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TOPLINE:

Both recreational use and unintentional exposure to marijuana vs other substances increased in the US from 2015 to 2021, especially in adolescents and children, a new survey showed. However, fewer major adverse events (AEs) and deaths occurred from the use of marijuana alone compared with the use of most licit and illicit substances.

METHODOLOGY:

• Researchers analyzed cases of substance exposure, including those of recreational use and unintentional-general exposures, reported to US poison centers from 2015 to 2021 using data from the National Poison Data System.
• Exposures to marijuana were compared with exposures to licit (alcohol, zolpidem, benzodiazepines, ketamine, tramadol, hydrocodone, and oxycodone) and illicit (cocaine and heroin) substances.
• Exposure characteristics, medical outcomes, and utilization-adjusted exposure rates were also assessed.
• Utilization-adjusted exposure rates per million people with past-year use or past-year nonmedical use were calculated using data from the National Survey on Drug Use and Health.

TAKEAWAY:

• A total of 63,645 cases of marijuana exposure were identified, with 36% involving recreational use and 24% involving unintentional-general exposure. A higher proportion of cases of recreational use of marijuana vs comparator substances involved adolescents aged 13-19 years (46% vs 3%-30%). Single-substance recreational use of marijuana had lower rates of serious AEs (3% vs 4%-40%) and deaths (0.04% vs 0.1%-2.5%) than other drugs except zolpidem (0 deaths).
• Cases of unintentional exposure to marijuana were most common in children younger than 6 years (70%). About 23% of children exposed to marijuana alone experienced serious AEs, which was higher than for exposure to most licit drugs (1%-17%) but lower than for exposure to illicit drugs (27%-32%). No deaths were reported in children with unintentional exposure to marijuana.
• The annual recreational use of marijuana increased 1.5-fold from 2015 to 2021. Utilization-adjusted recreational use rates per million people with past-year nonmedical use remained relatively steady from 2015 to 2019 (76-83 cases) and from 2020 to 2021 (86-88 cases), appearing lower than use rates for all prescription and illicit comparators but higher than use rates for alcohol.
• The annual unintentional exposure to marijuana increased 9.5-fold from 2015 to 2021 and primarily involved edibles (51%). The utilization-adjusted unintentional exposure case rates per million people with past-year use of marijuana increased from 2015 to 2021, surpassing those for most comparators (98 vs 18-66 cases) except for benzodiazepines and heroin.

IN PRACTICE:

“Overall, our study findings highlight the AEs associated with marijuana intentional and unintentional exposures and showcase the need for educating the public on the signs of marijuana poisoning and toxicity, particularly in children and adolescents,” the investigators wrote.

SOURCE:

This study was led by Sara Karami, PhD, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, FDA, Silver Spring, Maryland. It was published online on May 23 in Drug and Alcohol Dependence.

LIMITATIONS:

Data from poison centers were voluntarily shared and did not capture all exposures to any substance leading to AEs. Further, some cases of licit exposure may have involved illicit substances, some cases of drug exposure involving mild symptoms may not have been recorded, and cases of fatal poisoning were undercaptured due to unattended or out-of-hospital deaths.

DISCLOSURES:

The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.