Thursday, 28 July 2016

Your kid is way more likely to be poisoned by crayons than by marijuana

A new study in the journal JAMA Pediatrics is making waves this week with the news that there's been a sharp uptick in emergency-room visits and poison-control calls for marijuana poisoning among children in Colorado.

The study found that the number of marijuana-related hospital visits for children under the age of 10 more than doubled since the opening of Colorado's recreational marijuana market, from seven in 2013 to 16 visits in 2015. Marijuana-related poison control calls for young kids also rose sharply over that period, from 25 to 47.

Opponents of marijuana legalization were quick to jump on the findings. Kevin Sabet, president of Smart Approaches to Marijuana, tweeted his reaction:
On the other hand, it's not entirely surprising that a new market offering a product for the first time will lead to an uptick in cases of accidental ingestion and misuse. Marijuana edibles — pre-packaged candies, brownies and the like — are naturally appealing to small kids and accounted for nearly half of the hospital visits in the JAMA study.

Beyond that, the raw numbers on marijuana exposure are extremely low. Marijuana accounts for only 2.3 of every 1,000 poison control cases for kids 10 and younger in Colorado, according to the JAMA study. At the national level, kids are much more likely to be poisoned by any number of common household products, like diaper cream, toothpaste, or energy drinks, than they are to be poisoned by marijuana.

Part of this, of course, is a function of how common these products are. You are much more likely to find toothpaste and diaper cream in a house with a toddler than you are to find marijuana — hence, little kids are more likely to swallow toothpaste or diaper cream, and worried parents more likely to call poison control over it.

It's also worth noting that a call to a poison control center doesn't necessarily mean that a poison has taken place — a child may slurp down the toothpaste on her toothbrush prompting a panicked call to poison control, only to have the operator tell the parent that everything will be just fine.

You can correct for this somewhat by looking at rates of poisoning, however — for a given substance, how many poison control center calls for every 1 million adult users of the drug. We have a good sense of how many people use any given drug from federal surveys that are administered every year.

So here's the number of poison control center calls nationwide for children ages 5 and younger, by the type of drug the child accidentally consumed, in 2014. I'm sticking with the big three American drugs — alcohol, tobacco and marijuana — because lots of people use them and policymakers often frame marijuana debates with comparisons to booze or cigarettes.

Drug Poison control calls for kids 5 and under per 1 million adult users, 2014
Marijuana 9
Alcohol 9
Tobacco 134


Source: National Poison Data Center, National Survey on Drug Use and Health  
The big standout here is tobacco, which is kind of surprising. It's hard to tell why the tobacco number is so high, relatively speaking. The majority of little kid-related tobacco calls involves cigarettes.

It's possible that the sight of a 2-year-old gnawing on a Marlboro red is more concerning to the typical parent than say, if that same 2-year-old were to sneak a sip of dad's beer. Also, there historically has been a lot more public health messaging about the health risks of tobacco and nicotine than of alcohol, which may play a role, too.

The interesting number is marijuana, which has the exact same exposure rate for children as alcohol. But politicians generally aren't calling for alcohol to be outlawed in order to protect children. This is at least partly because legal alcohol has been around for forever. We’re comfortable with it. But legal marijuana  is new, and new things are scary.

As Smart About Marijuana's Sabet notes, "legalization hurts." But so does alcohol. So does tobacco. So do diaper cream, toothpaste, laundry detergent and crayons (1,683 crayon-related poison control calls for kids in 2014, in case you were curious).

This year, marijuana opponents are raising hundreds of thousands of dollars to combat what they say are the threats of the drug. But as far as I'm aware, there are currently no efforts afoot to ban crayons.

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