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Cannabis “Poisonings” Are on the up After Legalization, Say US Poison Centers

By Leo Bear-McGuinness

Published: May 24, 2021   
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The number of cannabis “poisonings” in the US has increased year on year, according to a new study.

The research, which used data from US poison centers, found such facilities are increasingly receiving calls about adverse events associated with cannabis products.

Published in JAMA Network Open, the study found that more calls were received in states with legal access to cannabis.

Making the call

To begin their study, the researchers, who were largely from Washington State University, accessed data from the National Poison Data System. Searching from January 2017 through to December 2019, they identified 28,630 calls made to poison centers across the US about cannabis exposures.

Among these calls, cannabis flower was the most commonly cited cause for impairment (65.5 percent), followed by edibles (19.3 percent), concentrates (9.6 percent), vaporized liquids (3.8 percent), and other manufactured products (1.8 percent). However, most incidences involving cannabis flower (61.6 percent) also involved other substances, such as alcohol.

Exposures to vaporized cannabis liquids were the most likely to have serious medical outcomes (42.3 percent). According to the data, the number of calls to US poison centers about the adverse effects of such liquids went from 33 in 2017, to 151 in 2018, to 891 in 2019.

Cases regarding edible consumption were most likely to involve children. Over the studied period, the number of calls to US poison centers about the adverse effects of edibles went from 697 in 2017, to 1,943 in 2018, to 2,897 in 2019.

“Children may be at particular risk for exposure to edible products, such as cookies or candy,” the researchers wrote in their study.

The authors go on to suggest that both minors and intended consumers could both be at risk from the emerging cannabis products of the legal industry.

“Market factors may drive the industry to continue developing novel products, which could present additional health risks,” they write. “Applying regulatory controls to market-driven innovations in potency and additives is key. Novice cannabis users are often advised to ‘start low, go slow.’ This guidance may be equally applicable to regulating new retail cannabis markets and products.”

As the study’s data were self-reported by individuals, the researchers also speculate that the true number of cannabis product “poisonings” could be a good deal higher. Further research into such adverse events, they say, is still needed.

Back in 2019, another study found that the number of cannabis-related calls to a poison control room had doubled in Massachusetts since the state legalized medical marijuana. Calls for single-substance cannabis exposure increased from 0.4 to 1.1 per 100,000 people between 2009 and 2016.

“While we’re pleased to see that the incidence is relatively low, we feel these cases are preventable,” Jennifer Whitehill, an assistant professor at the University of Massachusetts Amherst and lead author of that study, said in a press statement at the time. 

“As states across the country enact more permissive marijuana policies, we need to do more to promote safe storage in households with children,” she added.

While the increase in children experiencing adverse events from cannabis consumption was significant, the calls to the Regional Center for Poison Control and Prevention still only represented 0.15 percent of all calls to the Massachusetts poison center during the seven-year study period for the 0-to-19 age group. Rather than cannabis, the top three non-pharmaceutical causes of poisoning in 2018 were cosmetics, household cleaners, and toys, according to the center’s own 2018 report


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