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Study breakdown

Pediatric cannabis ER visits and hospitalizations rose sharply after Massachusetts legalization

EcologicalModerate evidence
The takeaway

Cannabis-related ER visits among children in Massachusetts increased 60% and hospitalizations rose 126% after recreational cannabis legalization, with the largest increases in children ages 0-5 and 6-12.

Parents in legal cannabis states, pediatricians, cannabis policy researchers, child safety advocates

126% increase in pediatric hospitalizations

What the researchers found

After recreational cannabis legalization in Massachusetts, pediatric cannabis-related ER visits increased from 18.5 to 31.0 per 100,000 (IRR 1.6, 95% CI 1.5-1.8) and hospitalizations increased significantly (IRR 2.2, 95% CI 1.8-2.7, a 126% increase). Children ages 0-5 and 6-12 experienced the highest increases.

Why it matters

The youngest children (0-5 years) showed some of the largest increases, likely from accidental ingestion of edibles. These products may be attractive to small children and are increasingly available in legal markets.

The numbers in context

2,357 ED visits and 538 hospitalizations over 6 years (2016-2021). ED visit IRR: 1.6 (95% CI 1.5-1.8). Hospitalization IRR: 2.2 (95% CI 1.8-2.7). Highest increases in ages 0-5 and 6-12.

How the study worked

Researchers compared cannabis-related ER visits and hospitalizations among children ages 0-19 before (2016-2018) and after (2019-2021) recreational cannabis legalization in Massachusetts, using state public health surveillance data.

What this study cannot tell us

Cannot determine whether increases are due to more exposures, increased willingness to seek care, or improved reporting after legalization. Pre-legalization period was only three years. Cannot assess severity differences.

How to read the evidence

State-level surveillance data with clear before/after comparison, but cannot fully separate legalization effects from reporting changes.

When this study was published

2024 study analyzing Massachusetts public health data from 2016-2021

The bigger picture

Massachusetts joins a growing list of states reporting increased pediatric cannabis exposures after legalization. The pattern highlights the importance of child-resistant packaging, clear labeling, and safe storage education as part of legalization implementation.

Questions still open

  • Are specific product types (edibles, gummies) driving pediatric exposures? Have packaging and labeling regulations reduced exposures in states that implemented them earlier?

Common questions

Which age group saw the biggest increase?
Children ages 0-5 and 6-12 experienced the highest increases in cannabis-related ER visits after legalization, likely driven by accidental ingestion of cannabis products.
Could the increase be due to more reporting rather than more exposures?
Possibly in part. After legalization, parents may be more willing to disclose cannabis exposure to healthcare providers, and clinicians may be more likely to test for it. However, the magnitude of increase (126% for hospitalizations) suggests real increases in exposures.

Read the original research

Recreational cannabis legalization and pediatric exposures in Massachusetts, United States.

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 30(5), 437-440

Citation

Argandykov, Dias; Raybould, Toby A; Gervasini, Alice; Hwabejire, John; Flaherty, Michael R. (2024). Recreational cannabis legalization and pediatric exposures in Massachusetts, United States.. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 30(5), 437-440. https://doi.org/10.1136/ip-2023-045052