Context, people. Context. (pot edibles edition)

From the Washington Post:


Between 2000 and 2006, there was no significant change in the number of children who were reported to have been exposed to marijuana. By the end of that period, medical marijuana was legal in 11 states.

But between 2006 and 2013, the rate of exposure increased by 147.5 percent. Even in states where medical marijuana use isn’t legal, the study found that exposure rates increased, though not as much as in states where it was legal.

In places such as Colorado, which has legalized both medical and recreational marijuana, this is a persistent problem for legalization advocates. Everyone agrees that drugs — like alcohol — should be kept away from kids, but it is unclear how to make edibles less likely to fall into the wrong hands.

First of all, I think that it’s fair to say that “everyone” agrees that pot edibles should be kept away from kids, just like alcohol and other drugs. It may be that edibles are more difficult for kids to distinguish from other substances, but no one thinks that we should just leave them “laying around”. No one serious anyway.

But the main point of this is the huge increase in exposure, especially with legalization. 147% is a big increase. But it’s relative. Let’s go to the study itself:

This study investigates marijuana exposures among children <6 years old in the United States using data from the National Poison Data System. From 2000 through 2013, there were 1969 marijuana exposures among children <6 years old and an exposure rate of 5.90 per million children. The mean age of an exposed child was 1.81 years (median = 1.58 years). The majority of the children were exposed through ingestion (75.0%), and 18.5% of exposures required admission to a health care facility. The rate of marijuana exposure was significantly (2.82 times) higher in states where its use was legalized prior to 2000 compared with states where its use is not legal. Because more states are likely to pass legislation legalizing medical and recreational use of marijuana, increased efforts to establish child-focused safety requirements regarding packaging of commercially sold marijuana products are needed to help prevent more children from being exposed to this schedule I substance.

From 2000 through 2013, there were 1969 marijuana exposures in kids five years of age and under reported to the National Poison Data System. This number did increase from just under 100 in 2000 to almost 250 in 2013.* That’s a 147% increase, yes. But that increase is relative.

Please understand that I’m not minimizing the fact that these numbers are real, and that kids eating pot edibles is a problem. About half of these kids required treatment in a healthcare facility. About 12% were admitted to general hospital wards, and about 7% required hospitalization in a critical care service.

But what concerns me about all of this is a lack of context. I see many articles hyperventilating about the dangers of pot brownies, but almost none on the dangers of other substances left around the house. In 2013 alone, more than 11,000 calls were made to the National Poison Data System for kids five years of age or under for exposure to alcohol. Three children died.

I’m not even talking about the more than 45,000 calls for exposure to antihistamines, or the almost 28,000 calls for antimucrobials, or the more than 25,000 calls for cough or cold medicines. Remember – this paper and article are concerned about the almost 250 calls made for pot edibles. Even when we acknowledge that the number for pot brownies could go up as marijuana becomes more and more legal – there’s still a long way to go to reach these other numbers.

We absolutely should be concerned about kids getting their hands on such things. We should be concerned about kids getting their hands on all things which they shouldn’t, and which could harm them. But if we want to improve the health of children, we should focus on the things that matter – the rate limiting steps – if we really want to make a difference. When I see stories and campaigns that focus on such things, I’ll be a much happier pediatric health services researcher.


*This paper seems to report only percentages and rates in the results, so I’m having to read the actual numbers off the charts. If I’m wrong, someone correct me. A cynical person would say that it’s hard to find actual numbers in the papers because they are really still pretty low, and not nearly as flashy as the relative percentage increases.

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