Did an 11-month-old Colorado toddler die of marijuana poisoning or not?
A report suggesting a “potential link” between the child’s death due to myocarditis (inflammation of the heart muscle) and exposure to cannabis had U.S. media claiming the “first-ever reported death” in a baby from a marijuana overdose.
Now the doctors behind the original paper say the news reports were “totally sensationalized” and that they haven’t shown cause and effect, just an association.
“We are absolutely not saying that marijuana killed that child,” co-author, Dr. Thomas Nappe, of St. Luke’s University Health Network in Bethlehem, Pa., told The Washington Post.
“Kid had myocarditis after marijuana exposure. We just said more study is needed,” his co-author, Christopher Hoyte, said in a tweet. “Not that marijuana was the cause of the death. News story totally overblown.”
If nothing else, the controversy is drawing attention, in the era of legal pot, to the risks of children getting access to cannabis, including marijuana-infused gummies, brownies, chocolates and other edibles.
Ottawa has said its plan is to have rules in place for the purchase of edibles around July 2019, one year after legalization and only after it has developed regulatory oversight for the goods, including rules on potency, limits on the amount of THC (the primary psychoactive in cannabis) per serving size and childproof packaging.
And a letter in the most recent issue of the Canadian Journal of Public Health warns the addition of edibles to the market “will inevitably exacerbate the already significant and economic burden of food-borne disease in the Canadian population.”
In their letter (headlined “Diarrhea ain’t dope”) the authors note that a number of outbreaks and recalls linked to food-borne pathogens, E. coli, salmonella and other bacteria, moulds and pesticides have been found in marijuana edibles. “High-risk, sealed products, like infused oils, are of particular concern for botulism,” they said.
“There is evidence of contaminated product out there,” said co-author Ken Diplock, a public health inspector by trade and now PhD candidate at the University of Waterloo’s School of Public Health and Health Systems.
It’s not clear whether edibles will be regulated in Canada as a food or drug. Last month, Colorado banned the sale of marijuana edibles that look like children’s candy.
Canadian doctors recently warned of the risks that edibles pose to youngsters. Unlike older children and adults, “infants and toddlers with cannabis intoxication primarily present with altered levels of consciousness ranging from mild encephalopathy (brain injury) to coma,” Dr. Michelle Murti wrote in the B.C. Medical Journal in October.
“Ingestion of cannabis cookies is the most common route of exposure for this age group.”
In the case of the 11-month-old, who died in a Colorado emergency room in 2015, the source of exposure isn’t clear.
The baby had been lethargic, irritable and nauseous after waking that morning, then suffered a seizure. He went into cardiac arrest in the emergency room and died, despite an hour’s attempt at resuscitating him.
An autopsy revealed myocarditis, and post-mortem tests confirmed the presence of THC in his blood. The child had been living in an “unstable motel-living situation” and his parents admitted possessing drugs, including cannabis, according to the case report
The presence of THC metabolites in the baby’s urine and blood was the only uncovered risk factor for his myocarditis, they said, adding it was “highly unlikely” due to exposure to second-smoke.
However, they can’t be certain of the exact time, dose or route of exposure, they said. And it’s also possible the child was already suffering “silent myocarditis” and the cannabis induced the fatal symptoms.
However, the authors cite a review of 986 calls to poison control centres in the U.S. from 2005 to 2011 involving children under nine who accidentally ingested cannabis. The call rate in nonlegal marijuana states didn’t change over the study period, but increased by 30 per cent more per year in states that had passed legislation decriminalizing pot.
There have been no confirmed deaths in children, and others warned against leaping to any conclusions based on the new report.
“You just can’t make those statements because then what happens is lay people say, ‘Oh my God, did you hear a kid died from marijuana poisoning?’ and it can be sensationalized,” Noah Kaufman, a Northern Colorado emergency room physician, told The Washington Post.
“It’s not based on reality. It’s based on somebody kind of jumping the gun and making a conclusion, and scientifically you can’t do that.”