As legalized marijuana appears in an increasing number of American homes, so too does evidence of a dark side: accidental ingestion of pot and pot-infused food by young children.
The results can be frightening to such children, who often suffer anxiety attacks when they start to feel unexpected symptoms of being high: hallucinations, dizziness, altered perception and impaired thinking.
And the trend should prompt equal concern among adult caregivers and public health authorities, since ingestion of highly potent marijuana by young children can suppress respiration and even induce coma, according to a study published online this week in JAMA Pediatrics.
"You talk to people about the secondary consequences of marijuana legalization and they say, 'Oh, I never thought of that,'" said Dr. Jeffrey Galinkin, a professor of anesthesiology and pediatrics at the University of Colorado-Denver, who was not involved in the study. "This is a public health disaster that's just waiting to happen."
The JAMA Pediatrics study was conducted by researchers from the Rocky Mountain Poison and Drug Center and Children's Hospital in Denver. Team members tallied visits to the center's emergency department for accidental marijuana ingestion between Oct. 1, 2009 and Dec. 31, 2011 — a period during which there was a sharp increase in medical marijuana cards issued to Coloradans, as the U.S. Justice Department relaxed its policy of enforcing federal laws against marijuana in states that allowed its use.
Doctors confirmed that 14 children 12 years old or younger had accidentally eaten pot. In nearly five years leading up to the study, the same emergency department had seen not a single lab-confirmed case of marijuana ingestion by young children.
The children affected ranged from 8 months to 12 years old. Though one child was discharged from the emergency department without delay and five were released after observation, eight were admitted to the hospital — two, to pediatric intensive care.
Eight of the children ingested marijuana when they ate food products — cakes, brownies, candies, drinks and other treats — made with the drug. And seven of the food-based cases involved medical marijuana, which packs an intense dose of marijuana's active ingredient — tetrahydrocannabinol, or THC.
Despite the recent legalization of pot for recreational purposes in two states — Colorado and Washington — and legalization of medical marijuana in a growing number of states, there are no requirements on states' books that marijuana products be dispensed in child-proof containers, nor that packaging bear warnings about the products' effects if accidentally ingested by children.
In an accompanying editorial, Drs. William Hurley and Suzan Mazor, who were not involved in the primary study, called for stepped-up tracking of accidental marijuana ingestion and suggested that dispensaries and retail establishments selling marijuana and marijuana-infused food products warn customers about the dangers to children.
Establishments could consider using child-proof containers as well, wrote Hurley, a physician with the Washington Poison Center, and Mazor, an emergency department pediatrician at Seattle Children's Hospital.
Galinkin said that accidental ingestion was only one of many medical effects that were not thought through as medical marijuana use has expanded.
Standards defining impairment for drivers under the influence of marijuana have not been set, he said, and the safety of prescribing opioid painkillers to patients who smoke marijuana for pain is not well understood.
For adolescents at risk of developing schizophrenia, Galinkin cited strong evidence that early marijuana use accelerates the age of the first symptoms of psychosis.
In a state with a weak mental health infrastructure, surging marijuana use among teens could be catastrophic, he said.