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Cited by 172Poisoning and overdose treatmentsCannabis and Cannabinoid ResearchForensic Toxicology and Drug Analysis

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Unintentional Cannabis Ingestion in Children: A Systematic Review

Richards, John R., Smith, Nishelle E., Moulin, Aimee K.·2017·The Journal of Pediatrics
DOI 10.1016/j.jpeds.2017.07.005
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Abstract

Objective To analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. Study design PubMed, OpenGrey, and Google Scholar were systematically searched. Articles were selected, reviewed, and graded using Oxford Center for Evidence-Based Medicine guidelines. Results Of 3316 articles, 44 were included (3582 children age ≤12 years). We found no high quality (Oxford Center for Evidence-Based Medicine level I or II) studies and 10 level III studies documenting lethargy as the most common presenting sign and confirming increasing incidence of unintentional ingestion in states having decriminalized medical and recreational cannabis. We identified 16 level IV case series, and 28 level V case reports with 114 children, mean age 25.2 ± 18.7 months, range 8 months to 12 years, and 50 female children (44%). The most common ingestion (n = 43, 38%) was cannabis resin, followed by cookies and joints (both n = 15, 13%). Other exposures included passive smoke, medical cannabis, candies, beverages, and hemp oil. Lethargy was the most common presenting sign (n = 81, 71%) followed by ataxia (n = 16, 14%). Tachycardia, mydriasis, and hypotonia were also commonly observed. All cases were cared for in the emergency department or admitted, and mean length of stay was 27.1 ± 27.0 hours. Twenty (18%) were admitted to the pediatric intensive care unit, and 7 (6%) were intubated. Conclusions Unintentional cannabis ingestion by children is a serious public health concern and is well-documented in numerous studies and case reports. Clinicians should consider cannabis toxicity in any child with sudden onset of lethargy or ataxia.

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  • Overdosing and unintentional cannabis use may cause short-term psychiatric, gastrointestinal, and cardiovascular problems in children, teens, and adults.

    “Overdosing and unintentional cannabis use may cause short term psychiatric, gastrointestinal, and cardiovascular problems in children, teens, and adults [22, 23].”

    From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [22]

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Metadata

Authors
Richards, J. R., Smith, N. E., & Moulin, A. K.
Affiliations
University of California Davis Medical Center (US)
Corresponding author
Richards, John R.
ORCID
Venue
The Journal of Pediatrics
Publisher
Elsevier BV
Published
2017-11
Volume
190
Pages
142-152
ISSN
0022-3476 (ISSN-L)
DOI
10.1016/j.jpeds.2017.07.005
OpenAlex
W2753388053
Cited by
172
References
1
Citations by year
2026: 12 · 2025: 16 · 2024: 16 · 2023: 21 · 2022: 27 · 2021: 30 · 2020: 22 · 2019: 15 · 2018: 12 · 2017: 1
FWCI
3.52
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Journal of Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
Funders
Agency for Healthcare Research and Quality (T32 HS022236)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
  • Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords
pediatric poisoning, cannabis toxicity, hashish, lethargy, ataxia, recreational cannabis, emergency department management, pediatric intensive care unit admission
MeSH terms
Cannabis, Marijuana Abuse, Child, Child, Preschool, Eating, Emergency Service, Hospital, Female, Humans, Infant, Male

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