Resident WOODHULL HOSPITAL UNION CITY, New Jersey, United States
Background: Recreational marijuana legalization (RML) is expanding across the US, but there is little data on the impact of RML on pediatric population regarding cannabis use. RML brings changes in perception, increased advertisement, and availability. Cannabis use has been shown to cause dependence, poor educational attainment and psychotic symptoms. Previous surveys examining the impact of RML on use of cannabis in pediatric population have shown conflicting results. Objective: This study aims to compare of the use (intentional/accidental) of cannabis in pediatric population over 4 year period in a hospital catering predominantly to African American and Hispanic community in New York. Design/Methods: In this retrospective study, we analyzed 1143 charts of children(0-18y) presenting to emergency for symptomatology warranting toxicology screening over four years divided into two cohorts (pre and post-RML). 332 charts of children presenting with positive urine toxicology for cannabinoid(THC) were analyzed further for demographic details, symptoms, co-morbidities, and outcomes. The chi-square test and Mann-Whitney U test were used to compare the two groups. Results: 332 children tested positive for THC, with a significant increase from pre-RML to post-RML periods (26.2% vs 31.7%, p< 0.05), with a significantly lower median age in post-RML. Most children belonged to African-American or Hispanic communities, and no ethnic differences were noted. The most common presenting symptom was altered mental status in both groups and around half of the children in both cohorts had a coexisting behavioral diagnosis, ADHD being most common. (Fig1) Post legalization cohort had a significantly higher cannabis-related intoxication rate (68 vs 20, p< 0.05). Adolescents were noted to have a significant increase in the use of cannabis edibles in the post-RML group. (48 vs 10,p < 0.05). A significant increase in the rate of cannabis intoxication and cannabis-related diagnosis in children was observed in post RML era.(Fig2)
Conclusion(s): This is one of the few studies examining the impact of RML in children with a standardized lab measure. A significant increase in the rate of positive urine toxicology, cannabis intoxication, and decreasing age of use highlights an emerging problem and the need for strict measures regarding cannabis availability to youth, particularly in vulnerable communities. Further studies with bigger sample size are the need of the hour to delineate the extent of impact and provide policymakers with education to curb this emerging public health problem.
