Children accidentally exposed to cannabis undergo twice as many medical tests and stay in the hospital much longer | Research

The takeaway

When cannabis exposure in children wasn't immediately recognized, they underwent more than twice as many diagnostic tests at four times the cost, with hospital stays averaging 18 hours compared to 4 hours for adolescents.

Parents, emergency physicians, policymakers working on cannabis packaging regulations, healthcare cost researchers

18.34 hours average hospital stay for children vs 4.22 hours for adolescents

What the researchers found

Children with unrecognized cannabis exposure underwent an average of 8.91 diagnostic tests compared to 4 for those where exposure was quickly identified, with more than 4-fold higher costs for potentially avoidable tests. Children's hospital stays averaged 18.34 hours versus 4.22 hours for adolescents.

Why it matters

As cannabis products become more available, accidental pediatric exposures may increase. Delayed recognition leads to unnecessary testing, higher costs, and prolonged hospital stays that could be avoided with better awareness and reporting.

The numbers in context

37 children, 38 adolescents; mean time to recognition 2.3 hours (children) vs 0.4 hours (adolescents); 8.91 vs 4 diagnostic tests; 4-fold higher avoidable test costs; 18.34 vs 4.22 hours hospital stay

How the study worked

Retrospective chart review of 75 patients (37 children, 38 adolescents) ages 31 days to 20 years with positive marijuana toxicology screens at a children's hospital emergency department from November 2009 to December 2014.

What this study cannot tell us

Retrospective single-center study, relatively small sample, data from 2009-2014 predates widespread legalization, cannot account for all confounders in testing decisions.

How to read the evidence

Retrospective chart review from a single children's hospital with a moderate sample size

When this study was published

Published in 2021 using 2009-2014 data, before widespread cannabis legalization changed the landscape of pediatric exposures.

The bigger picture

These findings underscore the importance of childproof packaging for cannabis products and prompt disclosure of possible exposure, which can significantly reduce unnecessary medical interventions and healthcare costs.

Questions still open

Have pediatric cannabis exposures increased since state-level legalization? Would standardized screening protocols reduce unnecessary testing? How effective are childproof packaging requirements in preventing accidental exposures?

Common questions

What happens when a child accidentally ingests cannabis?

In this study, children averaged 18-hour hospital stays. When exposure wasn't immediately identified, they underwent an average of nearly 9 diagnostic tests as doctors investigated their symptoms.

Does disclosing cannabis exposure make a difference?

Yes, significantly. Patients where exposure was quickly identified underwent half as many tests at one-quarter the cost, with much shorter hospital stays.

Read the original research

Increased Testing and Health Care Costs for Pediatric Cannabis Exposures.

Pediatric emergency care, 37(12), e850-e854

View on PubMed ↗Publisher’s paper ↗

Citation

Bashqoy, Ferras; Heizer, Justin W; Reiter, Pamela D; Wang, George S; Borgelt, Laura M. (2021). Increased Testing and Health Care Costs for Pediatric Cannabis Exposures.. Pediatric emergency care, 37(12), e850-e854. https://doi.org/10.1097/PEC.0000000000001811