{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:24:38Z","timestamp":1782779078873,"version":"3.54.5"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to explore a dose-response relationship of delta-9-tetrahydrocannabinol (THC) in THC-na\u00efve children after unintentional acute exposure and compare clinical outcomes with non-na\u00efve children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was performed on children aged 31 days to 20 years who presented to Children's Hospital Colorado for care related to acute THC toxicity. The children were divided into groups based on exposure: group 1 (THC na\u00efve) and group 2 (THC non-na\u00efve).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 38 children (age, 3.5 [3] years) met inclusion for group 1 and an equal number of children (age, 15.1 [3.9] years) met the criteria for comparison in group 2. Eight na\u00efve patients had documentation of estimated THC dose ingested (mean [SD], 7.13 [5.8] mg\/kg; range, 2.9\u201319.5 mg\/kg). A direct relationship between estimated oral THC dose, level of medical intervention required, and hospital disposition was observed. Lethargy\/somnolence was more common in the na\u00efve group (84% vs. 26%,<jats:italic toggle=\"yes\">P<\/jats:italic>&lt; 0.0001) whereas problems in cognition, perception, and behavior were more common in the non-na\u00efve group (4% vs 11%,<jats:italic toggle=\"yes\">P<\/jats:italic>= 0.01). The duration of clinical effect and length of hospital stay were longer in the na\u00efve group (19.3 vs 5.0 hours,<jats:italic toggle=\"yes\">P<\/jats:italic>&lt; 0.0001) and (0.73 vs 0.19 days,<jats:italic toggle=\"yes\">P<\/jats:italic>&lt; 0.0001) respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There seems to be a direct relationship between the estimated oral THC dose (mg\/kg), hospital disposition, and level of medical intervention required. Symptoms and duration of effects after THC exposure varied based on the route of exposure, age of patient, and history of previous THC experience.<\/jats:p><\/jats:sec>","DOI":"10.1097\/pec.0000000000000770","type":"journal-article","created":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T17:38:12Z","timestamp":1461087492000},"page":"457-462","source":"Crossref","is-referenced-by-count":21,"title":["Marijuana Misadventures in Children"],"prefix":"10.1097","volume":"34","author":[{"given":"Justin W.","family":"Heizer","sequence":"first","affiliation":[{"name":"Pharmacy Department, Children's Hospital Colorado; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.","family":"Borgelt","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferras","family":"Bashqoy","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Children's Hospital Colorado; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George S.","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela D.","family":"Reiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20230930","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1002\/phar.1187","article-title":"The pharmacologic and clinical effects of medical cannabis","volume":"33","year":"2013","journal-title":"Pharmacotherapy"},{"key":"bib2-20230930","first-page":"153","article-title":"Medicinal use of cannabis in the United States: historical perspectives, current trends, and future directions","volume":"5","year":"2009","journal-title":"J Opioid Manag"},{"key":"bib3-20230930","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1021\/ja01062a046","article-title":"Isolation, structure, and partial synthesis of an active constituent of hashish","volume":"86","year":"1964","journal-title":"J Am Chem Soc"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0031-6997(25)06861-9","article-title":"Pharmacokinetics and metabolism of delta 1-tetrahydrocannabinol and other cannabinoids with emphasis on man","volume":"38","year":"1986","journal-title":"Pharmacol Rev"},{"key":"bib7-20230930","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.chiabu.2011.03.012","article-title":"A case series of marijuana exposures in pediatric patients less than 5 years of age","volume":"35","year":"2011","journal-title":"Child Abuse Negl"},{"key":"bib8-20230930","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1192\/bjp.178.2.101","article-title":"Pharmacology and effects of cannabis: a brief review","volume":"178","year":"2001","journal-title":"Br J Psychiatry"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1177\/0269881108089870","article-title":"Modelling of the concentration-effect relationship of THC on central nervous system parameters and heart rate \u2014 insight into its mechanisms of action and a tool for clinical research and development of cannabinoids","volume":"22","year":"2008","journal-title":"J Psychopharmacol"},{"key":"bib11-20230930","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/S0140-6736(09)61037-0","article-title":"Adverse health effects of non-medical cannabis use","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"bib12-20230930","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.annemergmed.2014.01.017","article-title":"Association of unintentional pediatric exposures with decriminalization of marijuana in the United States","volume":"63","year":"2014","journal-title":"Ann Emerg Med"},{"key":"bib13-20230930","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1001\/jamapediatrics.2013.140","article-title":"Pediatric marijuana exposures in a medical marijuana state","volume":"167","year":"2013","journal-title":"JAMA Pediatr"},{"key":"bib15-20230930","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.drugalcdep.2014.04.016","article-title":"Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003-11","volume":"140","year":"2014","journal-title":"Drug Alcohol Depend"},{"key":"bib16-20230930","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1365-2125.2008.03329.x","article-title":"Biomarkers for the effects of cannabis and THC in healthy volunteers","volume":"67","year":"2009","journal-title":"Br J Clin Pharmacol"},{"key":"bib19-20230930","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1080\/15563650600907165","article-title":"2005 Annual Report of the American Association of Poison Control Centers' national poisoning and exposure database","volume":"44","year":"2006","journal-title":"Clin Toxicol (Phila)"},{"issue":"(4)","key":"bib20-20230930","first-page":"327","article-title":"Pharmacokinetics and pharmacodynamics of cannabinoids","volume":"42","year":"2003","journal-title":"Clin Pharmacokinet"},{"issue":"(4)","key":"bib21-20230930","first-page":"656","article-title":"Unheated Cannabis sativa extracts and its major compound THC-acid have potential immuno-modulating properties not mediated by CB1 and CB2 receptor coupled pathways","volume":"6","year":"2006","journal-title":"Int Immunopharmacol"},{"key":"bib22-20230930","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jat\/bku116","article-title":"Non-smoker exposure to secondhand cannabis smoke. 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