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)

The number of babies and toddlers who screened positive for marijuana in the Emergency Department at Cook Children’s continued trending up in 2022.

Last year’s data show 33 patients between ages 0-3 whose urine tested positive for a molecule called tetrahydrocannabinol (THC), the main psychoactive ingredient in the cannabis plant. Back in 2019, there were just eight patients from the same age group with THC-positive urine. The number climbed to 13 patients in 2020, and to 29 patients in 2021.   

Doctors at Cook Children’s say the marijuana intoxication cases they see in babies and toddlers are caused by accidental ingestion of edibles. Edibles are marijuana-infused food items such as gummies or other candy, cookies, brownies, beverages and other products. They aren’t safe for children to consume.

The U.S. Centers for Disease Control and Prevention (CDC) cites the longer-lasting and unpredictable effects of edibles, in which the strength of the ingredients might not be known. Ingestion can cause altered mental status, extreme sleepiness, high heart rate and trouble breathing in young children.

“We’re not here to judge but to provide a warning that if you’re going to have these in your home, you really need to lock them up so that kids can’t access them,” said Daniel Guzman, M.D., who works in the Cook Children’s Emergency Department (ED).

Teenagers made up the majority of the 693 patients in the ED who tested positive for THC in the urine screenings last year. Even though there were far fewer younger patients affected overall, any ingestion by babies and toddlers raises concern. To a curious child, a candy or cookie edible looks like something good to eat.

Recreational marijuana use is illegal in Texas. But a product called delta-8, derived from legally grown hemp, is legal to buy and sell as long as THC levels are less than 0.3%. Delta-8 concentrated in a lab can produce a “high” similar to marijuana. Also, low-level THC medical marijuana can be prescribed in Texas for patients with conditions such as epilepsy and multiple sclerosis. 

Medical experts point out that any amount of drug will have a much greater impact on a child’s small body than on an adult. They urge precautions by all caregivers – parents, older siblings, grandparents and babysitters - to prevent the youngest and most vulnerable from swallowing any edibles they happen to find on a nightstand, in a purse, in a vehicle or in other locations. A preschool in Prosper made national headlines last Halloween after four children became ill following alleged exposure to THC.

What are the signs of marijuana intoxication? How is it treated?

Emergency Department

Abnormal behavior, extreme sleepiness and unresponsiveness are red flags for marijuana ingestion. When children come to the ED with those symptoms, doctors try to rule out other possible causes such as infection or traumatic brain injury.

“Unfortunately, we’ve seen an uptick in the number of kids who have had marijuana ingestion or use over the last couple of years,” Dr. Guzman said. If doctors suspect the child might have eaten a marijuana edible, they will ask the parents or caregivers about any drugs in the home.

“It’s a fair question to ask given the breadth of kids coming in with accidental ingestions. It’s not to judge anybody – we just want to know what we’re dealing with so that we can treat it quickly and know what to expect.”

It takes about three hours to get results from THC tests in the urine samples. Meanwhile, supportive care is provided while the intoxicating effects wear off, usually within about 12 hours. Dr. Guzman said the medical team will monitor the patient’s vital signs and fluids, protect the airway, and watch for worsening symptoms. If the patient’s breathing rate becomes short and shallow, he said, extra oxygen or a breathing tube could be needed.   

Children diagnosed with marijuana ingestion can typically be discharged to go home from the ED after they become alert, act playful, and resume eating and drinking, Dr. Guzman said. More serious cases require further care in the Medical Center.   

Admitted to the Hospital

Kyle Brady, D.O., a pediatric hospitalist at Cook Children’s, said sometimes it takes longer for young patients’ bodies to eliminate the drug. They remain extremely sleepy. The medical team waits and observes. An electrocardiogram (EKG) may be needed to measure the patient’s heart rhythm during recovery. 

“The big thing is doing neuro checks and making sure they’re arousable,” Dr. Brady said. “With the ingestive THC, your liver has to process that chemical, and it just takes time. The smaller you are with how strong some of these compounds are, it can be a few days that we see them in the hospital.” 

Severe cases of marijuana ingestion are linked to high concentrations of THC, he said. “It can be very scary and worrisome to both the parent and the provider,” Dr. Brady said.

Before he will discharge a patient from the hospital following marijuana ingestion, Dr. Brady wants to see that they’re completely awake, playing, eating and able to crawl or walk appropriately for their age. 

What safety tips do the experts at Cook Children’s recommend? Keep marijuana edibles locked up and stored out of reach. And make sure babysitters and grandparents understand those products are harmful to children, even though they look attractive.

“A little kid should not be ingesting THC, and if you as a parent are using it recreationally, you need to use it responsibly and you need to treat it as you would any kind of alcohol product or any kind of household chemical,” Dr. Brady said.

Dr. Guzman pointed out that parents and caregivers must take steps to keep their children safe around firearms and swimming pools. Safety measures apply to marijuana edibles too.

“It’s all about access,” he said. “If we can be responsible adults when it comes to any of these injury prevention areas, then we can keep our kids from getting hurt.”

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

Data collected from the ED in 2021 show 29 patients between ages 0-3 whose urine tested positive for a molecule called tetrahydrocannabinol (THC), the cannabis plant’s main psychoactive ingredient. In 2020, there were 13 patients from that age group with marijuana detected in urine. In 2019, the count was eight.    

The rise in accidental ingestion by babies and toddlers reflects concerns nationally about the danger posed by edibles – cookies, brownies or candy infused with marijuana – or other products such as vaping fluids. The same way a crawling or cruising child might swallow a button on the floor or a coin on a coffee table, a marijuana product can wind up in the mouth of a curious youngster.      

Kyle Brady, D.O., a pediatric hospitalist at Cook Children’s, cited a recent case in which a toddler ate an older sibling’s marijuana gummies. The toddler had trouble waking up and was hospitalized until the drug’s effects wore off.

“It was scary for everyone involved,” Dr. Brady said. “It is something we’re seeing more of.”

In the data from the Cook Children’s ED over the past three years, most of the babies and toddlers with THC in their urine spent at least 24 hours in the hospital to recover. Dr. Brady said signs of marijuana intoxication can include altered mental status, sleepiness, impaired coordination, hypermobility, high heart rate and trouble breathing. If admission to the hospital is needed, the medical team will monitor the patient’s vital signs and fluids, protect the airway, and be on guard for worsening symptoms, he said.   

“It’s all supportive care and giving the body time to clear the metabolite,” Dr. Brady said. “The severity depends on how much they ingested. The main thing for hospitalization is to make sure their body can clear it in an appropriate time.”

Jamye Coffman, M.D., serves as medical director of the Cook Children’s C.A.R.E. Team, which stands for Child Advocacy Resources and Evaluation. The scope of the C.A.R.E. Team includes examinations for pediatric patients suffering from drug exposure. Exams are conducted following a referral from Child Protective Services, law enforcement agencies or a medical provider.

Dr. Coffman said marijuana intoxication typically causes one of two extremes: lethargy or agitation.

 “Over the last year or two we’ve seen more of those kids coming through the Emergency Department,” she said. “Sometimes we have to do fluids or hydrate them. But for the most part, it’s waiting and watching and making sure that it gets out of their system at least enough to where they can go home.” 

The U.S. Centers for Disease Control and Prevention (CDC) reports that edibles pose a greater risk for poisoning or injury compared to smoked marijuana. The CDC cites the longer-lasting and unpredictable effects of edibles, in which the strength of the ingredients might not be known. 

“Children, adults, and pets can mistake marijuana products, particularly edibles, for regular food or candy. Consuming marijuana can make children very sick. They may have problems walking or sitting up or may have a hard time breathing,” according to the CDC website. “Since marijuana use has been legalized in some states, accidental marijuana poisonings in children have increased, sometimes requiring visits to the emergency room or hospitalization.”

Dr. Coffman identified three particular concerns:

The legalization of recreational marijuana has made edibles more accessible even in states like Texas where it remains illegal.

The concentration of THC has become increasingly potent in recreational marijuana and much higher than the levels in prescribed medical marijuana.  

Candy and baked goods infused with marijuana are attractive to children, who don’t realize they’re eating a substance that could harm them.

“To a 2-year-old, a cookie is a cookie is a cookie, or a brownie or a gummy or a lollipop or whatever. They’re going to get into it,” Dr. Coffman said. “We’ve had kids have gummy parties. They think it’s just regular candy. That one edible can have a huge amount of THC.” 

Dr. Brady said when a patient shows up in the emergency room with sleepiness or suspicious symptoms, the doctors have to work to eliminate other possible causes such as traumatic brain injury. Once a patient is admitted to Cook Children’s with the diagnosis of marijuana intoxication, Dr. Brady said, the medical team waits and watches until the patient's body can eliminate the drug. Supportive care is provided as necessary while the intoxicating effects wear off.  

In 2021, there were 540 patients in the Cook Children’s Emergency Department who tested positive for THC in the urine screens. The vast majority were 12 years or older.

Unlike a young child who ingests marijuana accidentally, the adolescents generally present with different medical issues caused by purposeful and chronic use, Dr. Brady said. Prolonged use can lead to coughing, lung injury, seizures and repeated bouts of severe vomiting, a condition known as cannabinoid hyperemesis syndrome. And then? Severe vomiting may result in dehydration and bleeding of the esophagus with extreme marijuana use. Dr. Brady says he’s seeing more teenage patients with marijuana-induced vomiting.

Dr. Coffman also has witnessed an upward trend in marijuana-related cases in her 22 years at Cook Children’s. She pointed out that any amount of drug will have a much greater impact on a child’s small body than on an adult. With infants and toddlers, the risk of intoxication usually comes from resin, vaping cartridges, beverages or edibles that were unintentionally left within reach by a family member, caregiver or houseguest.

“If the children are crawling age and they can pull up on furniture, if you leave something out or it drops on the floor, or it gets between cushions on a couch, they can find it. They’re low to the ground. If it’s down there, they’re going to find it.”

She sometimes encounters parents or caregivers who are reluctant to disclose how the child was exposed to marijuana. Others are more forthcoming with information. “It’s nice that they do tell us, because then it gets us down the right path of diagnosis and treatment faster instead of waiting for the test results to come back,” Dr. Coffman said.  

Keeping Kids Safe from Ingestion

First, never consume or smoke marijuana around children. The American Lung Association warns that people who are exposed to secondhand marijuana smoke can have detectable levels of THC in their systems.

Other recommendations… Keep product packages securely sealed, locked away and stored where children can’t discover or reach them. Dr. Coffman emphasized there should be absolutely no access because there’s no safe amount of marijuana for children unless prescribed by a physician.

“It is a dangerous substance for little kids, and people need to be aware that it’s dangerous,” she said. “I’ve had some parents say, ‘Well, it’s just herbal.’ No, it’s beyond being just herbal. It can actually be dangerous.”

From Dr. Brady: “You have to treat it like you would any kind of medication, keeping it locked up, keeping it out of sight and out of reach, and making sure it is truly a childproof container. That is the best thing you can do.”

Anxiety and depression drive some teens to recreational marijuana as a way to self-medicate. But that coping strategy can backfire.

Health advocacy groups indicate a link between marijuana use and an increased chance for mental health problems. The National Institute on Drug Abuse and the American Academy of Child Adolescent Psychiatry, for instance, both list a correlation to schizophrenia, depression and anxiety. The Centers for Disease Control and Prevention cites those risks plus temporary psychosis – “not knowing what is real, hallucinations and paranoia” – on its list of mental health implications for dope users.

Lisa Elliott, Ph.D., psychologist/neuropsychologist and manager of the Behavioral Health Clinic at Cook Children’s in Denton, estimated that at least half of her adolescent patients report having tried or using marijuana. For those already struggling with their emotional well-being, is this something to avoid? “Yes. Put that in all capital letters: YES. We have too much evidence to show how harmful it is,” Dr. Elliott said. “There is a significant amount of research that supports the negative impact marijuana/THC use has, especially on the developing brain, so much so that it scares me for our kids’ future.”

Read more about the link between suicidality and young adults here.

Those harmful effects go beyond anxiety and depression to include impairment to intellectual functioning, memory, learning, attention, problem-solving skills and coordination, according to Dr. Elliott. Marijuana use also can cause coughing and wheezing, damage to the immune system and addiction for some people, she said. And when it comes to suicide, some studies show a relationship.    

“There’s been a significant increase in suicides as well as mental health disorders in states that have legalized marijuana,” Dr. Elliott said. “Can we say that marijuana causes suicides? We can’t really say that, but there’s a direct correlation. However, we also know that whenever you’re more depressed and also if you’re coming out of depression, you’re more likely to feel suicidal.”

Just breathe. Open up. You matter. That’s the truth behind the Joy Campaign, an ongoing rollout of articles, videos and other resources aimed to prevent youth suicide. Cook Children’s initiated the Joy Campaign in response to rising numbers of suicide attempts in our region and nationally. While raising awareness, the Joy Campaign delivers help and hope for children and teens who struggle with mental health. This article looks at the ways marijuana use complicates the picture.

How common is recreational marijuana among adolescents? The National Institute on Drug Abuse reports that 11.4% of eighth graders and 35.2% of 12th graders surveyed in 2020 said they had used marijuana in the past year. The Substance Abuse and Mental Health Services Administration calls marijuana the most common illegal drug in the United States, with particular risks for young users and pregnant women.

At Cook Children’s in 2019, there were 830 patients who acknowledged recent use of marijuana when they came to the Emergency Department (ED) for various complaints. That statistic increased to 986 patients in 2020 and 1,105 patients in 2021.  Patients as young as 10 years old were among that group who indicated “yes” to marijuana use on their ED intake paperwork.

In that three-year span at Cook Children’s, most of those who admitted using marijuana were discharged from the ED to home or self-care. Records show some of those patients left the ED against medical advice or were discharged to court or law enforcement. And there were 207 self-reporting marijuana users who were discharged from the Cook Children’s ED to psychiatric hospitals during 2019-2021.

 Dr. Elliott and others say marijuana products have become more potent in recent years. The cannabis plant’s main psychoactive ingredient, a molecule called tetrahydrocannabinol (THC), causes the “high” feeling. Marijuana can be smoked, vaped in an electronic cigarette, eaten in candy or baked edibles, or inhaled in dabs that contain especially high THC concentration.  

Recreational marijuana remains illegal in Texas. In states where it’s legal, consumers must be 21 or older to buy marijuana for non-medical use. Recreational use differs from approved medical use of cannabidiol oil (CBD). Doctors may prescribe CBD in children to help manage epileptic seizures and some other illnesses. But many young people mistakenly confuse THC with the medicinal value of CBD, Dr. Elliott said.  

To set the record straight in therapy sessions, she provides her patients with facts about the documented negative impacts of marijuana, including exacerbated problems with mental health, impaired driving, difficulty in school, diminished IQ scores, aggression, anger and legal consequences. Adolescents who admit to marijuana use tell Dr. Elliott that the drug is easy to come by, even at home or school. She asks them why they started and how it impacts them.

“They’ll say that they will smoke marijuana because it helps them deal with the stress and the trauma and as well as the conflict and unrest in our world. Some of them report that it helps them feel happier, relaxed. Several report that they use it to help them sleep. And several of them report that they used it because they were bored (during the pandemic lockdown) and couldn’t go do things.”

Depending on the reason they’re using the drug, Dr. Elliott works with her patients to treat any contributing factors such as anxiety or depression, peer pressure and low self-esteem. “I try to encourage them and lead them toward healthy coping tools,” she said. “There have been times when I have discharged patients and referred them to therapists who specialize in drugs and addiction because they’re unwilling to stop smoking. Therapy is not productive if they’re high.”  

The Child Mind Institute, a nonprofit organization promoting mental health, sponsored a virtual symposium in October 2021 that featured new research and a panel of experts on the topic “Marijuana and the Teenage Brain.” Among the symposium’s highlights: 

THC exposure in animal models has shown repeated association with increased risk for developing anxiety, depression, substance abuse disorders and psychosis. Exposure to THC changes the cells in the brain and restructures how the gene networks talk to each other.

Adolescence is a critical period for brain development. The adolescent brain is primed to take risks, satisfy immediate wants and be easily swayed by social influences.

Parents should have frequent conversations with their children about the facts that marijuana can be addictive, there’s no such thing as a safe amount, and there’s no way to predict how it will impact a person. Factors such as age, genetics and amount/concentration of the drug play a role. 

 Dr. Elliott cited the statistic that about 1 in 10 people who use marijuana will become addicted. For those who start using before age 18, the addiction risk rises to 1 in 6. Warning signs of Cannabis Use Disorder include cravings, unsuccessful efforts to quit, and increased tolerance to the drug.

“One of the most frightening concerns with marijuana use is the increase in psychotic episodes, especially in those who have a family history of mental illness,” she said. “We also know the recent research really shows that for kids and teens who smoke that higher potency of marijuana, it will increase their chances of developing psychosis nearly five times more than those who have never used.”

Parents should stay alert to behavior changes -- such as secrecy, a sudden decline in grades, less motivation – that might point to a cause for concern in teens. Dr. Elliott recommended that parents speak to their children early and often about the dangers of marijuana. Her encouragement to parents? Keep an ongoing dialogue, stay calm, and set clear expectations and boundaries. And if their teens do start using marijuana, find out why.  

“If they’re feeling stressed, let’s get them into therapy. If they need help sleeping, let’s go talk to our pediatrician and get the sleep addressed,” Dr. Elliott said. She pointed to the good news of hope for families who stay vigilant regarding drug use, social media and mental health in general.

“Parents need to increase their awareness and be hyper alert to this as being an issue. And to create that dialogue and open communication and to be willing to seek help, because if you’re willing to seek help, it teaches your child healthy coping tools.”

About Cook Children's Behavioral Health Program 

Growing up in today's world is hard, and many children or teens may go through life experiences that cause them to feel anxious, depressed or even suicidal. It can be hard for parents and caregivers to know when to ask for help. The Behavioral Health Center at Cook Children’s brings all services together in an expanded space to provide a dedicated team of physicians and professionals with the facilities, resources, tools and programs that deliver the high-quality treatment these vulnerable children need and deserve.

Cook Children's Behavioral Health (cookchildrens.org)

Compassionate Cultivation will be the first of the three licensed dispensaries to open in the state, but will be followed, in theory, by the other two companies that received licenses last year under the Texas Compassionate Use Act, which was passed in 2015.

Watch the story here. 

The bill required DPS to license at least three dispensing organizations by Sept. 1, 2017, should they meet requirements.

On Feb. 8, 2018, the first medical dispensary in the state of Texas will open.

What does all of this mean for children with epilepsy?

1. What is it in the cannabis plant that helps treat epilepsy?

The truth is we don’t yet really know. There are over 500 chemical compounds in the cannabis plant and over 100 of them are plant-based cannabinoids (phytocannabinoids) which may interact with the endocannabinoid system of the human body and treat disease. Cannabidiol (CBD) is a non-psychoactive component (i.e. does not produce a “high” feeling) and has been most widely studied so far for epilepsy. It does not interact with either of the two known cannabinoid receptors in the brain and its mechanism is still unclear. Tetrahydrocannabidiol (THC) is the component in the plant that produces a high and does interact with the cannabinoid receptors, but for many reasons, is not likely to be a good choice as an antiepileptic compound.

2. What is CBD oil and what types of CBD oil are now legal in Texas?

A CBD oil is an oil made from a cannabis plant that is high in CBD and typically lower in THC. The oil may contain amounts of multiple other compounds found in the plant as well. The 2015 Texas Compassionate Use Act allows for “high” CBD (more than 10 percent by weight)/”low” THC ( less than 0.5 percent by weight). This is slightly higher than the amount of THC (less than 0.3 percent) allowed in a plant to be considered hemp. Hemp oils are produced from these lower THC plants and are often a poor source of CBD but have been legal and widely available.

3. People on the Internet already say CBD oil works, so why aren’t all doctors OK with using it over typical medications prescribed for seizures?

All FDA approved antiepileptic medications have gone through rigorous studies to prove they work and they are safe to use. The studies are blinded and placebo-controlled which means neither the doctor nor the patient knows whether they are getting the real drug or a placebo until the study is complete. This helps remove bias (i.e. people feeling like their seizures are better because they know they are taking the real drug). It also helps separate which side effects are due to the drug and which occur randomly in the course of life (for example fevers, rash, nausea which can occur commonly regardless). CBD has only recently been tested in this type of rigorous study – more on this later – and the other components of the plant lack this type of research so far.

4. If CBD has already been studied, why are some doctors still hesitant to recommend CBD oil?

When people are treated with typical antiepileptic drugs, they are taking a single compound, like carbamazepine or levetiracetam for example. When you get a CBD oil, you get a substance that may have a high amount of CBD, but it also can contain varied amounts of the multiple other compounds from the plant. We do not know how effective and safe those other compounds are, so we must be cautious to recommend it to treat your child. Currently, there are no testing standards to make sure the CBD oil you get from a company contains what the label says, thus the formulation may change some from month to month – something akin to getting a different generic antiepileptic medication each month. While all CBD oils contain the similar CBD compound, they may be produced from different types of plant, using different growing techniques/conditions, and manufactured with different processes – thus creating different medications with different other compounds included. Think of it as being prescribed a sodium-channel drug like carbamazepine, but potentially getting one of multiple other sodium channel drugs such as oxcarbazepine, phenytoin, rufinamide, lamotrigine, etc. So doctors aren’t necessarily averse to CBD oils, we just have to be realistic about their limitations.

5.What did the studies of CBD show?

First, understand that the Greenwich Biosciences CBD compound Epidiolex is not the same as the CBD oil you get from a dispensary. It is a nearly pure CBD substance produced under strict standards to ensure the drug is the same with every batch. In 120 patients with Dravet syndrome, 43 percent on CBD had more than 50 percent reduction of convulsive seizures versus 27 percent on placebo. This was actually not a statistically significant difference. In 171 patients with Lennox-Gastaut syndrome, 44 percent on CBD had more than 50 percent reduction of drop seizures versus 23.5 percent on placebo and this was significant. From these results we can conclude that CBD does appear to have some antiseizure effect, but it is not necessarily any better than most other available drugs. It is also not without side effect, as diarrhea (19%), sleepiness (15%), fever (13%), decreased appetite (13%), and vomiting (11%) were reported. So CBD is an option for epilepsy treatment, but is not likely to cure every patient.

6. How does the Texas Compassionate Use Act work?

Under this law, doctors can register to recommend CBD oils only to patients with intractable epilepsy. To register, a doctor must be board certified in Neurology or Child Neurology and must also be certified in Epilepsy/Neurophysiology or spend more than 50 percent of their practice treating patients with epilepsy. If a registered doctor feels CBD oil is appropriate for their patient because the patient has tried all reasonable, better-studied and available treatment alternatives, the doctor can recommend an amount of CBD to be taken. This recommendation must be approved by a second registered doctor who reviews the case and agrees with the decision. Registered patients can then go to one of three dispensaries in the state to get a CBD oil.

7 .Will the CBD oil be covered by insurance?

No. As this is not an FDA approved treatment, it is unlikely any insurance company will cover the cost. The price is typically several hundred dollars per month depending on the amount of CBD recommended.

8. Now that we have this law, it is legal right?

The cannabis plant and all the components of the plant remain a schedule 1 substance on the Drug Enforcement Agency’s list- meaning it has no medicinal value and is illegal. CBD is part of the plant and still falls under this category for federal law despite what a state law may say. While the 2013 directive from the Department of Justice indicated they had better things to do than prosecute people following the laws of their state, Jeff Sessions reversed this opinion several weeks ago – thus it is unclear how the federal government will choose to deal with CBD oils now.

9. When will a pharmaceutical grade CBD oil be available?

Greenwich Biosciences has submitted their drug, Epidiolex, to the FDA for approval December 2017. While the FDA could take years to rule, they have indicated their plan is to rule on approval by summer 2018. Once approved, this drug would be obtained from a pharmacy, prescribed by a doctor, and more likely to be covered by insurance.

Previously on this topic:

• Texas legalizes non-euphoric cannabdiol for seizures in epileptic patients
• Drug in Cook Children's epilepsy trial shows positive results in separate trial
• Success in CBD study: Cook Children's researchers play a vital role
• Cannabis oil trial ongoing at Cook Children's
• Study: Cannabis Oil Can Dramatically Decrease Epileptic Seizures

The Food and Drug Administration has published results of an ongoing study that found cannabis oil can dramatically decrease the number of seizures in some epileptic children.

A Fort Worth family, who is part of the trial, says it changed their lives.

Read the full story here.

When you get past the years of hard work, science and sacrifice of the families involved, the largest study in the world of cannabidiol (CBD) comes down to that one word.

Cook Children's participated in GW Pharmaceuticals latest Phase 3 clinical trial for Epidiolex, a cannabidiol-based oil used to treat children with Lennox Gastaut syndrome, a rare form of childhood epilepsy.

GW Pharmaceuticals announced positive results for the completed study of adjunctive Epidiolex (cannabidiol) in the treatment of drop seizures in patients with Lennox Gastaut syndrome (LGS, GWEP1414).

Patients taking 20mg of Epidiolex saw seizures drop an average of 42 percent compared to a drop of 17 percent in patients taking a placebo. Patients taking 10mg of Epidiolex experienced a 37 percent drop in seizures versues the 17 drop among those taking the placebo.

For Scott Perry, M.D., medical director of the Epilepsy Monitoring Unit and Genetic Epilepsy Clinic at Cook Children’s Jane and John Justin's Neurosciences Center, taking part in a study of this magnitude is the conclusion of more than a decade of his life’s work.

The study enrolled 171 children (average age of 15) from around the world with Lennox-Gastaut Syndrome. Ten of those patients were from Cook Children’s.

Of the patients who completed this trial, 99 percent have opted to continue into an open-label extension trial. The success has prompted GW to seek Food and Drug Administrative approval to make the drug available for prescription by physicians.

With the results from GW Pharmaceuticals showing positive results, there is hope that this may be the answer that parents with children who have hundreds of seizures a day have been looking for.

“The Epilepsy Foundation is thrilled to learn about the recent preliminary results for an innovative new therapy from GW for LGS. LGS in so many cases is extremely difficult to treat, and is an incredible challenge for children and families. We feel a tremendous sense of urgency to stop seizures, and believe that the pursuit of new therapies offers hope to individuals who have no currently available therapy to effectively stop their seizures. The Epilepsy Foundation will continue to be a champion for GW’s efforts to pursue this innovative new therapy as studies progress. We thank GW and all our partners who invest in a better tomorrow for people with epilepsy,” stated Philip Gattone, President and Chief Executive Officer of the Epilepsy Foundation.

Further data will be presented in future publications and medical meetings.

Cook Children’s has participated in three studies that examine CBD as a treatment for severe cases of epilepsy. The worldwide studies gathered data to see if CBD is an effective form of treatment for two uncontrollable forms of epilepsy – Lennox-Gastaut syndrome and Dravet syndrome.

To learn more about the use of CBD, four families graciously agreed to allow us to follow them during the trial, involving Lennox-Gastaut syndrome. These are their stories.

Jordyn's story

At 15 years old, Vanessa Castro was a teen mother. Her daughter, Jordyn, was diagnosed with a rare form of epilepsy Lennox-Gastaut syndrome when she was an infant

Through it all, Vanessa never gave up on her daughter and her fight to see her little girl get better.

At 14 years old, Jordyn had the developmental abilities of an18 month old. She suffered 50 to more than 100 seizures per day and lived on multiple medications, none of which worked.

"If you’re a parent of a child with epilepsy, you know the routine: you start a new medication and the seizures reduce (if you’re lucky) and then a few months go by and they start to increase again," Vanessa said. "Over the years, your hope starts to diminish and you come to realize that this is your child’s life. Not to mention you live in constant fear because you never know if or when that one seizure will come and take your child from you."

Following brain surgery, Jordyn had a stroke that left her paralyzed. After months of rehab, she regained the ability to walk again. Unfortunately, the seizures continued.

Jordyn could only go a day or two, without having a seizure. But there were also days with more than 50 seizures. At a neurology appointment, Dr. Perry approached Vannessa about the CBD study.

The first appointment went from 9 a.m. to 5 p.m., and that was just the screening to make sure Jordyn could even partake in the program. Multiple day-long appointments followed. The study's structure was a challenge for the single mom.

"I have to call every day between 8 p.m. and midnight to report the type and quantity of seizures, which takes about 5-10 minutes," Vanessa said. "If I miss more than two calls, we are kicked out of the program. I work full-time and have two children, so my time is managed wisely. Remembering to call has been a challenge because by the time I’m done with family time, it’s 9 p.m. and I’m ready for bed. But I continue to try my best because my daughter deserves it."

But as time progressed, Vanessa saw results. It began with her daughter going four days with only one seizure. Then she went one full week seizure-free.

Even though this was a blind study, meaning she wasn’t sure if her child was actually receiving the drug or a placebo, Vanessa had little doubt her daughter was taking the medication because of the amazing success she saw throughout. Now, in the next open-label phase, she knows her daughter is taking the medication.

Although it may be the norm for most moms, watching her daughter walk to the bathroom and turning on the light by herself is nothing short of miraculous.

Rikki's story

From 2013 to before the trial, Rikki Adan took at least 13 medications to control his seizures.

Rikki suffered his first seizure at 3 months old in February 2013 and finally after battling Lennox-Gastaut syndrome for nearly three years, the family learned they would be a part of the CBD trial.

"We were all happy that maybe, just maybe, this medication would help my son,” said Sandy Adan, Rikki’s mother. “But sad, scared, upset and nervous also. But words of wisdom from my Jasmine, my daughter helped us. 'Mom, you have given him so many other medications, what if this is the one? If we don't try it, we'll never know.'”

The family began the study in August 2015. The first 30 days were hard, keeping a log of every seizure. For Sandy, mother of four, it made it difficult to keep up with a busy household and continue to chronicle Rikki's seizures.

The seizures impact the entire family. Virginia, age 12 and Rikki's sister wrote, "When I was first told my baby brother had epilepsy, I was really worried. I didn't really know what epilepsy was. When it was explained to me, I understood, but I still questioned why? I know that it is completely OK to be worried, but we still have to stay strong. He is a blessing and we will never give up on him."

The family made it through the trial and continue to take the medication. They are seeing results. Although his seizures aren't fully controlled, Sandy said she has seen a significant change in the severity and frequency of the seizures.

Cody’s story

Cody Tabor, 12 years old, hit all of the milestones one would expect from a normal, well-developed child as a baby. Then, just like that, everything changed.

When he was 19 months old, Cody woke up one Sunday morning with a high fever. His mom, Tess, took him to an ER in Jasper, Texas, and he was admitted. He received antibiotic shots every four hours. 

The next day Tess believed that Cody was on her way to recovery and she would be going home soon. Then she got one of the great shocks of her life.

“As I turned to pick up the phone, I heard a noise,” Tess said. “I turn back around to look at Cody and he was in the rocking chair. He had the most terrifying look on his face. To this day, I will never forget that look. It was the scariest thing I have ever seen in my life. I picked him up ran out of the hospital room screaming, ‘What is wrong with my baby? What is wrong with my baby?’”

Cody was having a seizure. The medical team ran back in the room with Cody, trying to help him. Tess stayed out in the hall scared and crying.

After his initial seizure, things seemed to be snowballing downhill for Cody. He had side effects to a medication that gave him near paralysis. He couldn’t move, even to roll over. Tess said it was “like all the muscles in his body just disappeared.”

In a matter of a few days, Tess, a single mom at the time, watched her normally developing baby suddenly having hundreds of seizures at a time.

Doctors told Tess that Cody did not have much longer to live and that everyone should begin saying their goodbyes.

Tess credits her faith for helping her cope with the way her life had suddenly turned upside down. For the next couple of years, Tess and Cody spent more time in a hospital in Houston than they did at their own home.

Life got better for Tess, but much more hectic. She married her husband, Tommy, and adopted his three kids. They moved to Lubbock, Texas in 2007.

Things were looking up for Cody too. He was going to school, taking speech therapy, physical therapy and occupational therapy. But he still suffered from seizures. After one particular bad one, he was air lifted to Cook Children’s where “we found the providers we love,” Tess said. “So that is where we stay to this day.”

It was then that Cody met Dr. Perry, who diagnosed Cody with Lennox-Gastaut syndrome. From there, other diagnoses came fast – cerebral palsy, developmental delays, innocent heart murmurs and immunoglobulin A (IGA) deficiency.

Tess was frightened at what she had learned about Lennox-Gastaut and yet relieved that at least now this thing that had plagued her son had a name and maybe they could fight it.

The next six years were filled with frustration and struggles. Cody’s treatment included trials of 13 different seizure medications twice daily, but the seizures continued.

It got to the point where Tess felt there was nothing left to do for her son.

“He has been on every medication that I am aware of out there, he has had the surgery to separate the two sides of his brain, he has had the vagal nerve stimulator surgery and nothing has worked,” Tess said.

She would try anything to bring back the little boy she’d known before the seizures began.

Then last fall, she found her first glimmer of hope in a long time when Dr. Perry told her Cook Children’s would be in a clinical trial for cannabidiol treating Lennox-Gastaut.

“My biggest concern about the trial was failure,” Tess said. “I was scared that the oil would not work or help him. If this oil fails then what happens to my son? Where do we go from here? How does he get better? These are questions that I have every day, scared to death that this oil is going to be another failed attempt to help him. It has to work. It just has to.”

Tess said her prayer is a simple one – for Cody to have a better life in some way being big or small. And she also hopes that this trial will make a difference for children in the future.

“I want every parent to be able to have the choice in trying the oil when nothing else has worked,” said Tess. “I want what we are doing to make a difference and make a pathway for others. The oil can help with so much more than seizures. It can help others out there that hit a wall with traditional treatments.”

Cody is currently in the open-label trial.

“Cody has not shown as much improvement as other participating patients in the trial,” Dr. Perry said."Unfortunately, this suggests not every patient is going to improve significantly on CBD treatment."

Jaxon's story

When Jaxon Lane Huffman was born on Dec. 17, 2010, he looked to be perfectly healthy boy.

At 2 ½ months  old,Jaxon's parents woke up to notice he was having "weird movements" while he was sleeping. Doctors told the Huffmans that their son was probably suffering from acid reflux.

The Huffmans began to video Jaxon's movements while he was sleeping. After confirming he was having seizures, Jaxon's pediatrician sent the family to a hospital where he could be monitored for epilepsy.

Later that day, Jaxon was diagnosed with simple partial seizures with an unknown cause at that time. Jaxon was prescribed Phenobarbital for his seizures. He responded well to the medication, and continued to develop like any other baby boy would.

He was seizure-free on the medication, and his parents were hopeful that this was the end of the seizures for their son. Little did they know, that this was only the beginning for Jaxon. Things would soon get worse.

At 6 months old, Jaxon's seizures began again and this time he was having as many as 100 consecutive spasms. The seizures increased in length and he was diagnosed with infantile spasms (sudden bending forward of the body with stiffening of the arms and legs). 

Neurologists tried several medications, but Jaxon suffered several side effects, including high blood pressure, a swollen face and weight gain. Frustrated, the Huffmans took their little boy to Cook Children's.

Dr. Perry found that Jaxon had atrophy of his brain and abnormalities in several areas.

"I cannot describe the feeling when we heard the news," Jennifer said. "As a parent, you have these hopes and dreams for your child to live a wonderful life. Not only was our child not developing, but now we find out that his brain is not developing properly. All we knew to do from that point on was to pray.”

Jaxon tried numerous treatments and was up to four seizure medications or more at a time, but the seizures continued. He also participated in physical therapy, occupational therapy and speech/feeding therapy two times each per week.

At age 4, Jaxon had very little head control, no trunk control, no use of his arms or legs, and was non-verbal. He had no muscle tone, and was not able to sit, crawl, stand or walk. He had 20-40 cluster seizures every day, which consisted of up to 100 spasms per cluster at times. He had three to five grand mal seizures daily and in some cases, stopped breathing.

After much discussion with Dr. Perry, Jaxon was referred to palliative care. "We have exhausted all treatment options for Jaxon at this time," Jennifer said. "We are asking for the opportunity for Jaxon to be able to try CBD. This is the only option left for Jaxon.”

Following the first 12 weeks of the trial, Jennifer saw little difference in Jaxon. Convinced that her son had been on the placebo, the family continued the next phase of the trial. This time they knew Jaxon would receive the CBD oil. 

Since going on CBD, Jennifer has seen Jaxson's seizures decrease by as much as 50 percent. Jaxon still has clusters of seizures, but they are dramatically reduced. Where he once had 20 to 40 clusters a day, he now has an average of about six or seven. It now takes a week or more to have the same amount as he had in one or two days previously. He hasn't had a Grand mal seizure in close to three weeks. 

The decrease in seizures has brought a sense of peace and normalcy that the Huffmans hadn't experienced in a long time. Jaxon is moving more, making noises and laughing more. He has stood in his walker and even moved it for the first time since the family brought it home when Jaxon was 2 years old. 

Perhaps, most importantly, he's sleeping through the night on most nights. Before, the family, including Jaxon's brother and sister, would wake up because of seizures during the night. 

"It's definitely been less stressful," Jennifer said. "Getting through most nights without the constant interruption of seizures has been a huge help for all of us. Knowing that he's getting rest and a good night sleep, honestly, that's the thing that means the most to us right now."

Jennifer said she went into the trial with realistic expectations. She didn't expect it to be cure all, but hoped that it would improve Jaxon's quality of life and that's what she has gotten for her little boy.

"I would have loved for it to have completely stopped his seizures," Jennifer said. "That would have been great. But I knew realistically that probably wasn't going to happen. Knowing that going in, this has not felt like a disappointment for us. We treasure all the little victories we've had during the trial."

The future

Dr. Perry said the inititial research into CBD as a treatment of epilepsy is likely just the tip of the iceberg. He said there's enough evidence to suggest that CBD warrants further investigation as a therapy, but not enough enough evidence, yet, to wholeheartedly support it for more common uses until all the reserach is done.

"If the studies prove positive, there will likely be a whole new class of cannabis-derived drugs in the pipeline for the treatment of epilepsy and Cook Children’s will remain intimately involved in researching those treatments," Dr. Perry said. "Research to discover cures for epilepsy is a primary focus of the Cook Children’s Comprehensive Epilepsy program."

Learn more:

• Scott Perry, M.D.
• Jane and John Justin Neurosciences Center 
• Drug in Cook Children's epilepsy trial shows positive results in separate trial
• Texas legalizes non-euphoric cannabidiol for seizures in epileptic patients
• Cook Children's Epilepsy Monitoring Unit

The Texas Department of Public Safety will be responsible for the licensing of at least three dispensing organizations by Sept. 1, 2017 before CBD will be available for patients.

CBD is the non-euphoric component of marijuana and contains no psychoactive properties, so it doesn’t produce a “high.” CBD is not administered by children smoking. It is typically formulated into an oil-based liquid so it can be given by mouth.

Texas agencies will regulate the distribution of the oils to patients whose symptoms have not responded to available treatments and the risks of treatment are outweighed by the potential benefits, according to their epileptologist. The treatment has to be agreed upon by two epileptologists before CBD can be administered.

M. Scott Perry, M.D., medical director of the Epilepsy Monitoring Unit and Tuberous Sclerosis Complex Clinic at Cook Children’s, estimates he discusses with parents and patients the pros and cons of marijuana use for epilepsy three or four times a day at minimum.

Dr. Perry said families are looking for any therapy that works for their child’s uncontrolled seizures once other options have failed, and some have either left the state or had plans on leaving Texas if the bill didn’t become law.

“I think we have seen enough in the other states that have already made CBD available to understand there is potential benefit to CBD use,” Dr. Perry said. “From what we’ve seen in the medical community so far, it’s very encouraging, but more research still needs to be done before CBD is a treatment of choice for most patients with epilepsy. For now, CBD may provide benefit for a small population with intractable (unmanageable) epilepsy, in which other treatments have been unhelpful. I’m glad that this bill will now afford me the same opportunity as other physicians in my field to prescribe CBD to this population of patients in Texas.”

Welcome to today’s drug culture of “code names” and “street terms.” You may not know what those words mean, but more than likely your kids do.

Russell Johnson, a sergeant in the Narcotics Unit for the Fort Worth Police Department, says the world of recreational drug use has changed dramatically from even just a few years ago.

The availability and quantity of drugs has changed. It’s not nearly as hard to obtain drugs today because it’s more accepted and isn’t criticized as much by parts of society.

Johnson says if your child is using drugs, there will be an overall change in behavior and friends. Teens might be more lazy than normal and their grades will drop across the board. “This could be an indicator of something else that’s extremely stressful on a teen’s life too, but when you look at all of them, something is not right,” he said.

Rosanne Thurman, director of Pharmacy at Cook Children’s, believes it’s important for parents to make sure that their kids are aware they shouldn’t take any drug that’s not prescribed by their doctor and to make sure they follow the instructions of the prescription.

“It’s so hard for parents to stay informed on what is happening out there as far as illegal drugs. So, I think you have to talk to your kids a lot from a young age,” Thurman said. “Let them know that just because a friend is doing something, that doesn’t mean you should be doing it too. Along with these drugs that aren’t prescribed, we’ve also seen problems with teens and college-aged kids exchanging prescription medication. So let them know that a prescription is only for the person who has been prescribed the medication from a doctor and should be the only person taking the medication. It’s so important to sit down and talk to your children about these issues and to let them know the dangers that are involved.”

In an effort to help you stay informed, here’s a list of 11 unsafe drugs that are either trending or have been popular recently that parents need to know about:

1. “Beezin”- This most recent trend involves teens rubbing Burt’s Bees lip balm onto their eyelids. The balm contains peppermint oil, which creates a tingling sensation that teens claim enhances the feeling of being drunk or high, helps keep them alert after a long night and increases their attention span. However, this can irritate eyes and even cause an eye infection or swelling. Teens think it’s safe to do this because Burt’s Bees is “natural” and won’t cause any harm, but that is far from the truth.

2. “Sizzurp” – This concoction is made by combining soda, candy and prescription cough medicine with codeine in it. This lethal cocktail is highly addictive because of the sweetness and is supposed to provide the user with a euphoric high. But it is extremely dangerous because it can lead to seizures and possibly cause you to stop breathing. Popular culture, including hit songs and Internet videos highlight this drug and refer to it as “purple drank,” “lean” and “syrup."

3. Caffeine powder – This powdered caffeine is used by teens to enhance their workouts and accelerate the process of weight loss. This substance is extremely easy to overdose on – one serving is a sixteenth of a teaspoon and is difficult for people to measure. According to the FDA, a teaspoon is roughly equal to 25 cups of coffee. Teens assume it’s safe to mix this powder into drinks because caffeine is in sodas, energy drinks and coffee. But high levels of caffeine can lead to rapid heartbeat, seizures and even death. You won’t see this in stores, but it’s cheap and easy to buy online.

4. E-cigarettes – This electronic form of cigarettes are battery-operated devices that produce flavored nicotine that look and feel like tobacco smoke. Even though e-cigarettes do not contain tobacco, they still supply nicotine which is a highly addictive drug. But still, e-cigarettes are legal for adults. Some teenagers have used e-cigarettes to smoke marijuana and replace the nicotine with THC. Synthetic marijuana in liquid form can be ordered from the Internet and the user can get a high that is extremely potent because there is no method of dose control.

5. Club drug: MDMA – This stimulant enchants users because of its euphoric and energetic effect. It can come in a crystallized powder form “Molly” and in pill form “ecstasy.” Teens and young adults take this drug at raves, nightclubs and concerts to dance vigorously and heighten the feelings of emotional closeness. However, taking this substance can lead to dehydration, high blood pressure and severe rises in body temperature. It also can result in complications including heart attacks, heart failure, strokes and kidney failure.

6. Club drug: Rohypnol – This substance is commonly known as the “date rape drug.” At parties, people secretly place the drug in drinks. Due to the strong amnesia produced by the drug, victims have limited or no recollection of the night after taking the substance. This is why it is crucial to never take your eyes away from your drink. This drug also is referred to as “roofies” and “forget-me pill.”

7. Synthetic weed – This fake weed is a popular option for teenagers because it doesn’t show up in drug tests like regular weed. But it is incredibly unsafe and toxic because as chemists synthesize the weed, it becomes stronger and up to 80 times more potent than regular weed. There are several detrimental side effects including extreme agitation, anxiety/paranoia, vomiting, hallucinations and even brain damage. "Spice," "K-2" and "Yucatan Fire" are names associated with it.

8. Bath salts – This substance is not what we put in our bathtubs. People inject it, snort it and mix it with food or drink to receive a euphoric high. But it also can make users hallucinate, execute violent behavior and have suicidal thoughts. Watch out for these street terms: “Ivory Wave," "Purple Wave," Vanilla Sky" and "Bliss.”

9. Prescription drug: Xanax – This pill is prescribed to alleviate anxiety and panic disorders. It is extremely addictive and highly abused. Teenagers mistakenly believe that because it’s a prescription drug, it’s safer than street drugs and is free from harmful side effects. The most common street names are “bars” and “Z-bar."

10. “Huffing” – This term refers to purposefully inhaling chemical vapors to get high. Users will inhale several household items including nail polish remover, glue, felt-tip markers, spray paint, hair-care products and deodorant. This practice is not healthy and initially causes drowsiness, lightheadedness and loss of inhibition.

11. Palcohol – this new product is freeze-dried alcohol in powder form. It is packaged in small packets which makes it easy to prepare a to-go drink. But the risk of abuse and misuse is high because the accessibility of the packets could stimulate over-consumption of alcohol and lead to drunk driving. This powdered substance can be snorted as well and cause an immediate high with other harmful side effects.

*Article written by Amanda Burmeister