The coming legalization of marijuana has health care professionals in Canada worried about a spike in accidental poisonings of children who might mistake edible pot products for regular cookies and brownies.
They need look no further than a 2016 Colorado study that found accidental ingestion became an issue, particularly with toddlers, following marijuana legalization in that state.
Dr. Nancy Murphy, medical director of the IWK Health Centre's regional poison control centre in Halifax, says the data for her province shows such poisonings are rare. But health care professionals fear that could change when the drug is legalized.
When it does happen, it usually involves very young children, typically under the age of two.
"That's when children are very exploratory and get into things they shouldn't get into," she said.
Symptoms in children can include drowsiness, elevated heart rate and trouble breathing. In some cases, young patients need to be treated in intensive care units.
In most cases in Colorado, patients ingested edible cannabis, such as cookies, brownies and candies, since they look like normal, kid-friendly foods.
One way to help prevent that is the packaging, Murphy said.
"Child-resistant packaging has made a huge difference," she said. "The way it's labelled, having opaque rather than clear packaging so they can't see what's on the inside."
That recommendation is contained in the final report released by Prime Minister Justin Trudeau's federal task force on cannabis legalization and regulation in November 2016.
'Be really safe with storage'
But Murphy believes the rules need to go further to prevent children from being injured. For one thing, cannabis advertising should not target young audiences, she said.
Dr. Sam Wang, one of the authors of the Colorado study, agrees child-resistant packaging rules aren't enough to keep children safe.
The regulation was already in place when Colorado saw a spike in cases of unintentional ingestion. The state has imposed more stringent regulations since his study was published, he said.
"I think the state and the marijuana industry and the public health community has been very responsive since the study came out," Wang said. "We passed some prevention measures for marijuana products."
Marijuana gummy candies
One of those measures was adding warning labels to cannabis product packages. Also, gummy candies in the shapes of animals are no longer allowed, since they can appeal to kids, though gummy candies in other shapes, such as marijuana plant leaves, are allowed.
Trudeau's task force also said the Canadian government should prohibit any cannabis product that can be "appealing to children."
Poison control centres on alert
Wang said monitoring at home is the key to preventing harm. Child-resistant packaging can only go so far; what happens at home "is a whole other story."
For example, if a parent takes marijuana cookies out of their original packaging and puts them in a plastic container, there's a greater chance children could get into it.
Murphy agrees education and public awareness go hand in hand with strict regulations.
"We have the advantage of having had people go through this before, and so we can take those lessons and incorporate them into a more proactive approach," she said.
Poison centres across the country will continue to track accidental poisonings from cannabis exposure, and plan to work together and share their data with Health Canada with the goal of understanding the health implications associated with the legalization of cannabis.
"That's going to be important … once the status changes, to see if it's having a negative impact on patients," she said.