Minimum tetrahydrocannabinol dose that produces severe symptoms in children

Abstract

Introduction: More than one-half of the United States have legalized medical or retail cannabis. Pediatric exploratory ingestions commonly involve children who ingest edible tetrahydrocannabinol products. Cannabis product package sizes and contents vary considerably. Determining the rate of severe symptoms in children who ingest specific doses of tetrahydrocannabinol products may help guide education and regulation.

Methods: We searched the Oregon Poison Center records for a three-year period and included cases that were human, age <6 years old, ingestion, and single-substance edible tetrahydrocannabinol products. Exclusion criteria were incomplete symptom or outcome data, no follow up, and cases without a reliable report of the dose ingested.

Results: One-hundred thirty-two cases met inclusion and exclusion criteria. Sixty-one children had tetrahydrocannabinol ingestions that were >30 mg, 28% of whom developed severe symptoms and 84% had moderate/major effects. Central nervous system depression was reported in 66% and respiratory depression was reported in 17% of patients who ingested >30 mg of tetrahydrocannabinol.

Discussion: These data may be helpful in developing risk reduction education to mitigate harms from pediatric exploratory ingestions of tetrahydrocannabinol edibles.

Conclusion: Children who ingest >30 mg tetrahydrocannabinol in edibles had a higher risk of respiratory depression, central nervous system depression, hypotension, and severe symptoms.

Keywords: Cannabis; children; dose-response; poisoning; tetrahydrocannabinol.