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Cannabis Poisoning Among BC Children B.C. Injury Research and Prevention Unit 2020-06

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www.injuryresearch.bc.ca  © BCIRPU June 2020 | Page 1emergency department visits were becauseChildren and Cannabis (0–11-years-old)Rates of cannabis consumption among Canadians 15 years and older peaked briefly after legalization, but have since returned to levels similar to before legalization.10–12Cannabis Poisoning Among BC ChildrenBackgroundThe recreational use of cannabis—also known as marijuana, weed, or pot—became legal in Canada in October 2018.1 This drug is commonly used among Canadian youth.2This psychoactive substance can elicit feelings of euphoria when consumed in moderation,3 but can have negative effects if too much is consumed or if the users are inexperienced. Young children are vulnerable to poisoning from inadvertently consuming cannabis and products containing cannabis (e.g., edibles, topicals). 4This study looked at cannabis poisonings among children aged 16 years or younger who were treated at the BC Children’s Hospital’s Emergency Department before and two-months after legalization. Tanya Little/Shutterstock???Common signs ofcannabis poisoning include:vomiting dizziness slurred speechdecreased consciousness12.5%cannabisof all poisoning-related  Compared to intentional use, few poisonings resulted from unintentional ingestion of cannabis. However, early research suggests that very young children are at greater risk of more serious side effects from consuming cannabis.5 The median age* for unintentional ingestion of cannabis leading to poisoning was 3 years old. In all cases, cannabis products unintentionally ingested belonged to the child’s parents or siblings and were left lying around. These included edibles (e.g., brownies, chocolate, candy), topicals, and cannabis cigarettes.Most unintentional ingestions occurred on the weekend (Saturday and Sunday). In all cases, unintentional exposure to cannabis occurred at the child’s home.4,67–9was consumed intentionallyChildren are vulnerable to cannabis poisoningdue to their fast metabolismand low body weightwww.injuryresearch.bc.ca  © BCIRPU June 2020 | Page 2Properly store all cannabis products out of the reach of young children.Have a conversation about cannabis use, its health risks, symptoms of cannabis poisonings, and harm reduction behaviours. Recognize the signs of cannabis poisoning so you can intervene as a bystander.If you suspect symptoms of cannabis poisoning, call the BC Drug and Poison Information Centre (1-800-567-8911).Preventing Cannabis PoisoningAlthough cannabis poisoning does not often result in long-term harm, the symptoms can require emergency department care. To prevent poisoning:Study DetailsData was provided by the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). CHIRPP is an emergency department (ED) surveillance system that collects information on all injuries, including poisoning. Data was collected from the emergency department of BC Children’s Hospital for cannabis-related injuries betwen January 1, 2016 and December 31, 2018.Teens and Cannabis (12–16-years-old)ReferencesMotortion Films/Shutterstock* The median is the middle number in a sorted, ascending or descending, list of numbers and can be more descriptive of that data set than the average.  For a data set, it may be thought of as the “middle” value.The majority of cannabis poisonings among youth resulted from intentional use. Poisoned teens most frequently reported inhaling cannabis, such as through a blunt, joint, bong, pipe, or vaporizer. Edible use leading to poisoning was infrequent.Most poisonings involved the use of cannabis with one or more other psychoactive substances. These included alcohol, illicit drugs, and/or medication with alcohol being the most popular co-ingested substance. Both cannabis-only and co-ingestion poisonings were more prevalent on weekdays. Most reported consuming cannabis with peers and in residential spaces (i.e., at home or at a friend’s house).Icons from Freepik, Flaticon (smashicons,  photo3idea_studio)ofgrade 7 to 12across Canada cannabis usereported paststudents2For more information, visit: https://bit.ly/37kA3DFThe median age* forintentional cannabis useleading to poisoning15wasyears of ageThe risk of poisoning   increases  when  substances, such as alcohol,are same time or before or after cannabis  13 consumed at the 1. HealthLink BC. Cannabis [Internet]. 2018 [cited 2019 May 15]. Available from:  https://www.healthlinkbc.ca/health-feature/cannabis2. Health Canada. Summary of results for the Canadian Student Tobacco, Alcohol and Drugs Survey 2018-19 (CSTAD) [Internet]. 2019 [cited 2020 Jan 5]. Available from: https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey/2018-2019-summary.html3. Sharma P, Murthy P, Bharath MMS. Chemistry, metabolism, and toxicology of cannabis: Clinical implications. Iran J Psychiatry. 2012;7(4):149–56.4. Guidet C, Gregoire M, Le Dreau A, Vrignaud B, Deslandes G, Monteil-Ganière C. Cannabis intoxication after accidental ingestion in infants: urine and plasma concentrations of “-9-tetrahydrocannabinol (THC), THC-COOH and 11-OH-THC in 10 patients. Clin Toxicol [Internet]; 2019 [cited 2019 Jun 1]. Available from: https://doi.org/10.1080/15563650.2019.16555695. Murti M. Pediatric presentations and risks from consuming cannabis edibles. B C Med J [Internet]. 2017 [cited 2020 May 14];59(8):398-399 COHP. Available from: https://www.bcmj.org/cohp/pediatric-presentations-and-risks-consuming-cannabis-edibles6. Meier MH, Docherty M, Leischow SJ, Grimm KJ, Pardini D. Cannabis concentrate use in adolescents. Pediatrics. 2019;144(3):e20190338. doi: https://doi.org/10.1542/peds.2019-03387. Murphy K. “Greening out”: treating cannabis-related problems in the ED. Nurs Made Incred Easy. 2017;15(6):47-50.8. Chen YC, Klig JE. Cannabis-related emergencies in children and teens. Curr Opin Pediatr. 2019;31(3):291-6.9. Ashton HC. Pharmacology and effects of cannabis: a brief review. Br J Psychiatry. 2001;178(2):101-6.10. Statistics Canada, National Cannabis Survey, first quarter 2019. The Daily, May 2. Statistics Canada catalogue no. 11-001-X [Internet]. 2019. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/190502/dq190502a-eng.htm 11. Statistics Canada, National Cannabis Survey, second quarter 2019. The Daily, August 15. Statistics Canada catalogue no. 11-001-X [Internet]. 2019. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/190815/dq190815a-eng.htm12. Statistics Canada, National Cannabis Survey, third quarter 2019. The Daily, October 30. Statistics Canada catalogue no. 11-001-X [Internet]. 2019. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/191030/dq191030a-eng.htm13. Singh AK. Alcohol interaction with cocaine, methamphetamine, opioids, nicotine, cannabis, and γ-hydroxybutyric acid. Biomedicines [Internet]. 2019 Mar 7 [cited 2019 Jul 15];7(16):1–31. Available from: https://www.mdpi.com/2227-9059/7/1/1613

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