Thomas Anita Anne, Dickerson-Young Tavis, Mazor Suzan
From the Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Washington/Seattle Children's Hospital, Seattle, WA.
Pediatr Emerg Care. 2021 Oct 1;37(10):e594-e598. doi: 10.1097/PEC.0000000000001703.
Recreational marijuana became commercially available in Washington State in 2014. Children with marijuana intoxication can have lethargy and altered mental status, often resulting in extensive workup.
The aim of this study was to quantify the incidence of pediatric marijuana exposure before and after marijuana legalization/commercial availability in Washington State at a tertiary care children's hospital.
Charts of patients 9 years or younger evaluated at a tertiary care pediatric hospital from October 8, 2007, to October 31, 2016, were retrospectively reviewed. Inclusion criteria were positive tetrahydrocannabinol urine toxicology screen and diagnosis consistent with unintentional marijuana exposure. Data included age, sex, exposure date range, symptoms, ancillary tests, consults, disposition, and marijuana source. Data were analyzed in R using descriptive statistics.
Seventeen unintentional marijuana exposures were identified during our study period, 8 cases before and 9 cases after legalization of recreational marijuana, which is 1.19 events per year in the 6.75 years before legalization compared with 3.88 events per year in the 2.32 years after (P < 0.05). Age range was 17 months to 7 years, with a median age of 21 months. Eighty-two percent received laboratory tests, 47% underwent head computed tomography, 6% underwent lumbar puncture, and 100% underwent social work evaluation. Thirty-five percent were discharged from the emergency department, 47% were admitted to general medicine, and 18% were admitted to the critical care unit.
Unintentional marijuana exposure incidence increased after legalization of recreational marijuana in Washington State at a tertiary care children's hospital. Providers should be aware of this increasing incidence. These data should be considered in the drafting of future marijuana legislation.
2014年，娱乐用大麻在华盛顿州开始商业化销售。大麻中毒的儿童可能会出现嗜睡和精神状态改变，常常需要进行全面检查。
本研究的目的是量化华盛顿州一家三级护理儿童医院在大麻合法化/商业化销售前后小儿接触大麻的发生率。
回顾性分析2007年10月8日至2016年10月31日在一家三级护理儿童医院接受评估的9岁及以下患者的病历。纳入标准为尿四氢大麻酚毒理学筛查呈阳性且诊断与意外接触大麻相符。数据包括年龄、性别、接触日期范围、症状、辅助检查、会诊、处置情况以及大麻来源。使用R软件进行描述性统计分析数据。
在我们的研究期间共确定了17例意外接触大麻的病例，其中8例发生在娱乐用大麻合法化之前，9例发生在合法化之后。合法化前的6.75年中每年发生1.19起事件，而合法化后的2.32年中每年发生3.88起事件（P < 0.05）。年龄范围为17个月至7岁，中位年龄为21个月。82%的患者接受了实验室检查，47%的患者进行了头部计算机断层扫描，6%的患者进行了腰椎穿刺，100%的患者接受了社会工作评估。35%的患者从急诊科出院，47%的患者入住普通内科，18%的患者入住重症监护病房。
在华盛顿州一家三级护理儿童医院，娱乐用大麻合法化后意外接触大麻的发生率有所增加。医疗服务提供者应意识到这一发生率的上升。在起草未来的大麻立法时应考虑这些数据。
