P3A231: Clinical and Demographic Presentation of Accidental Ingestion of Marijuana in Children: A Single-site Retrospective Cohort

Background: Accidental ingestion of cannabis in young children is a growing public health concern. The legalization of medical marijuana has led to an increase in accidental exposure to marijuana in children under six years of age. In the current study, we aimed to explore the clinical characteristics and demographic presentation of children 0 through 6 years of age who presented to the Emergency Department with accidental ingestion of cannabis at Dayton Children’s Hospital (DCH) in Ohio.

Methods: We reviewed a cohort of children aged 0 to 6 years diagnosed with accidental ingestion of cannabinoids (CBD) presenting to DCH between January 1, 2010, and September 1, 2022. Data abstracted consisted of age at ingestion, source and location of cannabis ingestion, parental use of drugs, health insurance, CBD forms and packaging, and patient demographics.

Results: One hundred twenty-three patients (78 female) were included in this study. The mean age at ingestion was 2.3 years (±1.6). Half of the patients were white (51.2%) and living with both parents (52.9%). The majority of patients had Medicaid as their primary insurance (84.6%). CBD edibles (58.6%), such as gummies, cookies, and brownies, were the most common product ingested. Most CBD ingestion occurred at a family member’s home (90.7%), and a majority reported CBD was not kept in a child-proof container (95.6%). The source of exposure was marijuana products used by family members in 85.9% of patients. 72.4% of patients were admitted to the hospital, with 14% admitted to the ICU. Neurological symptoms at onset included altered mental status (74%), and seizures (9.8%). A brain CT was performed on 54.5% of patients, of which 88.6% were completely normal. There was a 14-fold increase in accidental marijuana cases post-2017 (115 cases) after the legalization of marijuana in Ohio, compared to pre-2017 (8 cases). Social work consult was obtained in 98.6% patients and CSB referral was made for 99.2% patients seen by social work

Conclusion: The study showed that the accidental ingestion of cannabis in young children has significantly increased since the legalization of medical marijuana in Ohio. The vast majority of children had public insurance and were exposed at home due to consumption of marijuana products by family members. We recommend that it is imperative to educate users of medical marijuana about the risks and consequences of accidental exposure to marijuana in young children and to focus on the most vulnerable populations, namely the Medicaid population. Providing child proof containers for the marijuana products should be made mandatory for all dispensing pharmacies.