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Recent Trends in Marijuana-Related Hospital Encounters in Young Children

  • Colleen E. Bennett
    Correspondence
    Address correspondence to Colleen E. Bennett, MD, MSHP, Division of General Pediatrics, The Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Buerger Center 12th Floor Rm 12-241, Philadelphia PA 19104
    Affiliations
    Division of General Pediatrics, The Children's Hospital of Philadelphia (CE Bennett and JN Wood), Philadelphia, Pa

    National Clinician Scholars Program, University of Pennsylvania (CE Bennett, A Venkataramani, and JN Wood), Philadelphia, Pa

    Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (CE Bennett, FM Henretig, and JN Wood), Philadelphia, Pa
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  • Atheendar Venkataramani
    Affiliations
    National Clinician Scholars Program, University of Pennsylvania (CE Bennett, A Venkataramani, and JN Wood), Philadelphia, Pa

    Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center (A Venkataramani, FM Henretig, and JN Wood), Philadelphia, Pa

    Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania (A Venkataramani), Philadelphia, Pa
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  • Fred M. Henretig
    Affiliations
    Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center (A Venkataramani, FM Henretig, and JN Wood), Philadelphia, Pa

    Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (CE Bennett, FM Henretig, and JN Wood), Philadelphia, Pa

    Division of Emergency Medicine and Poison Control Center, The Children's Hospital of Philadelphia (FM Henretig), Philadelphia, Pa
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  • Jennifer Faerber
    Affiliations
    Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia (J Faerber and L Song), Philadelphia, Pa
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  • Lihai Song
    Affiliations
    Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia (J Faerber and L Song), Philadelphia, Pa
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  • Joanne N. Wood
    Affiliations
    Division of General Pediatrics, The Children's Hospital of Philadelphia (CE Bennett and JN Wood), Philadelphia, Pa

    National Clinician Scholars Program, University of Pennsylvania (CE Bennett, A Venkataramani, and JN Wood), Philadelphia, Pa

    Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center (A Venkataramani, FM Henretig, and JN Wood), Philadelphia, Pa

    Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (CE Bennett, FM Henretig, and JN Wood), Philadelphia, Pa
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      Abstract

      Objective

      Multiple states have passed legislation permitting marijuana use. The impact of legalization on trends in hospital encounters for marijuana exposures in young children across states remains unknown. We aimed to describe trends in marijuana-related hospital encounters over time in children <6 years and assess the association of state-level marijuana legislation with the rate of marijuana-related hospitalizations.

      Methods

      We identified inpatient, emergency department and observation encounters for children <6 years with marijuana exposures (defined by International Classification of Diseases diagnosis codes) unique on the patient-year level at 52 children's hospitals in the Pediatric Health Information System database from 01/01/2004 to 12/31/2018. Trends in encounters across the study period were evaluated using negative binomial regression with outcome of marijuana-related hospital encounters and year as the predictor variable accounting for clustering by hospital. We then estimated a negative binomial regression difference-in-difference model to examine the association between the main outcome and state recreational and medical marijuana legalization.

      Results

      Of the 1296 included unique patient-year encounters, 50% were female with mean age 2.1 years (standard deviation = 1.4). Fifty percent were inpatient (n = 645) and 15% required intensive care with 4% requiring mechanical ventilation. There was a 13.3-fold increase in exposures in 2018 compared to 2004 (P< .001). We did not find an effect of state legalization status for recreational (P = .24) or medical (P = .30) marijuana.

      Conclusions

      The observed dramatic increase in marijuana-related hospital encounters highlights the need for prevention strategies aimed at reducing unintentional marijuana exposures in young children, even in states without legislation permitting marijuana use.

      Keywords

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