Children With Cannabis Poisoning More Likely to Undergo Multiple Diagnostic Tests in Emergency Departments in States Where Cannabis is Illegal

Young children who went to an emergency department with symptoms of cannabis ingestion were more likely to undergo multiple tests and invasive procedures in states where recreational cannabis is illegal as compared with states where recreational cannabis is legal, according to a study published in the June 2024 Pediatrics. The study, “Cannabis Legalization and Resource Use for Ingestions by Young Children”  (published online May 1), reviewed data from between January 2016 and April 2023 and found differences in emergency department testing  and treatment for pediatric cannabis ingestions based on state-level legalization. The study analyzed data on 3,649 children from 47 hospitals in the Pediatric Health Information System database. There was a large increase in frequency of emergency department visits for cannabis ingestions by young children during the study period, and these encounters were associated with a large amount of diagnostic testing. In states where recreational cannabis is legal, children ages 5 and under with cannabis poisoning were less likely to undergo advanced neuroimaging (head CT or MRI), lumbar puncture, intensive care unit admission and mechanical ventilation. In contrast, urine testing was more common in states where recreational cannabis was legal. The authors state that while the reason for the differences in emergency care are unclear, factors such as increased provider awareness, more forthcoming caregiver history, or differences in tetrahydrocannabinol  (THC) quantity and storage in the home are likely at play. They observe the need for education on the early recognition and management of cannabis intoxication in young children and a focus on policies and procedures to minimize invasive and potentially harmful testing. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.