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Before you get mad, we promise we’re not here to take away your weed. In fact, we’re here to applaud our state for blazing a trail in one particular area: harm reduction with edibles. We’ll be blunt: cannabis edibles are a major concern when they’re ingested by young children, especially in large doses. Children react differently than adults. Instead of just a high, young kids can also experience slowed breathing, slowed heart rate, confusion, and extreme drowsiness. If nobody reports the child got into cannabis and doctors don’t know what’s going on, they may also be tested for life-threatening conditions like head trauma, stroke, or a brain infection (meningitis). Concerning symptoms can escalate to the point of intensive care admission. With availability comes exposure At the poison center, the substances we treat most frequently are the ones closest at hand. Our call volume is closely tied to our everyday environments—like over-the-counter pain relievers in medicine cabinets or cleaning products under the sink. We also see specific trends crop up with the seasons. For example, mushroom ingestions peak in the spring and fall, while glow stick exposures light up our phone lines around Halloween. Simply put: when availability increases, exposure follows. Cannabis is no different. Legalization of cannabis reliably results in an increased number of calls rolling in to poison centers about young children. You can see it in our patient case volume below, with the blue line showing cannabis exposures in children younger than 6 years. Exposures started increasing in 2014, the year retail cannabis sales began in Washington. Nationally, poison centers saw a significant increase in pediatric cannabis exposures during April of 2020, too, as stay at home orders meant an increased amount of time around the substances we keep at home (no, we did not miss the irony of it being 4/20). The increased number of cases per month was sustained at least through December of 2020. Harm reduction through edible packaging rules Most states with legal cannabis require child-resistant, opaque containers that do not depict cartoon characters. Washington didn’t go into this process half-baked, but instead set a high bar by requiring child-resistant individual wrapping around each dose of cannabis edibles (see picture below; each product is one single serving of 10mg THC). Products with multiple servings are also allowed, like a bag of gummies or a box of chocolates. In these bulk containers, each individual gummy, chocolate square, etc. is in its own wrapping. This isn’t the case in many other states with legal cannabis, where only the bulk container needs to be child resistant. So, if a curious child cracks open a bulk jar of gummies, they can eat a whole handful in seconds. In Washington, having to open every single wrapper acts as an obstacle, slowing the child down and giving adults time to intervene (of course, this does not include homemade products). This safety strategy is a joint benefit for adults, too. Adults are less likely to misunderstand the recommended dose and ingest multiples when the product is individually wrapped. Also, can we point out something cool? That big red hand that says “Not For Kids” is our phone number (1-800-222-1222). It’s required on all edibles packaging in Washington, so the number for poison help is available right away if a child gets into edibles. How does this translate to poison center data? Do more robust packaging rules translate to safer kids? We think the proof is in patient outcomes. Instead of only looking at the number of pediatric patients we helped, we took a deeper dive by analyzing how they fared compared to those nationwide. The following graphs represent Washington Poison Center data compared with data from all U.S. Poison Centers combined. Children in Washington are much less likely to be admitted to the hospital and to the ICU (intensive care unit). They’re also a lot less likely to have severe effects from their exposure. We think this is mostly due to kids consuming much lower amounts of cannabis here in the Evergreen state. As you can see though, we still treat pediatric patients with severe effects. This is your reminder to always store cannabis products in their original, child-resistant containers, out of sight and reach of kids, and locked up. Summary and conclusion:
submitted by /u/WAPoisonCenter-WAPC |
