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Striking rise in accidental marijuana poisonings

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Signs and symptoms are nonspecific

Another reason for the rise in accidental marijuana poisonings is the increased potency of the drug currently available in the United States, compared with 40 years ago. THC levels have risen from 2% to nearly 8% during that time, said Dr. William Hurley and Dr. Suzan Mazor.

Physicians may now need additional training to recognize and manage toxic reactions to marijuana. Children can present with anxiety, hallucinations, panic episodes, dyspnea, chest pain, nausea, vomiting, dizziness, somnolence, CNS depression, respiratory depression, and coma, which unfortunately are the same signs and symptoms for other toxicities and disorders.

Emergency medicine, pediatric emergency medicine, and primary care pediatric providers will be the first to see patients accidentally exposed to marijuana. They should be alert to "investigating the availability of marijuana in the child’s environment" and should use a rapid urine test to confirm the diagnosis. "No antidote exists for marijuana toxic reactions, and supportive care should be provided, including control of anxiety, control of vomiting, airway control, and ventilation as needed," they said.

Dr. Hurley is at the University of Washington and the Washington Poison Center, both in Seattle. Dr. Mazor is in the division of emergency medicine at Seattle Children’s Hospital. Neither Dr. Hurley nor Dr. Mazor reported any financial conflicts of interest. These remarks were taken from their editorial accompanying Dr. Wang’s report (JAMA Ped. 2013 May 27 [doi: 10.1001/jamapediatrics.2013.2273]).


 

FROM JAMA PEDIATRICS

Seventeen states and Washington, D.C., have passed laws to decriminalize medical marijuana at the state level, even though marijuana is a schedule I drug under the Controlled Substances Act. "In November 2012, Colorado and Washington [State] passed amendments legalizing the recreational use of marijuana," Dr. Wang and his associates said.

No financial conflicts of interest were reported.

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