Delta-9 THC detection in the young pediatric postmortem population: 2018-2024

Area of Science:

• Forensic Toxicology
• Pediatric Health
• Cannabinoid Analysis

Background:

• Increasing rates of pediatric cannabis exposure noted in poison control and ER visits.
• Focus on delta-9 tetrahydrocannabinol (THC) and its metabolites in young children.

Purpose of the Study:

• To determine the frequency of THC and metabolite detection in postmortem pediatric cases (<10 years).
• To analyze trends in pediatric cannabinoid exposure using laboratory data.

Main Methods:

• Analysis of 17,512 postmortem blood cases from 2018-2024.
• Screening via ELISA and confirmation with LC-MS/MS for THC and metabolites.
• Evaluation of results based on limit of detection (LOD) and limit of quantitation (LOQ).

Main Results:

• THC/metabolite positivity rates ranged from 1.6% to 2.8% (LOD) and 0.43% to 1.1% (LOQ).
• The majority of positive cases (86%) involved children ≤2 years old, with a significant portion (31%) being infants <1 month or intrauterine demise.
• Cannabis was the sole identified drug in 49% of cases, with caffeine being the most common co-finding (26%).

Conclusions:

• The study indicates a concerning increase in cannabis exposure among young children.
• Findings highlight the vulnerability of infants to cannabis toxicity.
• Emphasizes the need for continued monitoring and awareness of pediatric cannabinoid exposure.