Cannabis legalization in Alberta increased accidental ingestions by children but not overall pediatric ER visits

After Canadian cannabis legalization, unintentional cannabis ingestions increased 77% in children and 36% in older teens, even though overall pediatric cannabis-related ER volume did not change when accounting for pre-existing trends.

Yeung, Matthew E M et al.·Pediatrics·2021·Moderate EvidenceRetrospective Cohort
RTHC-03629Retrospective CohortModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Pediatric cannabis-related ED visit volume did not change post-legalization when accounting for pre-existing trends. However, unintentional ingestions increased significantly in children aged 0-11 (IRR 1.77) and older adolescents aged 15-17 (IRR 1.36). Hyperemesis cases increased among older adolescents (RR 1.64), while co-ingestant use decreased (RR 0.77).

Key Numbers

Study period: Oct 2013-Feb 2020. Unintentional ingestion IRR children: 1.77 (95% CI 1.42-2.20). Older teen ingestion IRR: 1.36 (95% CI 1.07-1.71). Older teen hyperemesis RR: 1.64 (95% CI 1.13-2.37). Co-ingestant use decrease RR: 0.77.

How They Did This

Retrospective analysis of National Ambulatory Care Reporting System data for urban Alberta cannabis-related pediatric ED visits from October 2013 to February 2020. Used interrupted time series, incident rate ratios, and relative risk ratios across three age groups.

Why This Research Matters

While total pediatric cannabis ER visits did not spike after legalization, the shift toward accidental ingestions in young children highlights the importance of child-resistant packaging and safe storage of cannabis edibles.

The Bigger Picture

The increase in accidental ingestions suggests edible cannabis products are reaching children despite regulations, while the decrease in co-ingestant use among teens may reflect a shift toward cannabis-only consumption after legalization.

What This Study Doesn't Tell Us

Limited to urban Alberta EDs. Cannot distinguish between pre-legalization medical cannabis access and post-legalization recreational access. ICD coding may miss some cannabis cases.

Questions This Raises

  • ?Are current child-resistant packaging requirements sufficient?
  • ?Has the edible cannabis market specifically driven the increase in pediatric accidental ingestions?

Trust & Context

Key Stat:
77% increase in unintentional cannabis ingestions among children aged 0-11
Evidence Grade:
Population-level administrative data with interrupted time series design, a strong quasi-experimental approach.
Study Age:
Published in 2021 covering October 2013 to February 2020.
Original Title:
Emergency Department Pediatric Visits in Alberta for Cannabis After Legalization.
Published In:
Pediatrics, 148(4) (2021)
Database ID:
RTHC-03629

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Did pediatric ER visits for cannabis increase after legalization?

Overall volume did not change when accounting for pre-existing trends, but accidental ingestions specifically increased 77% in children and 36% in older teens.

What changed about how teens presented to the ER?

Teens showed more hyperemesis cases (64% increase) and less polydrug use (23% decrease), suggesting more cannabis-only consumption after legalization.

Read More on RethinkTHC

Cite This Study

RTHC-03629·https://rethinkthc.com/research/RTHC-03629

APA

Yeung, Matthew E M; Weaver, Colin G; Hartmann, Riley; Haines-Saah, Rebecca; Lang, Eddy. (2021). Emergency Department Pediatric Visits in Alberta for Cannabis After Legalization.. Pediatrics, 148(4). https://doi.org/10.1542/peds.2020-045922

MLA

Yeung, Matthew E M, et al. "Emergency Department Pediatric Visits in Alberta for Cannabis After Legalization.." Pediatrics, 2021. https://doi.org/10.1542/peds.2020-045922

RethinkTHC

RethinkTHC Research Database. "Emergency Department Pediatric Visits in Alberta for Cannabi..." RTHC-03629. Retrieved from https://rethinkthc.com/research/yeung-2021-emergency-department-pediatric-visits

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.