Edible Marijuana

11/22/2016

Healthy Living - November 22, 2016
Amy Movius, MD

 
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The 2016 presidential election took up so much attention this November that it was easy to forget there were other important issues on the ballot. Legalization of recreational marijuana was one such question Maine voters were asked to consider.
 
Regardless of politics, marijuana legalization carries with it specific health considerations including accidental overdose from eating marijuana in food form, known as “edibles.” If legalization occurs, this issue will become very relevant as edibles will be more common in the community. Edibles account for almost half of marijuana sales in Colorado - which legalized recreational pot in 2012.  It is usually marketed in the form of “treat food” such as cookies, brownies and candies and it affects the body quite differently than when it is smoked. 
 
When marijuana is eaten, it is absorbed over hours - much slower than when smoked. It lasts much longer as well. When the effects start and how long they last also varies tremendously between users. In addition, the amount of active marijuana substance (THC) in an edible “serving” is often much higher than would typically be smoked and a single cookie may contain several “servings”. The combination of these factors can - and has - cause serious problems.  Eating multiple servings close together is a common cause of marijuana toxicity in recreational users.  They often report eating multiple servings because they didn’t feel high right away. Besides that, not many of us eat just a piece of a cookie or brownie anyway. The toxicity varies from sleepiness, to coma, to psychosis. Sadly, the first reported death from isolated marijuana toxicity occurred in Colorado under these very circumstances.  The unfortunate young man ingested an entire edible cookie that was intended for multiple servings. He developed erratic behavior and jumped to his death from a balcony. In the CDC report his companions said he ate the rest of the cookie when he failed to feel “high” about an hour after eating the first portion.
 
The potential for poisoning in children from these products is huge. Colorado has been struggling with this reality - the number of reported cases has increased 150% since marijuana was legalized and most are from ingesting edible marijuana products. As a Pediatric Intensive Care specialist this doesn’t surprise me even a teeny tiny bit because marijuana edibles are food, usually kid-attractive treat food. Combine this with a high THC concentration and multiple servings in a single treat and the danger for children is obvious. 
 
Again, Colorado has been experiencing this first hand. Some poisoned children have required hospitalization, some in pediatric intensive care units, and a few of these have even needed to be placed on a respirator. In response to this outbreak of edible poisonings, Colorado has enacted some “catch-up” regulations. These include limiting the amount of THC in edible products, clearly labeling and measuring edible “servings,” and as of June 2016 banning sale of some marijuana candies because they were so appealing to children (the “gummy bear law”). 
 
I have no doubt that some edible marijuana is circulating in Maine right now. If recreational marijuana is legalized we can learn from Colorado’s experience and support regulations that limit marketing of edibles to plain, child proof packaging and NOT in treat form. This will help protect our children and seems like the type of no-nonsense approach Mainers of all political persuasions could embrace.