DRUG & POISON INFORMATION CENTER | |
4 Must-Know Facts About Marijuana Edibles | |
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Marijuana edibles have been in the news and on social media recently. They are widely available in many U.S. states and can look very tempting to a child. However, they can make children very sick.
Every year the National Poison Data System (NPDS) highlights trends of public health importance. In 2021, a concerning trend was noted that over 20,000 poisoning exposures to marijuana edibles were reported nationally. It showed that children (ages 5 and under) represented the largest age group with such poisoning exposures (nearly 36%). Ohio Poison Centers have experienced a 7-fold increase in accidental edible poisonings involving children since 2018, and this trend continues to rise.
For these reasons, we would like to remind parents four main points as edible marijuana products continue to become more available in Ohio and around the U.S.:
1. MARIJUANA FOOD PRODUCTS CAN LOOK JUST LIKE REGULAR FOODS.
In Ohio, packaging of marijuana edibles is prohibited from being attractive to children. But edibles may be obtained from many sources outside of Ohio that can look very similar to common foods or snacks that are in most homes. Even if the packaging isn’t attractive to kids, once opened, the product can resemble chips, candy, cookies, brownies, or gummies. Having these look-alike products in the home increases the risk of kids accidentally being exposed to marijuana. Any edible products kept in the home should be treated like alcohol—stored away from the reach of kids in a locked cabinet.
2. AMOUNT OF DRUG AND SERVING SIZE MATTERS.
Marijuana edibles often contain much higher amounts of tetrahydrocannabinol (THC), which is the psychoactive component we associate with marijuana use. One entire piece of candy or cookie may contain 5-6 servings of THC, which could result in an unintentional overdose. THC can cause lethargy, slow down breathing, affect the heart rate and even cause coma.
3. ABSORPTION AND TIMING OF DRUG EFFECT MAKE A DIFFERENCE.
Another concern is the way marijuana is absorbed into the body when it is ingested. When marijuana edibles are ingested, the psychotropic effects of the drug are delayed for 30-90 minutes afterward. The maximum or peak effect of the drug is not reached until 2-3 hours after ingestion, and the effects last on average from 4-12 hours. Someone experimenting with marijuana edibles might not feel the effects as quickly as expected. That could cause the user to eat more edibles, which may lead to overdose.
4. EDIBLES ARE READILY AVAILABLE.
The availability of edible products in states that have legalized medical or recreational marijuana is widespread. Our poison control center experience tells us that problems arise when these products are removed from their original packaging or kept within sight of children.
These four factors of marijuana edibles—packaging, drug amount, absorption rate and availability—can all contribute to accidental exposure in young children. The chance for accidental ingestion of marijuana edibles by kids is very real. It is important for parents to understand the potential dangers so we can help keep our kids as safe as possible. As parents, becoming educated about issues like this helps us start conversations with our kids to guide them in making good choices. We hope it helps you do the same!
Reference:
America’s Poison Centers. (2023). National Poison Data System. Retrieved from https://www.aapcc.org/national-poison-data-system
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Parents of Teens: Facts To Know About Nicotine in E-Cigarettes
While e-cigarette use in teens has gone down in recent years, teens are still vaping despite national policies aimed at reducing nicotine vaping among adolescents. Nicotine vaping ranks among the most frequently abused of all substances in these grades. See below information on past-year vaping among teens from the National Institute of Health (NIH).
What’s more, the Journal of the American Medical Association found that e-cigarette use in teens is associated with an increased risk for cigarette initiation and use, particularly among low-risk youths. While vaping might be a way for some adults to stop smoking, for teens, it’s a way to start.
Chances are high that teens have already been exposed to e-cigarettes, thought about using them, or have used them. So, what can parents do to reduce the likelihood that their teens will turn to vaping? At the Drug and Poison Information Center, we recommend learning everything you can about e-cigarettes and then having a frank conversation with your teen about the risks. Here are some facts to start the conversation:
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8 FACTS TO KNOW ABOUT E-CIGARETTES AND E-LIQUIDS
FACT #1: E-CIGARETTES CONTAIN HARMFUL CHEMICALS
According to smokefree.gov, e-cigarettes usually contain nicotine, which has been shown to harm brain development in not only children, but also young adults into their early 20s. E-cigarettes may also contain other dangerous substances, including heavy metals like lead, cancer-causing chemicals, and small particles that get inhaled deep into the lungs.
FACT #2: NICOTINE IS HIGHLY ADDICTIVE
Nicotine is one of the most addictive substances and is incredibly difficult to stop. Dependence hinges on various factors such as age, family or peer influence, genetics, medical history and more. The adolescent brain is highly susceptible to the adverse and addictive effects of nicotine, and the long-term effects of e-liquids are unclear.
FACT #3: NICOTINE IN E-LIQUIDS IS NEUROTOXIC
Neurotoxic substances, such as nicotine, can affect the brain adversely and cause other damaging side effects. E-liquids come in a variety of nicotine concentrations. Ingesting even a small amount of nicotine can potentially be fatal to a small child. It can also be absorbed through the skin. If this happens when refilling the e-cigarette, it can be incredibly dangerous. When liquid nicotine is accidentally ingested, it can cause vomiting and seizures and even affect the heart.
FACT #4: DESPITE LAWS, E-CIGARETTES CAN STILL BE EASY TO GET
In 2019, the Tobacco 21 law went into effect to restrict the sale of tobacco products in the United States to those over 21 only, including e-cigarettes. However, not all retailers always ask for identification, and online vendors of vaping devices may fail to verify the age of purchasers at the time of sale.
FACT #5: THEY COME IN BRIGHT COLORS AND FLAVORS
The bright colors, flavors, and smells of e-liquids can be appealing to both teens and children, making them seem harmless. It is important to keep e-cigarettes out of reach of small children, as many containers are not child-resistant. In early 2020, the FDA restricted flavors in reusable e-cigarettes to just menthol and tobacco. These flavor limitations don’t apply to disposable e-cigarettes, which are still on the market today.
FACT #6: THEY’RE DISCREET
It’s difficult to tell when someone is using an e-cigarette because they don’t smell like tobacco. They can also look like pens, key fobs, or flash drives. The newest product on the market is vape pens that look like highlighters.
FACT #7: THEY’RE BEING USED TO VAPE THC
Many young people also use vaping devices to consume cannabis products. In 2022, nearly 20% of 12th graders reported that they vaped marijuana in the past year (National Institute on Drug Abuse).
FACT #8: SEVERE LUNG INJURIES ARE ASSOCIATED WITH E-CIGARETTE USE
The Centers for Disease Control and Prevention reported in February 2020 that more than 2,800 people have acquired an acute lung injury or died related to the use of e-cigarettes. for more information about vaping and its impact on teens’ lungs, please read this blog post from our pulmonary team.
References:
American Lung Association. (2023). Tobacco 21 Laws. Retrieved from https://www.lung.org/policy-advocacy/tobacco/prevention/tobacco-21-laws
Berry, K. M., Fetterman, J. L., Bengamin, E. J., Bhatnagar, A., Barrington-Trimis, J. L., Leventhal, A. M., & Stokes, A. (2019, February). Association of electronic cigarette use with subsequent initiation of tobacco cigarettes in US youths. Journal of American Medical Association (JAMA), 2(2):e187794. doi:10.1001/jamanetworkopen.2018.7794. Retrieved from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2723425
Centers for Disease Control and Prevention (CDC). (2021). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
National Cancer Institute (NCI). (2023). Smokefree.gov. Retrieved from https://smokefree.gov/
National Institute on Drug Abuse (NIDA). (2022). Monitoring the Future. Retrieved from https://nida.nih.gov/research-topics/trends-statistics/monitoring-future
Images:
Breathe PA. (2023). Teen Vaping. Retreived from https://breathepa.org/teen-vaping/
National Institute of Health (NIH). (2019, February). Vaping rises among teens. News in Health. Retrieved from https://newsinhealth.nih.gov/2019/02/vaping-rises-among-teens
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Fentanyl Q&A
Q: What is fentanyl? Where did it come from? How is it manufactured?
A: It is important to understand there are really two types of Fentanyl. One type of Fentanyl is used in medicine as a pain reliever. This type of Fentanyl was approved by the Food and Drug Administration (FDA) in 1972 for medical use in human patients. Another type of Fentanyl, Illicitly Manufactured Fentanyl (or IMF), is produced illegally. This is the type of Fentanyl that you’ve probably heard about in the news and the type of Fentanyl that is found in the illicit drug supply. Both are considered synthetic opioids, meaning they are produced in a lab versus coming from a plant. Fentanyl that is used in medicine is manufactured in a controlled laboratory setting whereas Fentanyl that is illegally made is created in illegal drug labs, most commonly in China or Mexico. A few years ago, most IMF was manufactured overseas and then shipped to the US or Mexico to be smuggled across the border. Most recently, Fentanyl is manufactured in Mexico and then smuggled across the southern border. Illicitly manufactured fentanyl (IMF) can be either in liquid or powder form. This powder looks like other drugs such as heroin, cocaine, or methamphetamine so it’s impossible to tell if an illegal drug has IMF in it just by looking at it. This powder can be pressed into tablets that look very much like typical prescription medicine.
Q: Does fentanyl have any beneficial uses? At what dose does it become toxic?
A: Prescription Fentanyl was introduced as a pain reliever in 1972 and is superior due to its potency. It is used to treat severe pain in chronic illnesses and can be safely given by a physician in appropriate doses. Both prescription Fentanyl and IMF become toxic at an extremely small dose because of their high potency. Just one ounce of fentanyl can be as potent as 1 kilogram of heroin.
Q: What does Fentanyl do to the human body? Why is it so lethal?
A: Fentanyl can rapidly enter the brain and decrease the respiratory drive which quickly leads to respiratory depression (slow, weak, or no breathing) and/or fatal overdose.
Q: The news reports that fentanyl is appearing increasingly in illegal drugs. Is it just hard drugs that fentanyl is showing up in, or other drugs?
A: Illegal fentanyl typically appears in cocaine, heroin, or methamphetamine. However, drug dealers may not clean equipment or surfaces when diluting drugs, so it could potentially appear in any illicit drugs. It is also hard to estimate how potent these mixtures are because they could be mixed with variations of Fentanyl or other synthetic opioids, which can be extremely potent and deadly. Fentanyl has also been identified in “fake pills”, and may look like oxycodone, a prescription pain medication, or even candy. You may also have heard of Rainbow Fentanyl recently. These are brightly colored tablets that contain IMF.
Q: What is the most important thing to understand about fentanyl?
A: IMF is deadly. Fentanyl can be present in multiple illicit drugs due to contamination, and it is undetectable to the naked eye. Taking any amount of a drug contaminated with IMF can have deadly risks. Bottom line: avoid ANY drugs unless they are prescribed by your doctor and come directly from the pharmacy. If you know of someone who uses illicit drugs, it’s important to share these warnings with them. There is also a great resource from the Centers for Disease Control (CDC) on naloxone, the antidote for opioid overdose. In addition, knowing first aid and CPR is important for anyone in an emergency situation. The Red Cross offers first aid classes, and you can find more information by visiting redcross.org.
Q: Is there anything else you think is important to know about Fentanyl?
A: Fentanyl is a deadly and unpredictable drug, and any illegal substance could be contaminated with it. It is better to be safe than sorry and avoid any substances or products in question.
Reference:
Centers for Disease Control (CDC). (2023). Lifesaving naloxone. Retrieved from https://www.cdc.gov/stopoverdose/naloxone/
Savage, S. (2023, May 18). The facts on fentanyl (S1: EP8) In Now that's good chemistry. Indian Hill High School. https://open.spotify.com/episode/6FFizf6BJYcOZbZShqgsyj
Image:
Image: U.S. DEA (2023) https://www.dea.gov/factsheets/fentanyl
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Tiny Magnets: What Parents Should Know
Remember when you were young and were intrigued by the force between magnets? Taking magnets apart and putting them back together again is interesting to kids. But magnets today are smaller and stronger than they used to be. Newer products feature magnets that are often small enough to swallow, which can cause serious injuries or even death. In recent years, kids have needed emergency surgery after swallowing magnets. Here’s what to know about powerful magnets that are on the market today.
WHAT HAPPENS WHEN MULTIPLE MAGNETS ARE SWALLOWED
Many small foreign objects that are swallowed pass through the digestive system naturally and come out when a child poops (for example, a piece of chewed gum). This could be the natural course if just one magnet is ingested by someone. However, when multiple magnets enter the body, there is a high risk of the magnets sticking together which can cause severe complications.
WHAT HAPPENS WHEN MULTIPLE MAGNETS ARE INSIDE THE BODY
When multiple magnets enter the body separately, they travel through the stomach and intestines the way food does. The magnets can then become stuck together through the folds of the intestine or other body tissue, and can restrict blood supply to the area which can cause tissue death, bleeding, infection, and/or obstruction of the gastrointestinal (GI) tract which can be a life-threatening situation.
Magnets can also be a problem if they stick together in other areas of the body and can cause tissue damage. In some situations, surgery may be necessary to remove the magnets and repair the damage. Another problem that can occur is when one magnet is swallowed and is attracted to another ingested magnetic object in the body such as a button battery.
TYPES OF MAGNETS THAT ARE SWALLOWED
It may not be obvious that a toy or product contains magnets. Look closely at products and beware of the following, which could be accidentally injested by young children:
- Tiny magnets may be hidden under plastic or other materials, such as magnets in reusable balloons, toy building sets, etc.
- Products marketed toward adults may contain high-powered magnets—“desk toys,” artwork, stress relievers, etc.—that may be easily accessible to children at home.
- Magnets may also be used in fake jewelry and piercings for older children.
HOUSEHOLD RULES FOR MAGNETS
Make sure your entire family knows the dangers of small magnets and what happens if they get inside the body. Take these magnet precautions in your home to help keep your family safe:
- Avoid toys with high-powered magnets.
- Be aware of when magnets are used in products.
- Store magnetic toys in a locked cabinet, closet, or box out of reach of children.
- Only allow supervised use of these toys, and always count each piece after they are played with to ensure none are missing.
- Avoid magnetic toys and products for children and individuals with developmental delays or for anyone who may be at risk of swallowing foreign objects like magnets.
- Avoid magnetic fake body piercings, stress relievers, and artwork if possible, and keep any adult magnetic desk toys out of the reach of children.
SIGNS SOMEONE MAY HAVE SWALLOWED A MAGNET
You might not witness a magnet being ingested, and sometimes there are no initial symptoms. Signs a child has swallowed a magnet may include:
- Coughing, choking, or gagging may occur right when a magnet is swallowed. However, very small magnets may be swallowed easily without noiticeable signs.
- Later signs can be similar to a stomach virus (and mistaken for a stomach virus) including nausea, vomiting, abdominal pain, and fever.
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© 2023 By the Cincinnati Drug & Poison Information Center (DPIC)
Editors: Alysha Behrman RN, MSN, CSPI, OCPC, ICPS; Sheila Goertemoeller PharmD, DABAT, OCPC, ICPS ; Julia Conroy; Jewel Sisk; Jonathan Colvin, RN, MS; Shan Yin, MD, MPH
The opinions expressed herein are those of the contributing authors and do not necessarily reflect the views of the editor, publisher or supporting institutions. DPIC is a service of the Cincinnati Children’s Hospital Medical Center and Children’s Hospital Research Foundation. Services are also supported by: the US Department of Health and Human Services (HRSA), the Ohio Department of Health, Hamilton County Mental Health and Recovery Services Board, and the Ohio Department of Alcohol and Drug Addiction Services (ODADAS). Additional support for DPIC services is provided by Cuyahoga Department of Health and Human Services and additional member hospitals.
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