Patient Safety We use this forum to regularly report on findings from patient safety organizations, expert review committees of the Office of the Chief Coroner, and inquests.
Provinces permitting the sale of edible cannabis saw an increase in hospitalizations more than two times higher than provinces that prohibited its sale
Hospitalizations for unintentional cannabis poisonings among Canadian children has surged after legalization, particularly in jurisdictions where the sale of cannabis edibles was allowed.
Canada has seen a 6.3-fold increase in hospitalizations for unintentional cannabis poisoning among children under the age of 10 since the legalization of recreational cannabis, according to a study published in the New England Journal of Medicine.
The study found that hospitalizations for pediatric cannabis poisonings increased substantially across the country. Notably, provinces that permitted the sale of cannabis edibles, such as gummies, chocolates and baked goods, saw an increase in hospitalizations that was more than two times higher than the provinces that prohibited its sale (7.5 times vs. 3.0 times, respectively, from the pre-legalization rate).
These findings are the result of a unique scenario caused by the staggered roll out of cannabis products in Canada and differences in policy approaches to legalization among provinces, said Dr. Daniel Myran, lead author and family physician, public health and preventive medicine specialist, and postdoctoral fellow at the University of Ottawa Department of Family Medicine and The Ottawa Hospital.
In October 2018, dried cannabis flower was legalized across Canada, but the sale of cannabis edibles was initially prohibited. Starting in January 2020, Ontario, British Columbia and Alberta allowed the sale of cannabis edibles. In contrast, Quebec prohibited its sale largely due to their potential appeal to children.
Parents and caregivers need to be aware of potential harms to children and keep edible cannabis products out of children’s reach
Using health records that contained the cause of all hospitalizations in each province, researchers identified pediatric hospitalizations due to cannabis poisoning. During the seven-year study period (January 2015 to September 2021), there were a total of 581 hospitalizations in young children for cannabis poisoning. The average age of these children was 3.5 years.
Prior to legalization, the number of unintentional pediatric hospitalizations for cannabis poisoning per 100,000 children was the same in all provinces. Immediately after legalization, when only the sale of dried cannabis flower was allowed, hospitalization rates in all provinces increased 2.6 times compared to pre-legalization.
During the period when edibles were permitted in Ontario, British Columbia and Alberta, hospitalization rates in those provinces increased a further 2.9 times compared to the initial period following legalization, but remained unchanged in Quebec, where edibles were prohibited.
Dr. Keith Hay, a medical advisor at CPSO, said cannabis intoxication can have significant effects on young children, such as vomiting, behavioural changes, coordination, respiratory depression, and even coma.
As different cannabis formulations are legalized across the country, it is important for everyone, including parents and caregivers, to be aware of the potential harms to children and ensure cannabis products in the home are safely stored in a locked box or container out of children’s reach, and kept separate from regular food and drinks, he said.
The increases in cannabis hospitalizations occurred despite regulations aimed at preventing such poisonings, including THC limits 10 times lower than that allowed in some U.S. regions.
