Health equity and unintentional pediatric cannabis ingestion.

Blumberg M.; Thompson A.; George B.; Lendrum E.; Pomerantz W. · Injury epidemiology · 2026

**Background & Methods** This retrospective cohort study examined unintentional cannabis ingestion in children aged 0-6 years presenting to two high-volume pediatric trauma centers between June 2016 and September 2024, spanning periods before and after medical and recreational cannabis legalization. Emergency department records were reviewed for positive urine drug screens for tetrahydrocannabinol, with manual chart abstraction assessing ingestion type, source, location, and social management interventions including social work and child protective services involvement. **Key Findings** • Unintentional pediatric cannabis ingestion cases increased substantially over the study period, with 51.8% of 266 cases occurring in 2023-2024 following recreational legalization; the majority of children were under age 2 (58.3%), male (52.3%), non-Hispanic White (43.2%), and publicly insured (71.4%). • Edibles were the most common ingestion type (51.1%), typically sourced from primary guardians (40.2%); most cases presented with high acuity, with 83.5% triaged as ESI Level 1 or 2, 41.7% evaluated in trauma bays, and 82.0% requiring hospital admission, including 20.7% requiring critical care. • No significant disparities in social management were observed across socioeconomic strata by deprivation index: social work consultation (p=0.52), child protective services reporting (p=0.41), discharge to primary guardian (p=0.26), and discharge to primary residence (p=0.144) were equitable across demographic and socioeconomic groups, with social work involvement in 95.5% and CPS involvement in 80.1% of cases. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. The study characterizes clinical presentation severity (ESI triage levels, critical care requirements, trauma bay evaluation) but does not detail specific adverse effects or toxicological outcomes. **Evidence Quality** This retrospective cohort study is limited by its design at two specific trauma centers, potentially limiting generalizability. The restriction to children with confirmed positive urine drug screens may underestimate total incidence. The study provides descriptive epidemiology and identifies associations but lacks mechanistic or comparative intervention data. Evidence quality is moderate; findings are hypothesis-generating regarding health equity in management but require prospective validation.

More recent cannabis research