Pediatric cannabis poisonings in Michigan rose steadily after medical marijuana legalization | Research

The takeaway

From 2008 to 2019, Michigan saw 426 pediatric cannabis exposures reported to poison control, with cases doubling every 2.1 years and a bimodal age distribution peaking in young children (ingestions) and teenagers (inhalation).

Pediatricians, poison control specialists, cannabis policy makers, parents

Pediatric cannabis exposures doubled every 2.1 years

What the researchers found

426 pediatric cannabis exposures were reported to the Michigan Poison Center from 2008 to 2019. Cases doubled every 2.1 years, with a notable increase after 2016. Young children (0-5) most commonly ingested cannabis products, while teenagers (13-17) most often inhaled them. Overall, 76.8% of exposures were from ingestion.

Why it matters

As more states legalize cannabis, understanding pediatric exposure patterns helps inform child safety regulations, product packaging requirements, and public health messaging for households with children.

The numbers in context

426 total pediatric exposures; median age 6.0 years; 76.8% from ingestion; 18.5% from inhalation; doubling time of 2.1 years; bimodal age distribution; annual cases increased notably after 2016

How the study worked

Retrospective chart review of all pediatric (<18 years) single-substance cannabis exposures reported to the Michigan Poison Center from January 2008 through December 2019. Analyzed routes of exposure, product types, and temporal trends after medical legalization (2008) and recreational legalization (2018).

What this study cannot tell us

Poison center data likely underestimates true exposure rates since not all cases are reported. Single state (Michigan). Cannot determine severity outcomes for all cases. Temporal trends may reflect increased reporting awareness alongside actual increases in exposure.

How to read the evidence

Complete poison center data for a 12-year period with clear temporal trends, though underreporting is likely.

When this study was published

Published in 2021 covering 2008-2019 data.

The bigger picture

The steady increase in pediatric exposures mirrors trends reported in other legalization states and underscores the need for child-resistant packaging, clear labeling, and household storage education as cannabis products become more accessible.

Questions still open

Did recreational legalization in 2018 accelerate the trend beyond what medical legalization already established? What specific product types (edibles, concentrates) are most commonly involved in pediatric ingestions?

Common questions

Which age groups were most affected?

The distribution was bimodal: young children (0-5 years) had the highest number of ingestion exposures, while teenagers (13-17 years) had the highest number of inhalation exposures. The overall median age was 6 years.

How were children exposed?

76.8% of exposures were from ingestion (eating cannabis products), 18.5% from inhalation, and 4.2% from unknown routes. Edibles and other ingestible products were the most common source of exposure for young children.

Read the original research

Pediatric Cannabis Single-Substance Exposures Reported to the Michigan Poison Center From 2008-2019 After Medical Marijuana Legalization.

The Journal of emergency medicine, 60(6), 701-708

View on PubMed ↗Publisher’s paper ↗

Citation

Dean, Diana; Passalacqua, Karla D; Oh, Su Min; Aaron, Cynthia; Van Harn, Meredith G; King, Andrew. (2021). Pediatric Cannabis Single-Substance Exposures Reported to the Michigan Poison Center From 2008-2019 After Medical Marijuana Legalization.. The Journal of emergency medicine, 60(6), 701-708. https://doi.org/10.1016/j.jemermed.2020.12.028