Isabelle Claudet1, Sébastien Mouvier2, Magali Labadie3, Cécile Manin4, Anne-Pascale Michard-Lenoir5, Didier Eyer6, Damien Dufour7. 1. Service d'Accueil des Urgences Pédiatriques, Hôpital des Enfants, Centre Hospitalier Universitaire de Toulouse and Inserm, UMR 1027, Université Paul Sabatier Toulouse III, Toulouse, France; claudet.i@chu-toulouse.fr. 2. Urgences Enfants, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France. 3. Centre Antipoison et de Toxicovigilance, Groupe Hospitalier Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France. 4. Service de Pédiatrie, Centre Hospitalier de Perpignan, Perpignan, France. 5. Urgences Pédiatriques, Hôpital Couple Enfant, Centre Hospitalier Universitaire de Grenoble Alpes, La Tronche, France. 6. Urgences Pédiatriques, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; and. 7. Urgences Pédiatriques, Hôpital Jacques Monod, Groupe Hospitalier du Havre, Le Havre, France.
Abstract
BACKGROUND AND OBJECTIVES: In France, cannabis consumption is illegal. The health impact of its increasing use and higher tetrahydrocannabinol (THC) concentrations is still poorly documented, particularly that of unintentional pediatric intoxications. We sought to evaluate the French national trend of admissions for unintentional cannabis intoxication in children over an 11-year period (2004-2014). METHODS: A retrospective, national, multicenter, observational study of a pediatric cohort. All children aged <6 years admitted to a tertiary-level pediatric emergency department (PED) for proven cannabis intoxication (compatible symptoms and positive toxicological screening results) during the reference period were included. RESULTS: Twenty-four PEDs participated in our study; 235 children were included, and 71% of the patients were 18 months old or younger. Annual admissions increased by a factor of 13. Hashish resin was the main form ingested (72%). During the study period, the evolution was characterized by a national increase in intoxications, younger intoxicated children (1.28 ± 0.4 vs 1.7 ± 0.7 years, P = .005), and more comas (n = 38) (P = .05, odds ratio 3.5 [1.02-11.8]). Compared with other intoxications, other PED admissions, and the same age population, cannabis-related admissions were greater. There was a potential link between the increased incidence of comas and increased THC concentration in resin seized in France over the period. CONCLUSIONS: Children are collateral victims of changing trends in cannabis use and a prevailing THC concentration. Intoxicated children are more frequent, are younger, and have intoxications that are more severe. This raises a real issue of public health.
BACKGROUND AND OBJECTIVES: In France, cannabis consumption is illegal. The health impact of its increasing use and higher tetrahydrocannabinol (THC) concentrations is still poorly documented, particularly that of unintentional pediatric intoxications. We sought to evaluate the French national trend of admissions for unintentional cannabis intoxication in children over an 11-year period (2004-2014). METHODS: A retrospective, national, multicenter, observational study of a pediatric cohort. All children aged <6 years admitted to a tertiary-level pediatric emergency department (PED) for proven cannabis intoxication (compatible symptoms and positive toxicological screening results) during the reference period were included. RESULTS: Twenty-four PEDs participated in our study; 235 children were included, and 71% of the patients were 18 months old or younger. Annual admissions increased by a factor of 13. Hashish resin was the main form ingested (72%). During the study period, the evolution was characterized by a national increase in intoxications, younger intoxicated children (1.28 ± 0.4 vs 1.7 ± 0.7 years, P = .005), and more comas (n = 38) (P = .05, odds ratio 3.5 [1.02-11.8]). Compared with other intoxications, other PED admissions, and the same age population, cannabis-related admissions were greater. There was a potential link between the increased incidence of comas and increased THC concentration in resin seized in France over the period. CONCLUSIONS:Children are collateral victims of changing trends in cannabis use and a prevailing THC concentration. Intoxicated children are more frequent, are younger, and have intoxications that are more severe. This raises a real issue of public health.
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