Accidental cannabis poisoning is on the rise among Canadian kids. What can be done?

With some Canadian provinces seeing an increase in accidental cannabis poisoning among children, experts are stressing the need to make edibles look less appealing to kids.

A recent study published by the New England Journal of Medicine on Aug. 25 found that there has been a 6.3-fold increase in hospitalizations for unintentional cannabis poisoning among the under-10 age group in Canada since the legalization of recreational cannabis in October 2018.

Dr. Daniel Myran, the lead author of the study, said the average age of poisoning in kids is three and a half years old.

“These are busy preschoolers who are getting into places that, ideally, they shouldn’t be (at). They’re finding something that looks very appealing to eat with no understanding of the fact that it contains cannabis,” said Myran.

Myran said edibles in the form of gummies, chocolates, or even cookies can seem very tempting to children because they look similar to their everyday snacks and candy.

He said these edibles should always be kept “out of reach of children, locked up.” Legal products which are originally sold in child-resistant packaging should be retained in their kits until the time that they’re going to be consumed.

“There’s a variety of different ways that (adult consumers) can consume cannabis,” said Myran. “For people who are looking to consume higher quantities of delta-9-tetrahydrocannabinol (THC), there are potentially other ways that they could ingest that THC. It doesn’t need to be in the form of a sugar-coated gummy.”

According to Health Canada, legal edible cannabis has a limit of a maximum of 10 mg of THC per container.

THC is responsible for the way an individual’s brain and body responds to cannabis, including the high and intoxication, Health Canada states on its website.

Although THC has some therapeutic effects, it also has harmful effects which may be greater when the strength of THC is higher.

To further reduce the risk, Myran said markets can design and reformulate edibles to make them less appealing to children in an effort to avoid such accidents.

Makers can also try to limit the variety of sweet or dessert-like edible products.

“There are just certain products that no matter how you package them, no matter how you present them, (they will look appealing). Candy is candy, and kids will be interested in that,” said Myran. “And we don’t think this is a good idea to sell.”

However, Myran noted that events of accidental cannabis poisonings among children in Canada are “still relatively rare.”

Canada has had 581 hospitalizations from cannabis poisoning in children over a seven-year period, which represents a wider base of less severe poisonings, said Myran.

The New England Journal report, titled “Edible Cannabis Legalization and Unintentional Poisonings in Children,” compared three provinces in Canada — Ontario, British Columbia and Alberta — against a fourth province, Quebec, which had a ban on edibles at the time when the study was conducted.

Before legalization in 2018, hospitalization rates were similar across provinces. However, hospitalization rates in Ontario, B.C., Alberta and Quebec jumped 2.6 times during the first period of legalization between October 2018 to December 2019.

During the second period of legalization between January 2020 to September 2021, the hospitalization rates in Ontario, B.C. and Alberta were 7.5 times higher than before. Whereas, the hospitalization rate in Quebec was three times higher — largely due to the fact that edibles were not legalized at the time in the province, according to the study.

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Myran said it can be argued that more parental education is needed but the responsibility doesn’t solely fall on parents or caregivers.

“I don’t think that you ever want to look at a problem like this and say the only response here is for more parental education and responsibility,” he said.

Current government policies are “doing a fairly good job at making this problem not worse,” said Myran.

According to Health Canada, Cannabis products must be packaged in a child-resistant container and the label should contain the standardized cannabis symbol, the mandatory health warning message and include specific product information— such as the brand name, class of cannabis, (THC) and cannabidiol (CBD) information.

“These measures aim to reduce the risks of accidental consumption and overconsumption as well as reduce the appeal of cannabis products to young persons while providing consumers with the information they need to make informed decisions before using cannabis,” the advisory on Health Canada’s website says.

Zach Walsh, a psychology professor at the University of British Columbia, said besides securely storing cannabis products away from children, parents should also have clear communication with their kids about cannabis consumption when they are old enough.

He said keeping an open and honest line of communication with children about cannabis and drug use throughout their life could prevent adolescent substance abuse in the future.

Although the overall percentage of people in Canada reporting cannabis use decreased from 2020 to 2021, more youth than adults who use cannabis reported changing their patterns of use during the COVID-19 pandemic, according to the Canadian Centre on Substance Use and Addition’s (CCSA) Cannabis Legalization Observations 2021–2022 report.

CCSA’s report stated that there is also an increase in youth and young adults using cannabis vaporizers.

Walsh said parents often hide their cannabis use from children, but “the kids still know they’re using it,” and this “secrecy further stigmatizes the use of cannabis.”

“That’s not where we need to be when we’re dealing with … adolescents and substance use, particularly at this time when the stakes are so high with some of the white powder drugs and opioids,” said Walsh.

Walsh also warned of the over-regulation of cannabis, which could lead to “far worse consequences than the direct effects of cannabis.”

“One thing that we want to be cautious of, given the history of cannabis, is that it doesn’t turn into a sort of drug hysteria,” said Walsh. “Because as we’ve seen in the past with criminalization, promoting panic and overregulation haven’t protected children or anyone from cannabis.”

Myran said young children who have ingested cannabis would be uncoordinated and have trouble sleeping in severe cases.

He said people should seek prompt care at the emergency room or by calling a regional poison control center.

“Because when young children ingest large quantities of cannabis, they can actually stop breathing,” said Myran. “And these are kids who need to be supported in their breathing with breathing tubes and ventilators while the cannabis is metabolized or processed out of their system.”

He added that parents or caregivers should disclose the situation to health-care providers if they suspect their kids may have ingested cannabis.

A cannabis poisoning event can look like a variety of other serious medical conditions and health-care workers need to “do other types of invasive procedures to rule them out,” cautioned Myran.