With the growing legalization and availability of THC products, pediatric ED visits related to edible ingestion are on the rise. Here on HipPEMcrates, we have covered the concerning trends, the lack of proper labeling, and the small doses needed for severe toxicity in children.
The Philadelphia Poison Center recently issued an important alert outlining key definitions and insights on delta-8-THC and other minor cannabinoids.
Thank you to Dr. Kevin Osterhoudt, Medical Director of The Poison Control Center at Children’s Hospital of Philadelphia, for sharing this information with the CHOP Division of Emergency Medicine.
Definitions
Marijuana – The plant Cannabis sativa (or indica) with a delta-9-THC content greater than 0.3%.
Delta-9-THC – An intoxicating chemical in, or derived from, marijuana. Often just called “THC.”
Minor Cannabinoids – Marijuana and hemp contain small amounts of many chemicals which can potentially affect the brain. These include delta-8-THC, delta-10-THC, THCP, THCV, and others.
The Danger
Across the country, synthetic marijuana-like compounds are showing up on shelves in gas stations, convenience stores, and smoke shops. Thanks to loopholes and vague language in the 2018 U.S. Agriculture Improvement Act (“The Farm Bill”), the legality of these products remains uncertain, and there’s little in the way of oversight or enforcement. With no real regulation, what you’re buying is a mystery – potency, ingredients, and even the type of drug could vary wildly from one package to the next.
With this in mind, how do I interpret the urine drug screen?
If a patient is “positive” for THC on the UDS, consider these interpretations:
- The edible contained “regular” delta-9-THC
- Minor cannabinoids cross-reacted with the assay for delta-9-THC
- The patient has used delta-9-THC recently and now also used a minor cannabinoid
Caution: If the UDS is “negative” for THC, it does not rule out the use of minor cannabinoids.
Read More
Philadelphia Inquirer – Pennsylvania’s Wild West of unregulated weed
New York Times – Cannabis Poisonings Are Rising, Mostly Among Kids
CNN – Marijuana ads are enticing kids to try weed, study says
If you have a concern, contact the Poison Control at 1-800-222-1222.
Dr. Joshua Belfer, MD, is a Pediatric Emergency Medicine physician at the Children’s Hospital of Philadelphia, and is the Founder and Editor-in-Chief of HipPEMcrates. He can be reached at HipPEMcrates@gmail.com.
