Big concern: Keep pot-laced candies away from kids

[00:00:00] Host Amber Smith: Here's some expert advice from Dr. Michael Hodgman, a toxicologist in Upstate's department of emergency medicine, and the Upstate New York Poison Center. What's important to know about marijuana edibles?

[00:00:14] Michael Hodgman, MD: Edible products are the growth industry or growth product for marijuana producers, you might say. For example, in Canada, they legalized marijuana. I don't recall the (year) maybe 2019 or so. But it was about a year later before retail sales were allowed in Ontario, and on the first day there were retail recreational marijuana products for sale the stores in Ontario sold out of edible products. I mean, it was, it was crazy.

And we're seeing the same thing in other states where the products that are having the greatest year-to-year change in growth are these edible products. These edibles are very attractive. They look like candy. They look like food. There's infused beverages. We've even had a few cases with infused hot sauce, infused barbecue chips. I mean, it's just crazy.

I think the No. 1 exposure product that we get called to the poison center are gummies. I mean, they're just unbelievably popular. And again, they're easy to leave laying around, and these young kids get into them, and it's been a real issue.

Our real focus is on prevention, and particularly in young kids with edibles. And so, in the home, what we encourage is to treat this like any other drug when you have young kids in the house. And that's doing things to keep them out of reach of children. And one thing we in particular support here is the use of a lockbox, like you might for your medications. Use a lockbox to keep your edibles in it as well, and try and reduce that potential that one of your kids is going to accidentally get into one of these products.

Here in New York state now that marijuana is legal, there are very specific packaging laws for these products so that the packaging has to be child resistant and tamper-proof. And it has to not be attractive to children. I mean, it's not supposed to look like a candy. You know unfortunately, there's a lot of illicit products out there that violate every one of those rules. So a lot of these products, they're not following the New York State labeling.

But if the label's proper, first of all, it's got to be kind of a bland label with bland font for the print. It can't be like real colorful print or anything. And it has to have what the total amount of THC is in the package, what the unit dose is. There's also rules on the maximum unit dose that's allowable as a recreational marijuana product.

The maximum unit dose for a single dose for an adult is 10 milligrams. And so the product has to have that, the total dose. It also has to have precautions on it about the differences in when you experience the clinical effects when you ingest THC (tetrahydrocannabinol) versus when you smoke it.

When you smoke marijuana, the absorption through the lungs is very rapid to the brain, and the clinical effects are within minutes. When someone ingests a THC edible, the onset of clinical effects may not be for 60 to 90 minutes after you ingest the product. And there's a real risk there. Somebody can take it and a half hour later say, "huh, nothing's happened. I'm going to eat another one." This is something we call dose stacking. And so by the time you start getting the effect from the first one, then there's more after that. So the onset of effects is delayed, and that can affect anyone who's not aware of that. And the duration of effects from edibles is more prolonged than it is from smoking because, again, when somebody smokes it, they have the clinical effect very rapidly. And so they're able to titrate the effect because then they stop. Whereas with these edibles, if you've still got more that's going into your system, it can last a lot longer.

The other problem with young kids is whatever a unit dose is, that's a big dose for a little child. When you consider that a 10 milligram dose is what an adult should get. You get a 2-year- old that takes that same dose, that's a lot more. But the problem is also it's a gummy. It tastes good. Or it's a piece of candy. It tastes good. So how many stop with one or two pieces of candy, or how many people have only eaten one barbecue chip? The dose effect in these young kids can be really, really significant.

We don't know, sometimes, how many they took. But if we just consider maybe a 2-year-old child that weighs let's say 30 pounds, or about 15 kilograms that would be. And there have been some estimates that a dangerous dose in a kid that age could be , about 1.7 milligrams per kilogram, or that might be maybe 25 milligrams. So you could say a kid, a young child who just eats two to three gummies, they've already crossed that threshold to the potential for severe intoxication.

A lot of the kids that we see that just get into a few, I mean their clinical course is like you might expect with an adult. They're a little goofy, a little lethargic. Their behavior isn't quite normal. But then the more severe effects, we can sometimes see, is really profound sedation. Paradoxically, some kids will get very, very agitated and restless. And so we can see the whole spectrum of changes there.

[00:05:55] Host Amber Smith: You've been listening to Toxicologist Michael Hodgman from Upstate's Department of Emergency Medicine and the Upstate New York Poison Center.