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Canada legalized recreational cannabis use in 2017. A retrospective study of children (0-18 years) who presented to pediatric ED with cannabis intoxication/exposure was performed between Jan 1, 2008 to Dec 21, 2019 to assess the trend/severity of intoxication.
Methods
- Single center study: Hospital for Sick Children, Toronto
- Case identification by ICD 10 code for cannabis intoxication and positive urine drug screening test
- Pre-legalization period was defined as 1/1/2008 to 4/12/2017
- Peri-post legalization period was defined as 4/13/2017 to 12/31/2019
Result
A total of 298 patients were identified
- Pre-legalization period: 232 (77.8%)
- Peri-post legalization period: 66 (22.1%)
- Male: 150 (50.3%)
- Median age: 15.9 years (IQR: 15.0-16.8)
|
| Pre-legalization | Peri-post legalization | P value |
| Monthly ED visit | 2.1 (IRQ: 1.9-2.5) | 1.7 (IQR: 1.0-3.0) | 0.69 |
| ICU admission | 4.7% | 13.6% | 0.02 |
| Respiratory symptoms | 50.9% | 65.9% | 0.05 |
| Altered mental status | 14.2% | 28.8% | <0.01 |
| Age < 12 years | 3.0% | 12.1% | 0.04 |
| Unintentional exposure | 2.8% | 14.4% | 0.02 |
| Edible ingestion | 7.8% | 19.7% | 0.02 |
Respiratory symptoms: tachypnea/bradypnea, cyanosis, O2 sat < 92%, bronchospasm, oxygen requirement
- Edible ingestion was a predictor of ICU admission (OR: 4.1; 95% CI: 1.2-13.7)
Conclusion
- Legalization of recreational cannabis in Canada was associated with increased rates of severe intoxication in children.
References
Cohen N et al. Pediatric cannabis intoxication trends in the pre and post-legalization era. Clin Toxicol 2021. e-pub Jun 17, 2021.
https://doi.org/10.1080/15563650.2021.1939881