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Keep Cannabis Ingestions in Mind When Young Children Have Altered Mental Status

October 6, 2023

Cannabis seems to be everywhere these days. On my 1-mile walk to work, depending on my route, I may pass as many as 5 cannabis or marijuana dispensaries. I frequently hear talk about “edibles” that have varying amounts of tetrahydrocannabinol (THC), the substance in cannabis that gives you a high.  

When there is so much easy access to cannabis products, that means that we will likely see more accidental ingestions among children. Alexandra Van Oyen, DO from New York University and her colleagues from the New York City Poison Center, and Northshore University Hospital, remind us to think about THC when we see children who present with altered mental status in their Case Report being early released this week in Pediatrics, entitled “Urine Toxicology Test for Children with Altered Mental Status” (10.1542/peds.2022-060861). 

The authors present 5 cases of children who were 6 years and younger and presented with neurologic signs and symptoms (e.g., lethargy, changes in muscle tone, behavior changes) and who ultimately were found to have THC toxicity.

It is often difficult to get the history of ingestion, as adults in the home may not be aware that the child has ingested a THC-containing product. In some of these cases, it was only after the child had recovered somewhat that they admitted to eating a gummy candy or something similar.

We may be more likely to think about THC in our differential diagnosis for an older child or adolescent, but given the wide access to THC-containing edible products that look like candy, we need to think about urine toxicology screens for THC for the younger children as well.

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