Accidental cannabis ingestion in young children

A 3-year-old girl was brought to my office by her caregiver because she was not acting like herself. She was excessively sleepy, difficult to rouse, and had poor balance. The caregiver reported cannabis products in the home in the form of gummies the caregiver takes for sleep and anxiety. What symptoms should prompt consideration of marijuana ingestion and how should accidental ingestion be managed?

Cannabis is one of the most widely used drugs in the world. Many countries are decriminalizing and legalizing marijuana, but its negative impact on pediatric health is growing. Current evidence shows unintentional marijuana ingestion and severe toxicity are steadily increasing. Common symptoms of marijuana ingestion in young children are drowsiness, somnolence, nausea, and vomiting, with children being at high risk for severe symptoms of respiratory depression and seizures. Primary care providers should talk to families about issues surrounding marijuana in the home, including safe storage of products containing cannabis and when to suspect an accidental ingestion. Public health should focus on the packaging and distribution of edibles to prevent easy access and accidental ingestion by young children.