The effects of recreational cannabis legalization in Alberta on poison control centre calls and paediatric emergency department visits

Objectives To characterize cannabis-related presentations to the two major paediatric emergency departments (EDs) in Alberta as well as calls to Alberta's Poison and Drug Information Services (PADIS) and detect any changes in relation to legalization.Methods This was a retrospective medical record review analyzing all paediatric (ages 0 to 18) ED presentations for cannabis-related concerns. The two sites included were the Stollery Children's Hospital in Edmonton and the Alberta Children's Hospital in Calgary. We searched the PADIS database for all calls in the province for 'Cannabinoids and Analogues' for ages 0 to 19. The rates prior to and after legalization were compared.Results While we saw no overall difference in ED visits, pre- and post-legislation we found an increase in unintentional overdoses in children under 12 years of age (7% versus 15%, proportion change 1.13). The severity of presentations did not change during this time period (37% versus 42%, P 0.254). We also found an increase in calls to PADIS in the 2 years after legalization. There was an increase in exposure to edible cannabis formulations during this time period.Conclusion This study combines a province-wide medical record review of ED visits with poison control centre information to provide a complete look at cannabis intoxication in paediatric patients over the time of legalization. It adds to the growing body of evidence that legalization of recreational cannabis, especially edible formulations has resulted in increased unintentional overdoses in young children.