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JAMA Health Forum. 2023;4(1):e225041. doi:10.1001/jamahealthforum.2022.5041
Key Points
Question What is the association between legalization of recreational cannabis edibles and unintentional pediatric cannabis poisoning?
Findings This cross-sectional study of all children (n = 3.4 million) aged 0 to 9 years across 4 Canadian provinces found that jurisdictions that allowed the sale of cannabis edibles experienced much larger increases in cannabis poisonings and proportions of overall poisoning hospitalizations due to cannabis than the jurisdiction that prohibited edibles.
Meaning These findings suggest that restricting the sale of legal cannabis edibles may be a key policy to prevent unintentional pediatric cannabis poisonings following legalization.
Abstract
Objective To evaluate changes in proportions of all-cause hospitalizations for poisoning due to cannabis in children during 3 legalization policy periods in Canada’s 4 most populous provinces (including 3.4 million children aged 0-9 years).
Exposures Prelegalization (January 2015 to September 2018); period 1, in which dried flower only was legalized in all provinces (October 2018 to December 2019); and period 2, in which edibles were legalized in 3 provinces (exposed provinces) and restricted in 1 province (control province) (January 2020 to September 2021).
Main Outcomes and Measures The primary outcome was the proportion of hospitalizations due to cannabis poisoning out of all-cause poisoning hospitalizations. Data analysis was performed using descriptive statistics and Poisson regression models.
Results During the 7-year study period, there were 581 pediatric hospitalizations for cannabis poisoning (313 [53.9%] boys; 268 [46.1%] girls; mean [SD] age, 3.6 [2.5] years) and 4406 hospitalizations for all-cause poisonings. Of all-cause poisoning hospitalizations, the rate per 1000 due to cannabis poisoning before legalization was 57.42 in the exposed provinces and 38.50 in the control province. During period 1, the rate per 1000 poisoning hospitalizations increased to 149.71 in the exposed provinces (incidence rate ratio [IRR], 2.55; 95% CI, 1.88-3.46) and to 117.52 in the control province (IRR, 3.05; 95% CI, 1.82-5.11). During period 2, the rate per 1000 poisoning hospitalizations due to cannabis more than doubled to 318.04 in the exposed provinces (IRR, 2.16; 95% CI, 1.68-2.80) but remained similar at 137.93 in the control province (IRR, 1.18; 95% CI, 0.71-1.97).
Conclusions and Relevance This cross-sectional study found that following cannabis legalization, provinces that permitted edible cannabis sales experienced much larger increases in hospitalizations for unintentional pediatric poisonings than the province that prohibited cannabis edibles. In provinces with legal edibles, approximately one-third of pediatric hospitalizations for poisonings were due to cannabis. These findings suggest that restricting the sale of legal commercial edibles may be key to preventing pediatric poisonings after recreational cannabis legalization
Source: JAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum
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JAMA Psychiatry. Published online November 23, 2022. doi:10.1001/jamapsychiatry.2022.3915
Question Is there an association between adolescent high-dose Ä9-tetrahydrocannabinol (THC) exposure and cognitive vulnerability in adulthood?
Findings In this rat model, high-dose THC exposure during adolescence resulted in risky decision-making and impulsivity in adulthood, similar to results from reanalyzed data from 37 human chronic cannabis users, an association enhanced by acute THC reexposure. Adolescent THC exposure induced cell-specific and layer-specific changes in cannabinoid-1 receptor gene expression and astrocyte perturbations in the amygdala and prelimbic cortex.
Meaning These results emphasize significant neurobiological outcomes of high-dose adolescent THC exposure and cognitive vulnerability in adulthood.
Abstract
Importance Although perceived as relatively harmless and nonaddictive, adolescent cannabis use significantly increases the likelihood of developing cannabis use disorder in adulthood, especially for high-potency cannabis. Risky decision-making is associated with chronic cannabis use, but given confounds of human studies, it remains unclear whether adolescent cannabis exposure and Ä9-tetrahydrocannabinol (THC) potency specifically predicts risky decision-making or influences cognitive response to the drug later in life.
Objective To leverage a human data set of cannabis users and a rat model to evaluate the long-term outcomes of adolescent THC exposure on adult decision-making and impulse control.
Conclusions and Relevance In this translational study, high-dose adolescent THC exposure was associated with cognitive vulnerability in adulthood, especially with THC re-exposure. These data also suggest a link between astrocytes and cognition that altogether provides important insights regarding the neurobiological genesis of risky cannabis use that may help promote prevention and treatment efforts.
(Source: JAMA Adolescent Psychiatry )
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The latest study involved nearly 340,000 reports to poison centers involving all drugs over 20 years. Researchers looked solely at those involving children aged six to 18. They found cases involving marijuana rose the quickest of any substance, replacing alcohol in 2014 and rising fastest between 2017 and 2020 — when weed began to be decriminalized at the federal level – The sharpest surge in marijuana use was between 2017 to 2020, rising by about 40 percent in three years.
- Researchers in Oregon looked at 338,000 cases of intentional abuse or misuse
- Found marijuana has been leading cause of poisoning for children since 2018
- Researchers warned it was linked to legalization making drug more accessible
- Marijuana is considered particularly dangerous for young, developing brains and maypermanently change their structure leading to a loss of IQ.
Dr Adrienne Hughes, an emergency medicine expert at Oregon Health and Science University who led the study, said: 'These findings may reflect the impact of rapidly evolving cannabis legalization on this vulnerable population.
'Along with increasing cannabis legalization, we are also seeing the emergence of alternative modes of consumption, especially non-combustible products such as edibles and vaping devices. 'These edible products and vaping products are often marketed in ways that are attractive to youth, can be used with more discretion, and are more convenient. 'A focus group study with teenagers found that edibles were attractive to those concerned about smoking or the smell associated with smoking marijuana.'
(Source: Child marijuana use has soared 250% in last 20 years - replacing alcohol )
See Also, Women in States that Legalize Cannabis are Five times More Likely to Use Cannabis While Pregnant
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by Prabhjot Sohal, University of Western Ontario
Schulich School of Medicine & Dentistry researchers have shown that chronic exposure during adolescence to tetrahydrocannabinol (THC), the main psychoactive component of cannabis, may induce long-lasting memory impairments and increased anxiety levels.
The study, published in the journal Neuropsychopharmacology,NeuropsychopharmacologyThe study, published in the journal Neuropsychopharmacology, uses a rodent model to pinpoint two different parts of the brain—the dorsal and the ventral regions in the hippocampus—and shows evidence of different sets of abnormalities in each region following THC exposure.
The researchers identified several key molecular and neuronal anomalies in specific regions of the hippocampus that might be independently responsible for the cognitive and emotional side effects. The study confirms previous work from their lab that shows THC exposure during adolescence can induce long-lasting disturbances.
"Following the legalization of cannabis, there is evidence of a reduction in perceived risks associated with cannabis use. There is a need to expand knowledge on the potential negative consequences of cannabis exposure during adolescence and this study addresses some of those gaps," said Marta De Felice, who emphasized the need to have crucial scientific evidence to inform public health policy
"Adolescents consuming cannabis may not be thinking of the negative long-term impacts. Our findings suggest adolescent cannabis use may affect cognitive and emotional functions through different brain pathways," said Laviolette. "The detailed anatomical findings of the study give us a chance to use more targeted interventions that might reverse the long-lasting impairments and symptoms following cannabis exposure during adolescence."