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Toxic Tetrahydrocannabinol (THC) Dose in Pediatric Cannabis Edible Ingestions

Lesley C Pepin1, Mark W Simon1, Shireen Banerji1

  • 1Rocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, Colorado.

Pediatrics
|August 28, 2023
PubMed

Insights

Edible cannabis toxicity in children under 6 is linked to tetrahydrocannabinol (THC) dose. A dose of 1.7 mg/kg THC predicts severe and prolonged toxicity, guiding medical care.

Area of Science:

  • Pediatric Toxicology
  • Cannabis Pharmacology
  • Public Health

Background:

  • Edible cannabis products pose risks to children, with toxicity varying by tetrahydrocannabinol (THC) content.
  • Understanding the dose-response relationship is crucial for managing pediatric ingestions.

Purpose of the Study:

  • To characterize cannabis toxicity in relation to THC dose in young children (<6 years) who ingested edible cannabis products.
  • To identify a potential THC dosage threshold predicting severe or prolonged toxicity.

Main Methods:

  • Retrospective review of pediatric patients (<6 years) with known edible cannabis THC ingestion doses.
  • Toxicity classified as severe (cardiovascular, respiratory, neurologic effects) or prolonged (>6 hours).
  • Multivariable logistic regression and ROC curve analysis to determine THC dose as a predictor.

Main Results:

  • Eighty patients included; median age 2.9 years, median THC ingestion 2.1 mg/kg.
  • Severe and prolonged toxicity observed in 46% and 74% of cases, respectively.
  • THC dose significantly predicted severe (aOR 2.9) and prolonged toxicity (aOR 3.2); ≥1.7 mg/kg THC predicted severe (97.3% sensitivity) and prolonged toxicity (75.4% sensitivity).

Conclusions:

  • Tetrahydrocannabinol (THC) dose in edible cannabis directly correlates with toxicity severity in children under 6.
  • A THC ingestion threshold of 1.7 mg/kg may inform clinical management and regulatory measures for pediatric cannabis exposure.
Abstract

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