345 - Clinical Presentation, Outcomes and Trends of Accidental Cannabis Ingestions in Young Children – A Retrospective Observational Study

Marijuana is the most used federally illicit drug in the United States. As of April 2022, medical marijuana is legal in 37 states and recreational use in 18 states. Following legalization, edible cannabis products have been mass produced in packaging attractive to children, and some studies have shown increasing frequency and severity of cannabis ingestions. In New York, cannabis was legalized in 2016 for medicinal use and 2021 for recreational use.

Objective: This study aims to trend local accidental pediatric cannabis ingestions before and after legalization.

Design/Methods: A retrospective observational electronic medical record review was conducted at a tertiary-level pediatric emergency department in New York. TriNetX database was used to identify a cohort of children < 11 years old with cannabis ingestions between 1/2010 and 5/31/2022. 95 patients were identified in the search, of which 67 patients were excluded for prescribed cannabis use, incorrect age at admission, ingestion of other substance or no mention of ingestion in the chart. 28 patients were included in the cohort and results were analyzed using SPSS.

Results: 67.9% of cases occurred in 2021 and 2022, after legalization. 95.6% of cases that reported type of edible were kid-friendly products (Table 1). 67.9% of ingestions occurred in households with parental/grandparental consumption. Ingestions presented with a range of symptoms, most commonly drowsiness/lethargy (Table 2). No cases occurred prior to legalization in 2016. The incidence of ingestions significantly increased after recreational use was legalized in NY state (Figure 3). Unnecessary medical interventions included antibiotics (10.7%), CT Head (21.4%) and LP (3.6%).

Conclusion(s): There has been an increase in frequency of ingestions since legalization of cannabis in New York. All children treated for ingestions at our institution had unfortunate access to kid-friendly edible products. Young children tend to have severe ingestions and more associated unnecessary medical interventions. The frequency of cases increased after New York’s decriminalization thus this remains a significant public health concern.