Medical Marijuana: Child-Safe Packaging Needed

jolly lolly medical marijuana suckerThe Compassionate Use of Medical Marijuana Act aims to amend West Virginia state law so that physician-supervised patients with an authorized chronic or debilitating medical condition can cultivate plants and possess up to an ounce of usable marijuana for medical purposes. The measure also allows for the establishment of five compassion centers to dispense medical cannabis to qualified patients.  The proposal to legalize medical marijuana in West Virginia seems destined to die in committee this year, but now is the time to consider how to better protect children.  Bills of this type are gaining traction across the country, and we will likely see this come up for debate again in WV in 2014.

Certain safety measures have been included in House bills 2230 and 2961 which govern highway and workplace safety, but based on Colorado’s experience since legalizing cannabis use for medical purposes, some definite safeguards need to be in place to protect the children of our state.

Since the legalization of medical marijuana in Colorado, 14 children ages 8 months to 12 years old have been hospitalized for accidental ingestion of toxic amounts of pot in the past two years.  Though according to many medical professionals, it is nearly impossible for an adult to overdose on marijuana, children must be protected as much as possible from attractive forms of the delivery of this drug (such as suckers, gummy worms, or brownies — though I’m not sure why adults need these forms of delivery for their medicine) — primarily through the common sense of adult users, and secondly, through child-safe packaging and clear reporting and tracking for marijuana poisonings.

Already included in HB 2230 for the protection of drivers:  “Operating, navigating, or being in actual physical control of any motor vehicle, aircraft or motorboat while under the influence of marijuana, except that a registered qualifying patient or visiting qualifying patient may not be considered to be under the influence of marijuana solely because of the presence of metabolites or components of marijuana that appear in insufficient concentration to cause impairment.”

Addition safeguards in HB 2230 address hazardous work environments in West Virginia such as heavy equipment operations, coal mines, and gas well drilling sites:  “An employer is not required to allow the ingestion of marijuana in any workplace or to allow any employee to work while under the influence of marijuana,” and for the protection of employees:  “A registered qualifying patient may not be considered to be under the influence of marijuana solely because of the presence of metabolites or components of marijuana that appear in insufficient concentration to cause impairment.”

Tamper-proof Packaging Needed for Medical Cannabis:

An April 1, 2013, article by Michael Booth of the Denver Post focuses on the accidental ingestion of medical marijuana by children leading to ER visits which has spurred new debates about safe packaging.

From early 2005 to late 2009, Children’s Hospital Colorado had exactly zero emergency-room visits by kids who had ingested marijuana. In the following two years, when medical marijuana became legal in Colorado and federal officials backed off prosecution, it had 14.

Pioneering studies of ER charts by Colorado doctors show looser pot laws leading to childhood poisonings, often from mistakenly eating tantalizing “edibles” like gummy worms or brownies.

Those doctors are now helping lead the charge for mandatory safety packaging as Colorado gears up for even broader legal sales of pot with recreational-marijuana stores.

“We’ve seen a dramatic increase in pediatric exposure,” said Dr. George Wang, a Children’s ER doctor who also works with Denver Health’s Rocky Mountain Poison and Drug Center.

Safety packaging, as in other medicines, “is a supplement to careful parenting that has been shown to work,” said Wang’s colleague, Dr. Michael Kosnett. “There are solutions available right now.”

And the marijuana industry agrees, up to a point, but argues that the tamper-proof packaging would greatly increase the cost of producing these goods and would add to landfill problems.

Serious Medical Consequences for Small Children

There are serious medical consequences for small children, though, even while marijuana advocates say an adult “overdose” of pot is nearly impossible.

Prescribed dosages of THC, the active ingredient in marijuana products used to control nausea from chemotherapy, is between 4 and 12 milligrams for children ages 2 to 4, based on body surface area. Some “edibles” have 300 milligrams of THC, Kosnett said.

The researchers say individual safety packs would be best, but the current recommendation of all items leaving the store in one secure package is “better than nothing.”

Because there is no clear reporting category for marijuana poisonings, doctors have to cull through files to count cases. Presbyterian/St. Luke’s, which operates Rocky Mountain Hospital for Children, said it does not track similar cases.

The cases studied at Children’s included decreased levels of consciousness and breathing trouble. Children can also vomit from ingesting too much of a strong substance and aspirate the vomit.

Child-ingested pot is also dangerous because ER doctors aren’t looking for it as a cause of any symptoms they see, Wang said. That can lead to invasive and expensive diagnostic efforts, such as a spinal tap or CT scan, if parents are embarrassed or scared to mention the true cause.

“When children get admitted to the ICU, that’s serious,” Kosnett said. Symptoms may appear similar to meningitis, for example.

Safety packaging and parental prevention should be noncontroversial, said Dr. Robert Brockmann, president of the Colorado Academy of Family Physicians, especially as newly legal recreational use will greatly expand the supply.

“None of that information is being disseminated when it’s dispensed,” Brockmann said. “It’s like liquor or prescription medications, or anything else you don’t want your kids to get into.”

Kosnett likens the social moment to that of the 1970 U.S. Poison Prevention Packaging Act, which launched many of the safety containers now ubiquitous in medical and chemical markets. One standard for packages, Kosnett said, is that no more than 20 percent of 5-year-olds be able to open a container within 10 minutes.

Such measures have cut pediatric poisonings in various categories by 40 to 90 percent over the decades, he said.

Submitted by the Robinette Legal Group, PLLC, West Virginia Injury Lawyers. Free books and downloads for WV accident victims — Call us today: 304-594-1800 for your free copy of Righting the Wrong: WV Serious Injury Guide; Collision Care: WV Auto Injury Guide; or Beside Still Waters: WV Fatal Injury Guide for Families.

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Read more: Colorado pot accidents spur call for childproof packaging – The Denver Post