3 toddlers swallowed cannabis – and were hospitalized

In recent weeks, three toddlers between the ages of one and three arrived at the children’s emergency department at the French Hospital in Nazareth after being exposed to cannabis: In two of the cases, the toddlers ingested hashish, while in the third case, it was suspected that they swallowed chocolate or a cookie that contained the active substance in cannabis. In one of the cases, the family members first reported that the toddler bruised his head after he began to feel sleepy, but an initial urine test performed in the emergency room raised suspicions of exposure to cannabis. Later, the diagnosis was confirmed in a laboratory test, and an imaging test of the brain ruled out an intracranial injury.

Initially, the toddlers were hospitalized in the pediatric intensive care unit of the hospital, and later they were transferred to the children’s department. Their condition improved and they were released home. In all three cases, a report was sent to the police in accordance with the procedure.

“In recent years, there has been a sharp increase in cases of cannabis poisoning among young children, mainly due to the accidental ingestion of edible cannabis products,” says Dr. Beshara Mansour, director of the pediatric department and pediatric nephrology service at the hospital. They may look and taste like normal food products and are therefore particularly attractive to children.”

The most common manifestation of cannabis poisoning in children, according to Dr. Mansour, is suppression of the central nervous system. “The child may appear very sleepy or apathetic, and sometimes suffer from instability in walking (ataxia), decreased muscle tone and constricted pupils.”

The severity of the poisoning, according to him, is largely related to the amount of the active substance ingested in relation to the child’s weight. “Due to their low weight, even an amount that seems small to an adult may be significant for a toddler,” explains Dr. Mansour. “In severe cases, there may be a significant decrease in the state of consciousness, respiratory depression and even respiratory arrests, disturbances in heart rate and blood pressure, convulsions and unresponsiveness. Some children even need breathing.”

The diagnosis of cannabis poisoning is not always simple. “A child who comes to the emergency room with sudden sleepiness, instability or a change in consciousness can suffer from a variety of other conditions, including a drop in blood sugar, an infection of the central nervous system, seizures, a metabolic disorder or an intracranial process,” explains the doctor. A urine test to detect decomposition products of the active substance of cannabis can help in the diagnosis in the appropriate cases.”

In addition, he points out that it should be taken into account that cannabis may be contaminated or mixed with other substances, so when cannabis poisoning is suspected, exposure to other toxic substances should also be ruled out at the same time.

According to the doctor, the rapid urine test (urine stick) for detecting cannabis, which is available in emergency rooms and provides an immediate answer, has a sensitivity of approximately 80% to 95%, depending on the detection threshold. “This means that it may miss some cases of exposure, especially when the amount of the substance is low or when the test is performed shortly after exposure, and therefore it may also show a false positive result. Therefore, any positive test that is performed through the urine dipstick available in the emergency department should be confirmed through a more accurate laboratory test.”

Dr. Mansour explains that there is currently no specific antidote for cannabis poisoning, and the treatment is mainly supportive and includes supervision. “Monitoring of the state of consciousness and vital signs is usually required, while when it comes to more significant poisoning, cardiac and respiratory monitoring, support of the airways and breathing and treatment of convulsions may be required if necessary.”

According to him, the most important message is preventive. “Cannabis products should be kept out of the reach and sight of children, preferably in the original packaging and in a locked place. In any case of suspicion that a child has swallowed a product containing the substance, a medical evaluation should be sought without delay.”