Marijuana Legalization and Poisoned Children

Jacob SullumJacob SullumAfter the Justice Department signaled a more tolerant approach to medical marijuana in an October 2009 memo, the number of Colorado patients holding the state-issued cards that are required to buy cannabis from dispensaries jumped from 2,000 to 60,000. According to a new study reported in JAMA Pediatrics, the increase in registered patients was accompanied by an increase in accidental ingestions of marijuana by children. Researchers led by toxicologist George Sam Wang of the Rocky Mountain Poison and Drug Center found that a Denver children's hospital saw 14 patients younger than 12 who had ingested marijuana in the 27-month period from October 1, 2009, through December 31, 2011, compared to zero in the 57-month period from January 1, 2005, through September 30, 2009. The most common symptom was lethargy, observed in nine of the patients; the most serious symptom was respiratory insufficiency, observed in a 5-year-old boy. U.S. News & World report describes the medical consequences:

As with many similar poisonings, treatment is limited to supportive care and waiting until the marijuana clears the system...

Children recover quickly in most cases, Wang said. "They don't need more than a day or two of hospitalization," he said. "There were no deaths or lasting side effects."

Wang and his co-authors conclude that "the consequences of unintentional marijuana exposure in children should be part of the ongoing debate on legalizing marijuana." Fair enough, although the hazard that marijuana poses to children pales next to the hazard posed by alcohol, over-the-counter drugs such as aspirin, and prescription drugs such as opioid painkillers. All of those can kill in high enough doses, while the number of fatal marijuana ingestions can be counted on one hand with no fingers.

Which makes the U.S. News headline a bit misleading: "Kids Poisoned by Medical Marijuana, Study Finds." Likewise this CBS News headline:  "Laxer Marijuana Laws Linked to Increase in Kids' Accidental Poisonings." Not only does "poisoning" suggest a potentially deadly threat, but "laxer" implies that the government is failing to meet its regulatory responsibilities when it lets people use marijuana as a medicine. This Boston Globe headline is not as slanted but still leaves something to be desired: "Medical Marijuana Might Put Kids at Risk, Study Says." Well, yes, but so might just about any other medicine or recreational intoxicant. If anything, marijuana is less worrisome on this count than most other drugs.

"To prevent harm to children," says U.S. News, "Wang advises treating marijuana like any other drug and keeping it out of their reach, particularly if it's in a tempting form like cookies." Duh. The magazine adds that "some poison-control experts also are pushing for marijuana to come in tamper-proof packages as a way of keeping children away from it." Such a requirement is part of the marijuana legislation signed today by Colorado Gov. John Hickenlooper, which sets rules for the recreational pot shops that are supposed to open next year. The mandate imposes extra costs that will be passed on to consumers, and its effectiveness is questionable, especially if the problem is carelessness by adults who do not bother to keep cannabis out of children's reach. After all, those same adults have to open the tamper-resistant packages before they can consume the goodies inside, and then we are back to the same situation again.

Addendum: In the comments Steve Rolles notes the distinction between the "tamper-proof packages" to which U.S. News refers and "childproof" containers that can be resealed after some of the contents has been consumed so that they are still hard for little kids to open. H.B. 1317, one of the bills Hickenlooper signed today, calls upon the Colorado Department of Revenue's new Marijuana Enforcement Division (formerly the Medical Marijuana Enforcement Division) to create "requirements...similar to the federal Poison Prevention Packaging Act of 1970," which describes "special packaging" that is "designed or constructed to be significantly difficult for children under 5 years of age to open or obtain a toxic or harmful amount of the substance contained therein within a reasonable time and not difficult for normal adults to use properly." Something like the cap on bottle of pills or a can of paint thinner. How exactly that will work with, say, cannabis-infused candy bars or brownies remains unclear. When I asked Laura Harris, head of the Marijuana Enforcement Division, about this issue in January, she noted that legislators had contemplated a similar requirement for medical marijuana:

They said...you create a rule that describes a kind of packaging we want that will be child resistant, and that remains undone, because that's a thorny issue. What does that look like? 

Retailers can be forced to sell cannabis candy and pastries in resealable hard plastic containers with child-resistant locks, but consumers cannot be forced to put half-eaten edibles back in those cases and relock them.

[Thanks to Max Minkoff for the tip.]

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  • Fist of Etiquette||

    ...an increase in accidental ingestions of marijuana by children.

    Kids. They fuck everything up.

  • Austrian Anarchy||

    Teenage lethargy requires a two day hospital vacation? Sounds more like an LPN full employment scheme.

    How the hell do you tell the difference between every day teen lethargy and the weed induced variety anyway?

  • Rich||

    After all, those same adults have to open the tamper-resistant packages before they can consume the goodies inside, and then we are back to the same situation again.

    Only *worse*, because after consuming the goodies the adults can't remember where the packages are.

    Better just repeal this whole legalization nonsense.

  • kevin_hunt||

    The reason we repealed marijuana prohibition is because it never stopped anyone from using marijuana. I suppose you support bringing back alcohol prohibition, too?

  • some guy||

    Researchers led by toxicologist George Sam Wang of the Rocky Mountain Poison and Drug Center found that a Denver children's hospital saw 14 patients younger than 12 who had ingested marijuana in the 27-month period from October 1, 2009, through December 31, 2011, compared to zero in the 57-month period from January 1, 2005, through September 30, 2009

    So, pre-2009, how many parents were bringing their kids in with marijuana "poisoning" and not telling anyone about the marijuana because marijuana was illegal?

    "I don't know doctor. He's just being extra lazy, a little loopier than usual and very, very hungry. No idea why..."

  • Spartacus||

    Fair enough, although the hazard that marijuana poses to children pales next to the hazard posed by alcohol, over-the-counter drugs such as aspirin, and prescription drugs such as opioid painkillers.

    You left out tobacco. According to this article, there were over 13,000 nicotine ingestion cases involving children under 6 y.o. reported to poison control centers in 2006-2008.

  • Gordilocks||

    What's a little missing information?

    YOU DIDN'T NEED TO KNOW THAT!

  • Dweebston||

    Wang and his co-authors conclude that "the consequences of unintentional marijuana exposure in children should be part of the ongoing debate on legalizing marijuana."

    How nobly high-minded of you. I don't suppose making noises about "adding to the debate" is in any way influenced by wanting to legitimize the funding you've been granted to research an issue irrelevant to the actual debate over incarcerating nonviolent offenders of victimless laws.

    Improperly stored cleaners doubtlessly poison innumerable children, but we're not debating measures to imprison anyone who buys bleach.

  • Rich||

    Yet.

    ***cough***cold medicine and fertilizer***cough***

  • Steve Rolles||

    I think you are being unfair to the authors of the study - which is a perfectly legitimate contribution to the debate on how best to regulate legal cannabis products, and should reserve youre ire for the media scaremongering that Sullum highlights. The debate has beyond should we regulate or not (the rpohibtionists lost). Its now about how we regulate appropriately. I think you confuse the two.

    On the specific issue, there is a debate about how we protect children form cleaning products and pharmaceuticals aswell. But unlike those - which are already mostly protected by childproof packaging - canabis edibles are generally not. If that is creating identifyable risk or problems - they are relatively easily addressed.

  • MWG||

    "Fair enough, although the hazard that marijuana poses to children pales next to the hazard posed by alcohol, over-the-counter drugs such as aspirin, and prescription drugs such as opioid painkillers. All of those can kill in high enough doses, while the number of fatal marijuana ingestions can be counted on one hand with no fingers."

    Uhg... don't give them any ideas Sullem.

  • AlmightyJB||

    Yeah, when I was little I pulled a paintbrush out of a bucket of turpentine and licked it. So waddya gonna do.

  • Steve Rolles||

    Its an important point you make Jacob, but there seems to be a bit of confusion here between tamper proofing - designed to stop tampering with products before purchase or use (such as air sealed foil tops etc), and childproofing designed to stop children opening the containers (like pill bottles that you need to push down or squeeze and turn to open). The two are actually quite different in design and function.

    Signifincantly, regards your somewhat pessimistic last point, with a childproofed container - it it still childproofed after opening, as long as it has been closed again (Obviously tamperproofing is negated once opened, but thats not the issue under discussison). There is good evidence that childproofing pharmaceutical containers has been very effective at reducing or preventing poisonings.

  • ||

    That distinction may be correct, but it really isn't relevant. In the end, there's little rational reason to childproof MJ. It's packaging need only be comparable to tobacco and booze.

  • Steve Rolles||

    That might be the case to herbal cannabis (which children are unlikely to want to ingest)- but the issue here is specifically with edible preparations that are naturally attractive to children (such as cannabis infused cakes or candies) - for which there isnt an immediate equivalent for re alcohol and tobacco (except perhaps some of the alco-pops type drinks).

    I would argue that such cannabis products demand a different level of packaging protection - similar to pharmaceuticals (which is essentially what they are - albeit in unconventional preparation).

  • Plopper||

    I'm surprised no one has mentioned this and that Sullum didn't seem to think of it himself either.

    Do you really think the number of kids accidentally ingesting pot has increased just because it's illegal?

    I think it's more likely the increase is just a reporting increase. Most people would be afraid to tell the hospital their kid accidentally ate their pot because of possible legal implications.

    Why would you do it if it was illegal when you know the kid won't die and there's nothing the hospital is going to be able to do for them anyway? As far as I know there's no magical shot they can give them that will make the kid not high. Also, eating raw weed rarely does much of anything anyway.

  • Plopper||

    *just because it is legal

  • Mongo||

    Isn't the only way to OD on THC is by ingestion?

    I ate a ton of brownies (they were all crumbled and smashed in a bag) one time and got so high I was about to start freakin' out until the chick who ate them with me had a psychotic break and that snapped me back to reality!

  • sarcasmic||

    As with many similar poisonings, treatment is limited to supportive care and waiting until the marijuana clears the system...

    And a several thousand dollar bill. Don't forget the bill for several thousand dollars.

  • Mr Whipple||

    After the Justice Department signaled a more tolerant approach to medical marijuana in an October 2009 memo

    I guess Melinda Haag never got that memo?

  • Agammamon||

    Wait, how can you call something which isn't poisonous a poison?

    Are kids who drown "poisoned" by water?

  • WomSom||

    Oh come on man it cant be that bad!

    www.GetYourAnon.tk

  • kevin_hunt||

    This article in JAMA is a tempest in a teapot. Over the counter medications kill children, marijuana does not.

    "Some 100,000 kids end up in U.S. emergency rooms each year because they’ve accidentally been poisoned. No, they’re not all raiding the cupboard full of cleaning supplies. Close to 70% of those visits are from are overdoses of everyday over-the-counter drugs or prescription medications, according to a recent study by researchers at the Centers for Disease Control and Prevention. The leading culprit, which sends an estimated 7,226 U.S. kids to hospital each year: acetaminophen, or Tylenol."

    Source: Time Magazine

  • GordonFreeman1960||

    This could not be anymore of a non-story. No kids died, no one has died, there were not even any serious illnesses or symptoms. There were only 14 cases in 2 years. This 'issue' is not even an issue, it seems to just be more anti-pot hype designed to put pot in a "Reefer Madness' negative light. The anti-pot crowd needs to find real issues that are really important to attack like alcoholism and tobacco use.

  • Duncan20903||

    “Never let the facts get in the way of disseminating an effective piece of hysterical rhetoric” ~~ The motto of the Know Nothing prohibitionist

    What, you were expecting reason from the unreasonable?

  • Paul Pot||

    How many children have taken their parents benzodiazapine prescriptions by accident?
    Far better that marijuana replace pharmaceuticals and children accidentally take their parents marijuana than a whole host of other prescription drugs.
    Might it be that children having accidentally taken marijuana in the past was not reported because it was illegal and the parents feared they might lose their children to the authorities.
    Far better it be legal so that parents can get medical help without fear when unsure of what to do.
    Fear and criminality have no place in the health care system.
    And one simple suggestion.
    Keep out of reach of children.

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