Delta-8, delta-10, and THC-O acetate poison center cases nearly doubled from 2021 to 2022 | Research

The takeaway

Poison center reports involving delta-8, delta-10, and THC-O acetate increased 89% from 2021 to 2022, with children under 6 accounting for nearly a third of all cases.

People interested in the safety of hemp-derived THC products and their impact on children.

30.1% of poison center cases involved children under 6

What the researchers found

There were 5,022 reported cases from 2021-2022, with the rate per 100,000 population increasing 89.1% (from 0.55 to 1.04). Children under 6 accounted for 30.1% of cases, with a mode at age 2. Over a third (38.4%) experienced serious medical outcomes. The most common effects were mild CNS depression (25%), tachycardia (23%), and agitation (15.6%).

Why it matters

These products became widely available after the 2018 Farm Bill and are often marketed as legal alternatives to delta-9 THC. The rapid increase in poison center calls, especially involving young children, highlights a growing public health concern with limited regulatory oversight.

The numbers in context

5,022 total cases. 89.1% increase in rate from 2021 to 2022. 30.1% involved children under 6. Mode age: 2 years (8.9% of cases). 98.1% involved delta-8 THC. 94.2% were ingestions. 38.4% had serious medical outcomes. 10.3% admitted to noncritical care. 5.3% admitted to critical care.

How the study worked

Analysis of National Poison Data System data on delta-8 THC, delta-10 THC, and THC-O acetate exposures reported to US poison centers from January 2021 through December 2022. Census data were used for population-based rate calculations.

What this study cannot tell us

National Poison Data System relies on passive surveillance, likely underestimating true exposure rates. Product labeling accuracy for these substances is questionable. Cannot distinguish between products containing what they claim versus mislabeled products.

How to read the evidence

National surveillance data covering all US poison centers, though passive reporting likely undercounts actual exposures. Product identity verification is limited.

When this study was published

Published in 2024 covering exposure data from 2021-2022.

The bigger picture

The Farm Bill inadvertently created a market for hemp-derived psychoactive products that bypass state cannabis regulations. The surge in poisoning cases, particularly among toddlers, underscores the urgency of product safety standards and child-resistant packaging requirements for these products.

Questions still open

Are delta-8 and related products inherently more dangerous than delta-9 THC, or does the lack of regulation explain the adverse events? What specific product types (edibles, vapes) are responsible for most pediatric exposures? Would state-level regulation reduce these poisoning rates?

Common questions

What are delta-8 and THC-O acetate?

Delta-8 THC and THC-O acetate are psychoactive compounds derived from hemp that became widely available after the 2018 Farm Bill. They produce effects similar to delta-9 THC but exist in a regulatory gray area in many states.

Why are so many children exposed?

These products are often sold as edibles (gummies, candies) that are attractive to children, and many lack child-resistant packaging. Ninety-five percent of cases in children under 6 were ingestions, mostly occurring in homes.

How serious were the poisoning cases?

Over a third (38.4%) experienced serious medical outcomes. About 10% were admitted to noncritical care units and 5.3% to critical care. Common symptoms included drowsiness, rapid heart rate, and agitation.

Read the original research

Delta-8 tetrahydrocannabinol, delta-10 tetrahydrocannabinol, and tetrahydrocannabinol-O acetate exposures reported to America's Poison Centers.

Clinical toxicology (Philadelphia, Pa.), 62(4), 256-266

View on PubMed ↗Publisher’s paper ↗

Citation

Burgess, Alice; Hays, Hannah L; Badeti, Jaahnavi; Spiller, Henry A; Rine, Natalie I; Gaw, Christopher E; Ding, Kele; Smith, Gary A. (2024). Delta-8 tetrahydrocannabinol, delta-10 tetrahydrocannabinol, and tetrahydrocannabinol-O acetate exposures reported to America's Poison Centers.. Clinical toxicology (Philadelphia, Pa.), 62(4), 256-266. https://doi.org/10.1080/15563650.2024.2340115