Canadian researchers alarmed by the rise in the number of children hospitalized for accidental cannabis poisonings are calling for restrictions on edibles.
A study published Wednesday in the New England Journal of Medicine found that cases in children under 10 increased six-fold between January 2015 and September 2021, with a notable spike after edibles such as tetrahydrocannabinol-infused gummies, chocolates and baked goods ( THC) have been approved for sale in 2020.
The study’s lead author, Dr. Daniel Myran, looked at cases in Ontario, Alberta, British Columbia and Quebec and found that hospitalizations increased by more than two and a half times immediately after legalization. recreational use of dried cannabis flower in Canada in October 2018.
But he said rates rose again in Ontario, Alberta and British Columbia after those provinces approved edibles in January 2020, while rates remained the same in Quebec, which did not allow sales of edible products.
The Ottawa-based family physician said it suggests the decision to legalize edibles has increased health risks for children, even though federal and provincial rules limit potency, packaging and product access. .
Emergency physician Yaron Finkelstein, a lead researcher at the Hospital for Sick Children in Toronto, says he has witnessed serious cannabis poisonings “several times,” including children who suffered seizures, needed medical mechanical ventilation or lost consciousness.
“Because the effect of edibles takes longer to kick in than smoking, for example, these children may consume larger, highly concentrated amounts and when they do show up, they are very ill,” says the Dr Finkelstein.
In the case of a toddler in a coma, he said caregivers did not disclose cannabis poisoning as a possible cause until the child was given a CT scan and lumbar puncture to rule out other problems.
The researchers counted 581 hospitalizations of young children for cannabis poisoning during the seven years included in the study. Their average age was three and a half years.
The data did not specify if or how many poisonings were from edibles versus dried flowers, but Dr Myran says he is confident that legal edibles have increased risks for children due to the timing of cases. occur and the fact that Quebec was used as a control for the study.
In its guidance on packaging and labeling, Health Canada cites the need to “reduce the appeal and appeal of cannabis products, especially for young people”, by imposing requirements on packaging childproof, limited colors and warning labels. Other rules under the Cannabis Act limit the amount of THC per packet to 10 milligrams _ one tenth of what is allowed in many US states.
But many in the cannabis industry would like to see fewer restrictions, said Omar Khan, senior vice president of High Tide Inc., which operates 139 Canna Cabana stores in British Columbia, Alberta, Saskatchewan, Australia. Manitoba and Ontario.
He said stricter THC limits would compromise regulated products by causing some consumers to seek out illegal edibles with higher concentrations.
“You’re going to drive people into the illicit market even more. And they don’t sell regulated products, they don’t check people’s IDs. They sell 10, 20 units in a package, whereas under Health Canada regulations we are only allowed to sell one unit at a maximum of 10 milligrams per package,” according to Khan.
Dr Finkelstein insists that various government efforts to mitigate potential harm have proven ineffective in addressing unintentional poisonings in children. “Despite all these measures, we see this strong increase in the provinces that have allowed it. So we think the right way would be to ban cannabis edibles.”
Dr. Myran, also a preventive medicine specialist at the University of Ottawa and the Ottawa Hospital, said society can still reap the social and health benefits of decriminalizing dried cannabis without allowing colored products. resembling candies that attract children. “We are increasing the risk of health harm with very little public health or health gain. Canada’s public health approach to cannabis sought to avoid a poorly regulated industry or a commercialized industry. And I think it’s a real open question whether we’ve achieved that balance or not. To me, data like this suggests that we don’t have strong enough regulations. »
Daniel Myran acknowledges that decriminalizing cannabis has substantial public health, societal, and equity gains, but he says tighter controls on edibles would not reduce them.
The study published in the New England Journal of Medicine was funded by the Canadian Center on Substance Use and Addiction.