Careless Cannabis Legislation Leaves Children in Clinical Crisis

America’s experiment with liberal cannabis laws has produced a quiet public‑health crisis for children, with poison centres now fielding thousands of calls a year about kids who have eaten or otherwise been exposed to THC products that were never meant for them.

A surge no one planned for

The Bertino et al. study; Changes in Exposures of US Children Ages 12 and Under to Cannabis from 2000 to 2024 shows that paediatric cannabis exposures in the United States were essentially flat for a decade, then exploded as federal policy relaxed and commercial markets took off. From 2000 to 2009, annual exposures in children under six hovered between 108 and 141, with 132 cases in 2009. Starting in 2010—the year after the Department of Justice’s Ogden Memorandum signalled non‑prosecution for state‑legal medical marijuana—calls began climbing every year.

By 2024, poison centres logged 8,430 cannabis exposures in children under six, an increase of 6,386% since 2009. For kids aged six to twelve, cases rose even more dramatically—from 21 in 2009 to 2,894 in 2024, a jump of 13,781%. A business‑wire summary of the same data notes that more than 11,000 children 12 and under experienced cannabis exposures in both 2023 and 2024, underscoring that this is not a statistical blip but a new, entrenched reality.

This spike lines up closely with what policy researchers identify as the “fourth period” of modern U.S. cannabis policy: federal hands‑off enforcement beginning in 2009; wider state‑level legalization of medical and later recreational use; and then the 2018 Farm Bill, which legalized hemp and, with it, a vast array of psychoactive hemp‑derived cannabinoids.

Policy that pretends children don’t exist.

Cannabis laws were sold to the public as carefully calibrated frameworks for adult use, but the data suggest they have functioned as de facto green lights for an industry that designs, packages and markets products in ways that predictably ensnare children.

Between 2009 and 2024, the number of states with legal medical cannabis grew from 13 to 38, and those allowing recreational sales grew from zero to 24. Over the same period, “thousands of dispensaries” opened across the country, putting potent THC products into ordinary homes and neighbourhoods. The Agriculture Improvement Act of 2018—the Farm Bill—went further, explicitly legalizing all components of the hemp plant, including THC analogues like delta‑8 that can produce strong intoxication but are often regulated more loosely than traditional marijuana.

For children, the practical effect has been straightforward: vastly more psychoactive products at arm’s length, often in colourful, sugary forms resembling candy, chips and breakfast cereals. At convenience stores and gas stations, hemp‑derived THC gummies and chocolates are sold in packaging that could be mistaken for mainstream snacks, a design choice that regulators have repeatedly warned “appeals to children” and invites accidental ingestion.

The core failure is not simply legalization itself, but a policy mindset that treats child risk as an afterthought—assuming that adult‑oriented rules, coupled with parental vigilance, will be enough. The poison‑centre data say otherwise.

How cannabis hurts kids

Clinicians now describe paediatric cannabis intoxication as a growing, and distinct, toxicology problem. Unlike adult users, most young children are not choosing to consume cannabis; they are stumbling into it—often literally—when they find edibles in cupboards, bags or refrigerators at home.

Multiple studies have shown that oral ingestion is responsible for the majority of cannabis exposures in young children. Edibles, in particular, drive the most serious cases. A prospective cohort study of paediatric cannabis intoxication in North America found that “virtually all” hospital admissions of children under 10 for severe cannabis toxicity resulted from ingestion of edible preparations. These children can present deeply sedated, minimally responsive, with breathing difficulties and cardiovascular instability; many require intensive monitoring, and some need admission to intensive care units.

A large analysis of edible exposures between 2017 and 2021 reported that about 22.7% of affected children were admitted to hospital, and a significant share required ICU care, reflecting moderate or major clinical effects. Bertino’s summary of poison‑centre data notes that in previous work, over 20% of under‑six exposures led to hospital admission and up to 8% to intensive care. A narrative review in Paediatrics Annals describes increasing paediatric toxicity in jurisdictions that have legalized and commercialized cannabis, with well‑documented risks of respiratory depression, severe central nervous system depression, and cannabis hyperemesis syndrome in adolescents.

The harms are not limited to traditional delta‑9 THC. Hemp‑derived delta‑8 THC products have produced thousands of poison‑centre calls in just a few years, with children and teens making up the majority of exposures. The U.S. Food and Drug Administration report adverse events including hallucinations, vomiting, tremor, anxiety and loss of consciousness, with many cases requiring hospital care and at least one paediatric death under investigation. Yet these products are often marketed as “legal” or “safer” alternatives, obscuring their potency and risks.

An avoidable design problem

What makes this crisis particularly troubling is how much of it appears baked into product design and regulatory gaps, rather than being an unavoidable consequence of adult cannabis use.

The National Poison Data System shows paediatric exposures were relatively stable when cannabis was less commercialized and less available in child‑friendly formats. The inflection point coincides with three overlapping trends:

Normalization and commercialization. As dispensaries proliferated and cannabis branding matured, products became more enticing and widely distributed, moving from opaque bags to brightly labelled candy‑like packaging.
Potency escalation. Modern edibles often contain high doses of THC per piece or package, raising the stakes when a small child consumes even one gummy or brownie.
Regulatory lag. While alcohol and pharmaceuticals are subject to strict child‑resistant packaging standards and clear dosing rules, cannabis edibles and hemp‑derived THC products have frequently rolled out under patchwork regulations, with inconsistent limits on THC per package and variable enforcement against copycat branding.

Unintentional ingestions spike in regions that legalize and retail cannabis products, suggesting a direct relationship between retail availability, home presence of edibles, and paediatric poisonings. Yet at the federal level, policy has been slow to respond. The same Farm Bill that opened the door to hemp‑derived psychoactive did not build in robust measures to prevent child‑targeting designs or ensure child‑resistant packaging, leaving regulators like the FDA to play catch‑up with warning letters and ad‑hoc enforcement.

Clinicians and toxicologists are blunt: there is no antidote for THC intoxication, and prevention—through packaging, dosing limits, marketing restrictions and secure storage—is the only reliable way to protect children.

What a child‑centred cannabis policy would look like

The data in the Bertino study and the wider medical literature point toward a set of concrete, evidence‑based reforms that could sharply reduce harm without undoing adult legalization.

Bring hemp‑derived psychoactive products under robust regulation. As the Journal of Addiction Medicine article argues, delta‑8 and similar hemp‑derived THC analogues should be explicitly regulated as intoxicants, with clear age restrictions, product standards, labelling and marketing rules—rather than treated as quasi‑legal supplements.
Mandate true child‑resistant packaging and ban child‑appealing designs. Regulators could require opaque, non‑cartooned packaging for all THC‑containing edibles, prohibit look‑alike branding that mimics popular candies or cereals, and enforce standards that make accidental opening by young children highly unlikely.
Limit THC per unit and per package. Caps on total THC in an edible package and on per‑piece dosing would reduce the severity of intoxication when accidents occur, particularly for toddlers and preschoolers who may consume multiple pieces at once.
Integrate paediatric risk into licensing and retail rules. States could tie dispensary licensing to adherence with child‑safety standards, require staff training on safe storage messaging, and restrict product placement and advertising that target family spaces.
Fund public education and surveillance. Poison‑centre data are already a vital warning system, but more direct investment in surveillance, rapid reporting and parent‑focused education campaigns could bring awareness closer in line with the true risk.

None of these changes would abolish adult cannabis use. They would simply acknowledge that children live in the same homes and neighbourhoods as the adults whose access policy has prioritized—and that the public‑health balance needs to be re‑centred on those who have no say in what is stocked in the pantry or sold at the corner shop.

The lesson from the past decade of data is stark: when cannabis policy is written as if children don’t exist, they show up anyway—in emergency departments, toxicology registries and poison‑centre call logs. The question now is whether lawmakers are willing to treat that reality not as collateral damage, but as a design flaw that can and must be fixed.

By Dalgarno Institute