Pre-legalization baseline: most pediatric cannabis poisonings involved intentional use by older teens, often with other substances | Research

The takeaway

At a Canadian pediatric hospital before legalization, 114 cannabis-related poisonings were identified, with the vast majority involving intentional use by 15-year-olds, 71% of whom also consumed other substances.

Pediatricians, poison control professionals, cannabis policy researchers

71% of intentional cannabis poisonings involved co-ingestion of other substances

What the researchers found

Of 911 total poisonings, 114 (12.5%) were cannabis-related. Most were from intentional use by teens (median age 15), with 71.1% involving cannabis with other substances. Fewer than 10 were inadvertent ingestions by young children (median age 3), all at home from family-owned cannabis. Cannabis poisonings occurred more often on weekdays.

Why it matters

Establishing pre-legalization baselines allows future comparisons to determine whether recreational cannabis legalization changed the pattern of pediatric cannabis exposures.

The numbers in context

114 cannabis-related of 911 total poisonings (12.5%). Intentional use: 28.9% cannabis only, 71.1% with co-ingestions. Median age for inadvertent ingestion: 3 years. Median age for intentional use: 15 years. Most consumed via inhalation with peers.

How the study worked

Retrospective analysis of cannabis poisonings treated at BC Children's Hospital ED from 2016-2018, using the Canadian Hospitals Injury Reporting and Prevention Program database. Electronic health records reviewed for additional context.

What this study cannot tell us

Single hospital; pre-legalization period only; relies on ED presentations which may undercount less severe cases; retrospective chart review.

How to read the evidence

Single-center retrospective study providing a pre-legalization baseline; limited to ED presentations.

When this study was published

Published in 2020.

The bigger picture

The high rate of polysubstance involvement and the peer-group context of most adolescent cannabis poisonings suggest prevention strategies need to address broader substance use patterns, not just cannabis in isolation.

Questions still open

Have cannabis poisoning patterns changed since Canadian legalization in October 2018? Did edibles legalization (2019) increase inadvertent ingestions in young children?

Common questions

Did legalization change these patterns?

This study specifically established a pre-legalization baseline (2016-2018) for future comparison. The authors note that comparing pre- and post-legalization data will be important for evaluating policy impacts.

How common were accidental exposures in young children?

Fewer than 10 accidental ingestions by young children were identified over 3 years. All occurred at home and involved cannabis belonging to the child's family, suggesting safe storage is the primary prevention strategy.

Read the original research

Setting the baseline: a description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis.

Health promotion and chronic disease prevention in Canada : research, policy and practice, 40(5-6), 193-200

View on PubMed ↗Publisher’s paper ↗

Citation

Cheng, Phoebe; Zagaran, Atousa; Rajabali, Fahra; Turcotte, Kate; Babul, Shelina. (2020). Setting the baseline: a description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis.. Health promotion and chronic disease prevention in Canada : research, policy and practice, 40(5-6), 193-200. https://doi.org/10.24095/hpcdp.40.5/6.08