Three provinces that legalized cannabis edibles in early 2020 saw an increase in accidental cannabis poisonings among children aged 0-9 which was more than double that of Quebec, where edibles are prohibited, according to a new Canadian study.
Ontario, Alberta and British Columbia saw a 7.5 times increase in the rate of cannabis poisonings among young children after approving the sale of cannabis edibles compared to pre-legalization rates from 2015, while Quebec hospitalizations only increased threefold in the same time period.
“The goal of the study was to see how these hospitalizations for cannabis poisoning had changed following legalization of cannabis,” Dr. Daniel Myran, lead author of the study, told CTVNews.ca in a phone interview.
“And what we saw in our study is that the policy choices that were made by the different provinces had a very large impact on the changes in cannabis poisonings.”
Myran, a public health and preventive medicine specialist and postdoctoral fellow at the Ottawa Hospital and the University of Ottawa Department of Family Medicine, said the results underline the impact of the sale of edibles when it comes to these accidental poisonings.
Prior to the legalization of edibles, the increase of cannabis poisonings was relatively even across the four provinces included in the study, with all four seeing a doubling in poisoning rates following the initial legalization of the dried cannabis flower in 2018.
“Quebec sees it, Ontario sees it, Alberta sees it,” Myran said.
But the picture changes when edibles are legalized in 2019, and the provinces diverge in policy.
“When the new products come to market, when the edibles come out, you have almost a tripling again in Ontario, Alberta and B.C., and Quebec sees no further change, so it really isolates out the idea that legal edibles seem to be playing a pretty key role in these increases in poisonings.”
Cannabis edibles refers to a variety of food or drink products infused with cannabis, with products commonly taking the form of chocolates, gummies or baked goods.
In order to mitigate the risks of children accidentally consuming these edibles when the Cannabis Act was expanded in 2019, Health Canada stipulated restrictions to the amount of cannabis allowed in products and also outlined that products could not be marketed or packaged in a way that looked appealing to young people.
But once outside of their packaging, many edibles are virtually indistinguishable from their non-cannabis counterparts.
“Based on what these products look like when they’re out as their packaging, you cannot distinguish them from candy or other baked goods,” Myran said.
Provinces are allowed to regulate these products themselves, and starting in January 2020, Alberta, British Columbia and Ontario broadly approved the sale of edibles.
However, Quebec prohibited the sale of edibles, making it the perfect province to serve as a control for researchers.
Researchers analyzed the data on all hospitalizations for children aged 0-9 years in these four provinces, which collectively make up more than 85 per cent of Canada’s total population.
The study looked at three time periods of hospitalization data. They started with January 2015 to September 2018, before any cannabis had been legalized, then looked at the first period of legalization from October 2018 to December 2019. Finally, they looked at January 2020 through September 2021, when edibles had become legal in Alberta, Ontario and B.C. and were prohibited in Quebec.
There were 581 hospitalizations for cannabis poisonings in children aged 0-9 across the entire seven-year study period. The average age of children hospitalized with an accidental cannabis poisoning was three-and-a-half years old.
Myran clarified that they didn’t look at outcome, just hospitalization rates.
“By virtue of being hospitalized, these were children that the treating team was quite concerned about and they had at minimum needed some form of observation,” he said.
He stressed that the decriminalization of cannabis has had hugely beneficial impacts, but that proper regulation is important to protect everyone.
“One of the proposals that’s being made now as Health Canada revisits how we regulate these products is to get rid of [the limit of THC in legal edibles],” he said. “And you would worry that if we’re seeing this increase in poisonings with lower potency cannabis edibles, that if you allow these things to be 10 times more potent, you might see a much higher number of poisoning events, and much more severe poisoning events.”