Marijuana gummies and other edibles are sending more kids to the hospital

A 4-year-old Montgomery County girl began gasping for air one evening in early 2021, and seemed unusually drowsy though it was not yet bedtime. She was rushed more than 15 miles away to Children’s Hospital of Philadelphia, where she was diagnosed with acute respiratory distress and fitted with a breathing mask.

The following year in New Jersey, state officials said a 3-year-old was taken to the emergency room after starting to act “strange.” Upon arrival, the child suffered a seizure.

Both children were part of a dangerous trend: they had eaten products that contained marijuana.

Echoing the findings in a recent national study, poison control centers in Pennsylvania and New Jersey both report a surge in calls for help after children five years old and under accidentally swallowed products containing marijuana — in many cases because the packaging or its contents looked like candy. In both states, calls are up more than 10 times the level just five years earlier, when the problem was almost nonexistent.

In New Jersey, the number of calls climbed to 162 after pot became legal for adult recreational use in 2022, up 64% percent from 99 calls the year before.

And increasingly, the consequences are severe enough that children end up being admitted to the hospital, according to an Inquirer analysis of Pennsylvania hospital billing data.

In 2021, 36 children aged five and under were hospitalized with cannabis poisoning in Pennsylvania, including 16 cases in Philadelphia. This was more than five times higher than in 2019, according to the analysis, drawn from billing codes reported to the Pennsylvania Health Care Cost Containment Council.

Nationally, 1,600 children were hospitalized for complications of marijuana exposure from 2017 to 2021, according to a January study in Pediatrics. In addition to seizures and respiratory distress, complications can include an irregular heartbeat and even a coma, the study found.

The numbers are no surprise to Anthony Jaworski, clinical program manager of the Poison Control Center at CHOP, which fields calls from eastern Pennsylvania and Delaware.

“Not a week doesn’t go by where I’m walking the streets of Philadelphia and I see a candy wrapper, then I take a closer look and in the corner, and I see a little cannabis symbol,” he said. “That’s really concerning.”

Gummies and other marijuana edibles are not legal in Pennsylvania, which allows the sale of the drug only for medical use. In New Jersey, where adult recreational use and edibles both are allowed, state law prohibits pot packaging that resembles candy.

Still, such products can be found for sale on the street, said toxicologist Diane Calello, executive director of the New Jersey Poison Control Center at Rutgers New Jersey Medical School. Once, she saw marijuana edibles that were packaged to resemble the popular candy Nerds Rope.

“Any child who encounters that product is going to eat it,” she said. “Because it looks like something they’ve bought at the drugstore.”

Seizures and comas

Most children recover after accidental pot exposure, and those who are hospitalized generally are sent home within a day or two. Yet in Philadelphia in 2020, two toddlers spent several weeks in the hospital after swallowing marijuana products, the Inquirer analysis found. One suffered a cardiac arrest, and the other was diagnosed with brain damage, apparently as a result of respiratory failure.

And in October, a Virginia woman was charged with murder in the death of her 4-year-old son, who prosecutors said had eaten as many as 15 gummies.

Some physicians have questioned whether the pot alone was sufficient to cause the boy’s death, but there is no dispute that the complications can be severe.

The effects of marijuana are more pronounced in children partly because of their lower body weight, Calello and Jaworski said. The same-sized gummy packs a bigger punch in someone who weighs 30 pounds compared to someone who weighs five times that much.

Children also may be at higher risk because their brains are still developing, said Calello, a professor of emergency medicine at Rutgers. Yet some adults underestimate the risks to children because the drug is so widely accepted.

“People get lulled into a false sense of security because it’s something they’re familiar with,” she said. “But the effects on a young child are different.”

“A lot of people, they may not associate cannabis with making people sick,” Jaworski said. “Children are vulnerable.”

From 2019 to 2021, 60 children aged five and under were hospitalized with accidental cannabis poisoning in Pennsylvania, in most cases at children’s hospitals in Philadelphia and Pittsburgh, the Inquirer analysis found. Some were identified at first only with vague symptoms, including an altered mental state, fatigue, vomiting, or convulsions, before the cause was confirmed.

Prevention

The obvious way to stop kids from ingesting marijuana is to keep it out of their reach, both poison center officials said.

But that isn’t foolproof. Any adult’s attention can wander for a few seconds, long enough for kids to climb on a chair and grab a forbidden item.

That’s why good prevention depends on a multi-pronged approach, just like the combination of masks, vaccination, and social distancing that experts recommended during the COVID-19 pandemic. Recommended strategies include:

“We’re judgment-free,” Jaworski said. “The family doesn’t need to worry about repercussions or anything like that. They should not hesitate to call instead of resorting to Google.”

Medical treatment is essential, Calello said.

“Maybe the child starts acting weird. Maybe they are hallucinating and not making sense, or their eyes are crossed,” she said. “It’s a really harrowing experience. Without question, those children need to be in a hospital in a monitored setting.”