In Canada, recreational cannabis in the form of dried and fresh cannabis, oil, plants, and seeds became legal on October 17, 2018. The federal government has announced that edibles containing cannabis will become legal for sale and purchase on or before October 17, 2019.
Edible products include beer, tea, baked goods, candies, and other options that may lack the social stigma associated with smoking marijuana.
Although cannabis edible products still remain illegal, an increasing number of children have visited emergency departments across the country due to non-fatal cannabis poisoning.
THE DANGER OF EDIBLES
Edibles are manufactured with varying levels of Tetrahydrocannabinol (THC), the active ingredient found in marijuana. They can take the form of any type of food or drink, most often found as a type of candy or baked goods.
A substantial concern arises that children will mistakenly ingest cannabis-infused products for regular food, as they may be unable to read the labels that indicate the product contains THC or may not understand the meanings of the labels.
Unintentional poisoning by cannabis edibles is a risk to younger kids as they appeal to them because they are disguised as harmless enticements, such as brownies or gummies.
Intentional poisoning amongst teens and adults is likely to take place when experimenting with cannabis edibles as they do not realize that absorption takes hours when consuming edibles compared to minutes when smoking. Individuals will likely ingest toxic amounts as they ingest more of a cannabis product when they do not feel an immediate effect.
Teens may also accidentally ingest edibles if they receive them from their friends without being fully informed as to what is in the product.
For edibles, the labelling often does not provide enough information and the serving size is not clearly marked
Signs of cannabis poisoning include agitation, rapid breathing, high heart rate, and elevated blood pressure. Some also exhibit additional symptoms such as anxiety, abnormal behaviour, trouble focusing well or balance difficulties.
Death is extremely unlikely, however it may occur without proper and immediate medical intervention.
There are no medications that can counteract the poisoning by cannabis edibles. In hospital, medical care is provided through respiratory tubes or intravenous fluids as they wait for the patient to come down from the unintentional high.
TAKING A LESSON FROM THE COLORADO EXPERIENCE
In 2014, Colorado became the first jurisdiction in the world to legalize the sale of cannabis for recreational use.
Edibles account for approximately 45% of Colorado’s legal marijuana market.
Following legalization of cannabis, Colorado experienced a 34% increase in unintentional ingestion of edibles by children under the age of nine. Of these cases, 35% required hospitalizations for overdose symptoms.
As a result of this significant spike in hospitalizations related to cannabis, in August 2014 Colorado tightened their rules regarding the unregulated edibles market. They introduced an emergency rule making it illegal to sell cannabis infused products that resemble animals, fruit or people. Also, edibles have to be divisible into smaller servings containing no more than 10 milligrams of THC content. All edible products packaging requires a symbol of a diamond and the letters “THC!” to warn children and unsuspecting adults about the contents of the product. In addition, the words “candy” or “candies” cannot appear on marijuana packaging, unless part of the marijuana establishment’s name.
Colorado has also spent a great deal of money on education campaigns to discourage youth consumption and driving while impaired.
ALARMING PREDICTION FOR CHILDREN
Andrew Dixon (“Dixon”), an emergency pediatrician and professor at the University of Alberta, predicts that children face a higher risk of intentional and unintentional poisoning from edibles.
According to Dixon, there have been two cannabis poisonings this month at Stollery Children’s Hospital in Edmonton. Over the past few years, Dixon has only seen two or three children with cannabis poisoning.
According to the Canadian Institute for Health Information, there have been nearly 600 cases of cannabis poisoning last year for patients under the age of 20 in Ontario and Alberta. These provinces have also had 24 children under the age of four admitted to emergency rooms after eating cannabis edibles last year.
Data from the Canadian Institute for Health Information shows that over the past three years the number of emergency room visits due to cannabis overdoses in Ontario has almost tripled (from 449 in 2013-2014 to nearly 1,500 in 2017-18). In Alberta, the number of emergency room visits due to cannabis overdoses has nearly doubled during the same time period (from 431 in 2013-2014 to 832 in 2017-18).
According to Dr. Margaret Thompson, medical director of Ontario, Manitoba, and Nunavut poison centres and president of the Canadian Association of Poison Control Centres, every poison centre in Canada has reported increased exposure to cannabis.
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