Pot edibles are a burgeoning business in Colorado, and with the signing of marijuana-related legislation later this morning, that growth is expected to continue.
But according to a Colorado-centric study just published in the Journal of the American Medical Association Pediatrics, something else is rising, too -- the number of toddlers who have eaten edibles and gotten sick.
According to study co-author George Wang, a number required critical care procedures after admission.
According to Wang, a clinical instructor with Children's Hospital Colorado and the University of Colorado School of Medicine, as well as a medical toxicology fellow at the Rocky Mountain Poison & Drug Center, the study was inspired by simple observation.
"In the emergency room, we started seeing a few kids with marijuana exposures who were fairly symptomatic," he notes. "We wondered if we were seeing more of these kids from the end of 2009 than we did before then."
This date was chosen for a number of reasons, Wang continues. "That was about when our dispensary boom started," he points out. "There were more marijuana shops in Denver, more medical-marijuana card-holders. And then the Ogden memo came out" -- a reference to a document penned by Deputy Attorney General David Ogden directing U.S. Attorneys not to make MMJ businesses following state law a major priority. Wang's interpretation of the document: "It said the federal government wasn't going to crack down very hard" on such operations.
After determining the dividing line, Wang and Michael Kosnett, a CU medical school colleague, looked at emergency room visits at Children's Hospital involving unintentional marijuana exposure in kids via ingestion. "We saw zero from January 2005 through September 2009" out of 790 patients that fit the criteria, Wang says. "But from October 2009 through December 2011, we saw fourteen visits to the ER at Children's for children less than twelve who'd been unintentionally exposed to marijuana," out of 588 applicable patients.
Further examination of electronic records provided more details about the latter. "From what we were able to gather, eight of the fourteen were due to someone with medical marijuana, and seven of that eight got into some type of edible product: a cookie, candy, a brownie."
For the other six patients, there was no documentation about either medical marijuana or whether the exposure was due to ingesting a pot edible.
Although the search flagged children under age twelve, Wang says the focus of the study was on kids in the toddler age group, with the average being in the two-to-three-years range. How ill did they become?
"There was a spectrum of symptoms," he says, "from a little sleepy, a little ataxic or unbalanced, to more serious symptoms that needed to be treated by the critical care unit." For instance, "We had one child who had respiratory insufficiences and had difficulty breathing."
Fortunately, Wang notes, "there were no deaths," and all of the children recovered.
Could the lack of diagnoses prior to September 2009 be as a result of doctors simply not looking for the problem back then? Wang doesn't think so.
"We used our electronic medical records at Children's and did a search using codes," he explains. "We looked at all ingestions and exposures, including marijuana, and there were no coding changes" during the years covered by the study. As such, it's theoretically possible that something was missed, but the prospect is unlikely given that "we did the same search for both time periods."
In Wang's view, "what's interesting about the study is that we traditionally think of it not being that big a deal when kids unintentionally get into marijuana, since the symptoms are fairly minor. But the study showed evidence of kids getting quite sick from exposure."
After all, he goes on, "a child isn't going to know the difference between a regular cookie and a medical marijuana edible. He could eat the whole thing, get a large exposure to marijuana and get fairly symptomatic."
With this evidence in hand, Wang says, co-author Kostnett "worked with politicians in the legislature to get child resistant packaging into House Bill 1317," the main regulatory measure concerning the implementation of Amendment 64. But he sees education and harm prevention as equally important.
Wang believes parents who purchase medical marijuana edibles "need to treat them like any other potentially harmful medicine or household product. They need to try to keep them out of reach of children -- put them in secure locations."
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Otherwise, he says, the result could be "a hospital visit or severe symptoms."
More from our Marijuana archive: "Marijuana edibles THC limit could put me out of business, says Cheesecake Lady."