P4.049: Rising Trends in Pediatric Marijuana Ingestions: A Retrospective Analysis of the Impact of COVID-19 on Emergency Department Presentations

Background: Pediatric marijuana ingestions have increased dramatically in recent years, particularly with the rising availability of edible cannabis products. The impact of COVID-19-related lifestyle changes and cannabis policy shifts on ingestion rates, clinical severity, and healthcare utilization remains under examined. The goal of this study is to evaluate trends in pediatric marijuana ingestions before, during, and after the COVID-19 pandemic, focusing on age distribution, clinical outcomes, and the increasing burden on emergency and inpatient care.

Methods: This retrospective cohort study analyzed pediatric marijuana ingestion cases at a tertiary pediatric emergency department (ED) from 2016 to 2023. Cases were categorized as pre-pandemic (before March 11, 2020) and pandemic-era (until May 11, 2023). Linear regression was used to assess ingestion trends by age group, and chi-square tests examined associations between ingestion rates, and hospital disposition.

Results: The mean age of ingestion cases declined from 15.4 years (SD 3.0) pre-pandemic to 13.9 years (SD 4.6) during the pandemic. Cases among children aged 0-5 years increased by 1466.67%, with the strongest annual growth in the 6-11-year group (R² = 0.86, p < 0.05). Overall, marijuana ingestions rose by ~40 cases per year (p = 0.002). The proportion of total ED visits related to marijuana ingestion nearly tripled from 2016–2019 (0.20%-0.26%) to 2023 (0.70%).
Disposition analysis revealed a significant increase in hospital floor admissions (p = 0.0037) and ED visits (p = 0.0016), whereas ICU admissions remained stable. These trends align with national reports linking increased pediatric cannabis exposures to edible availability and legalization policies.

Conclusion: Pediatric marijuana ingestions have risen sharply, particularly among younger children, reflecting increased accessibility of cannabis products. The growing burden on emergency and inpatient services underscores the need for stricter child-resistant packaging, targeted caregiver education, and policy interventions to reduce accidental exposures. Further studies are needed to evaluate long-term neurodevelopmental effects and the effectiveness of regulatory measures.