Cook Children's Sees Increase in Emergency Care for Marijuana Ingestion

By Jean Yaeger

Cases of accidental marijuana ingestion increased again in 2023, a trend reflected in data from the Cook Children’s Emergency Department (ED).

Statistics from the ED at Cook Children’s Medical Center – Fort Worth show 50 patients between ages 0-3 whose urine tested positive for the main psychoactive ingredient in the cannabis plant. Another eight patients in the same age group at the Cook Children’s Medical Center – Prosper ED also had positive screenings last year.

That’s 58 babies and toddlers whose urine contained a molecule called tetrahydrocannabinol (THC), a marker of marijuana intoxication. For comparison, here are the yearly totals for THC-positive urine screenings in patients ages 3 and younger at the Fort Worth ED in recent years:

• 2019: 8
• 2020: 13
• 2021: 29
• 2022: 33

In all those years, the vast majority of patients with THC-positive urine screenings were teens. But there’s a special concern for babies and toddlers because of the drug’s stronger impact on their small bodies.

“Cannabis has the potential to cause significant harm to children in this age range over any other age range. These are the kids who are going to have the most serious side effects,” said Anelle Menendez, M.D., CSPI, clinical educator for the North Texas Poison Center. “It has the potential to cause very significant toxicity in children.”

No amount of marijuana is safe for children. A child who swallows a marijuana product – edibles like gummies or baked goods, or oil from a vaping cartridge – can become extremely sleepy or unresponsive. Their heartbeat could soar. They might struggle to breathe or have trouble crawling or walking.

Calls to the North Texas Poison Center regarding children exposed to cannabis rose more than 1,000% from 2019 to 2023, Dr. Menendez said.

That’s why parents, caregivers, siblings and guests are urged to take precautions with any marijuana in the home. Young children are curious; they put everything in their mouths. They could quickly eat a marijuana-infused candy or cookie they find on a nightstand or in a purse, for instance, leading to an accidental cannabis poisoning.

Klaressa Broughton works to raise awareness in her role as coordinator for the Poison Prevention program at the Center for Community Health, led by Cook Children’s. Broughton said the best safeguard is keeping marijuana out of the home altogether. But if it’s present, keep it locked up, out of reach and out of sight.

“I tell parents to be aware of who’s in their household,” she said. “Do you have toddlers? Do you have teenagers? Keep in mind who’s in your home, and then create a plan to have safe storage instead of leaving those gummies out on the counter.”

March 17-23 is National Poison Prevention Week, which promotes safe use of all drugs, chemicals and products that could be harmful in the wrong amounts. To amplify that message, here’s a closer look at what happens to young children’s brains and bodies from the “high” of ingesting THC.

Get Help Right Away

If a parent or caregiver suspects a child has swallowed an item containing THC, they should immediately seek medical help or call the poison control hotline. The experts who take calls at the hotline will ask how the child is acting and how much time has passed.

“We’re going to go through a thorough evaluation over the phone,” Dr. Menendez said. “What exactly did they get into? How much are you missing?”  Depending on the severity of symptoms, such as seizures, the caller might be instructed to call 911.

“It's going to have a very negative effect on your baby, and it will be one of the scariest moments you ever go through in your life,” she said. “There’s no judgement here; we’re here to help you the best we can.”

She advises adults not bringing marijuana into the home -- or if it’s there, to keep products locked up so that they’re not accessible. Don’t vape, smoke or consume edibles in front of children.

Emergency Care

When children come to the ED with suspected marijuana ingestion, the medical team will do a urine screening for the diagnosis. They’ll monitor the child’s vital signs and fluids, protect the airway, and watch for worsening symptoms. Extra oxygen or a breathing tube could be needed if the patient’s breathing rate becomes short and shallow.

The intoxicating effects wear off usually within about 12 hours. Children treated for marijuana ingestion can typically be discharged to go home from the ED after they become alert, act playful, and resume eating and drinking. High concentrations of THC tend to cause more severe cases, which may require being admitted to the hospital for additional monitoring.

Jamye Coffman, M.D, MPH serves as medical director of the Cook Children’s C.A.R.E. Team, which works to prevent child abuse and neglect. One of the team’s roles is providing medical evaluations for children injured by drug exposure. She’s seen a preschooler wind up on ventilation in the intensive care unit (ICU) from eating just one gummy with a potent THC level.

“A single gummy in the carpet or in the crevice of a couch can be found by a child and be toxic,” Dr. Coffman said.

Even more alarming is the danger of fentanyl ingestion for people of all ages. Dr. Coffman strongly cautioned parents and caregivers to understand that even a small amount of fentanyl can be lethal.

“One pill dropped on the floor or forgotten on a bedside stand could mean the death of your child,” she said. “There are no do-overs. To see a normal healthy child die so needlessly is heartbreaking.  I don’t know how to stress enough the dangerousness of this drug.”

Education and Resources

Poison prevention at Cook Children’s falls under the scope of injury prevention along with gun safety, drowning prevention, safe baby sleep and car seat safety through the Center for Community Health.

“The three things we focus on in my program are Safe Dosing, Safe Storage and Safe Disposal,” Broughton said.

She provides training and teams up with partners such as the North Texas Poison Center and Challenge of Tarrant County. They supply educational materials for events at schools, churches, community centers and other locations. Broughton also distributes resources such as medication lock boxes, cabinet locks and kits for disposing unused medications.  

She said marijuana should always be kept in locked storage because young children are attracted to colorful packaging and the sweet smell of edibles. And if they see a parent consume a marijuana product, they’ll want to try it too. Toddlers can climb onto counters, and it only takes a minute for them to get into something they shouldn’t have, Broughton pointed out. 

What should parents know? “If you choose to use marijuana, keep in mind who's in your home and how to keep your children safe,” Broughton said. “If you do expose them, know what happens and what to look out for.”

If you think your child has ingested marijuana, get medical help or call the Texas Poison Center at 1-800-222-1222. For more information: Marijuana Edibles - Texas Poison Center Network (poisoncontrol.org)

RELATED STORY:

• Statistics from Cook Children’s Emergency Department Show Increase in Marijuana Ingestion Among Children Ages 0-3 (checkupnewsroom.com)