel. According to Kosnett, they persuaded the panel to recommend child resistant packaging for marijuana edibles.
"Dr. Wang and I worked together to translate his study findings into public policy that would prevent poisoning," said Kosnett, who is also an attending physician at the Rocky Mountain Poison & Drug Center, a division of Denver Health. "We were gratified that our message to the governor's Amendment 64 Implementation Task Force and the legislature resulted in passage earlier this month of a law requiring the Colorado Department of Revenue to develop rules for child resistant packaging for marijuana products by July 1."
Child resistant packaging, Kosnett said, began with baby aspirin in the 1940s and in several studies has been associated with a 40 to 95 percent decline in pediatric poisonings from oral medications and hazardous household chemicals.
"We know that children will act quickly to ingest even unpalatable items like household cleaners, pills and capsules," he said. "The allure of these marijuana edibles which taste and look like simple sweets makes them especially risky."
So far, no other state has developed similar packaging laws, including Washington which legalized recreational marijuana last year, Kosnett said.
"I believe the experience here in Colorado and the appropriate response by the Colorado Legislature will serve as an example to the rest of the country," he said.
"As more states move to legalize marijuana this problem is only going to increase," said Wang. "Now is the time to be proactive and intervene."