{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:15:54Z","timestamp":1788419754285,"version":"build-2803163510"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pediatric poisonings involving opioids and cannabis represent two evolving public health challenges. This study compared national inpatient outcomes, complications, and hospital charges among children and adolescents hospitalized with a principal diagnosis of opioid vs. cannabis poisoning in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project National Inpatient Sample from 2016 to 2022. Children and adolescents aged 0\u201318 years with a principal diagnosis of opioid or cannabis poisoning were identified using ICD-10-CM codes. National estimates were generated using the NIS discharge weight (DISCWT), with variance estimation accounting for NIS_STRATUM and HOSP_NIS. A 1:1 nearest-neighbor age-matched analysis was performed on the unweighted discharge records before application of the national weights. Survey-weighted logistic regression was used for binary outcomes, and survey-weighted linear regression was used for length of stay and total hospital charges. Multivariable models were adjusted for age, sex, race\n                      <jats:bold>,<\/jats:bold>\n                      median household income quartile, weekend admission, and admission year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 17,555 weighted pediatric hospitalizations, comprising 10,780 opioid-related and 6,775 cannabis-related poisonings. The proportion classified as cannabis poisoning increased from 24.0% in 2016 to 47.2% in 2022 (survey-weighted trend odds ratio per year, 1.18; 95% CI, 1.14\u20131.23;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). In the age-matched analysis, opioid poisoning was associated with higher risks of mechanical ventilation for more than 24\u2005h (RR, 3.15; 95% CI, 2.00\u20134.95), acute kidney injury (RR, 1.58; 95% CI, 1.10\u20132.25), and respiratory failure (RR, 2.33; 95% CI, 1.25\u20134.35). In the full multivariable analysis, opioid poisoning remained associated with mechanical ventilation for more than 24\u2005h (aOR, 4.65; 95% CI, 2.96\u20137.31) and acute kidney injury (aOR, 2.55; 95% CI, 1.77\u20133.69). Opioid poisoning was also associated with an adjusted increase of 1.06 hospital days (95% CI, 0.78\u20131.34) and $17,286 in hospital charges (95% CI, $12,752-$21,820). Mortality was not reported comparatively because the unweighted number of events in one exposure group was 10 or fewer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cannabis poisoning accounted for an increasing proportion of pediatric opioid and cannabis poisoning hospitalizations during the study period. Nevertheless, opioid poisoning was associated with greater respiratory morbidity, longer hospitalization, and higher hospital charges. These findings support opioid-related respiratory monitoring and harm-reduction efforts by clinicians and public health agencies, together with child-resistant packaging, safe-storage counseling, and caregiver education for cannabis products.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1904477","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:38Z","timestamp":1788417638000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric opioid and cannabis poisoning hospitalizations in the United States, 2016\u20132022: a national age-matched inpatient analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Linor","family":"Fournier","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Carmel Medical Center","place":["Haifa, Israel"]},{"name":"The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology","place":["Haifa, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Shehadeh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Carmel Medical Center","place":["Haifa, Israel"]},{"name":"The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology","place":["Haifa, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Hamad","family":"Saied","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Carmel Medical Center","place":["Haifa, Israel"]},{"name":"The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology","place":["Haifa, Israel"]},{"name":"Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht","place":["Utrecht, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Maman","sequence":"additional","affiliation":[{"name":"The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology","place":["Haifa, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giora","family":"Pillar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Carmel Medical Center","place":["Haifa, Israel"]},{"name":"The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology","place":["Haifa, Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e20173335","DOI":"10.1542\/peds.2017-3335","article-title":"Opioid-Related critical care resource use in US children\u2019s hospitals","volume":"141","author":"Kane","year":"2018","journal-title":"Pediatrics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1513\/AnnalsATS.201701-022OC","article-title":"The critical care crisis of opioid overdoses in the United States","volume":"14","author":"Stevens","year":"2017","journal-title":"Ann Am Thorac Soc"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1001\/jamapediatrics.2016.2154","article-title":"National trends in hospitalizations for opioid poisonings among children and adolescents, 1997 to 2012","volume":"170","author":"Gaither","year":"2016","journal-title":"JAMA Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1097\/01.ccm.0000618708.38414.ea","article-title":"Analysis of 207,543 children with acute opioid poisonings from the national poison data system","volume":"48","author":"Land","year":"2020","journal-title":"Crit Care Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e2022057761","DOI":"10.1542\/peds.2022-057761","article-title":"Pediatric edible Cannabis exposures and acute toxicity: 2017\u20132021","volume":"151","author":"Tweet","year":"2023","journal-title":"Pediatrics"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1080\/15563650.2022.2064867","article-title":"Changes in unintentional pediatric Cannabis exposures in children ages 6 months-5 years","volume":"60","author":"Laudone","year":"2022","journal-title":"Clin Toxicol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1080\/15563650.2016.1209761","article-title":"Characterization of edible Cannabis product exposures reported to U.S. Poison centers","volume":"54","author":"Cao","year":"2016","journal-title":"Clin Toxicol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e239549","DOI":"10.1001\/jamanetworkopen.2023.9549","article-title":"Ingestion of illicit substances by young children before and during the COVID-19 pandemic","volume":"6","author":"Raffa","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e2020019893","DOI":"10.1542\/peds.2020-019893","article-title":"Edible Cannabis exposures among children: 2017\u20132019","volume":"147","author":"Whitehill","year":"2021","journal-title":"Pediatrics"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e230512","DOI":"10.1001\/jamahealthforum.2022.5041","article-title":"Hospitalizations for Cannabis poisoning before and after legalization of recreational Cannabis and edibles in Canada","volume":"4","author":"Myran","year":"2023","journal-title":"JAMA Health Forum"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1080\/10826084.2022.2069268","article-title":"Presence of content appealing to youth on Cannabis-infused edibles packaging","volume":"57","author":"Tan","year":"2022","journal-title":"Subst Use Misuse"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e2023061374","DOI":"10.1542\/peds.2023-061374","article-title":"Toxic tetrahydrocannabinol (THC) dose in pediatric Cannabis edible ingestions","volume":"152","author":"Pepin","year":"2023","journal-title":"Pediatrics"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1152\/jn.00017.2021","article-title":"Neuronal mechanisms underlying opioid-induced respiratory depression: our current understanding","volume":"125","author":"Ramirez","year":"2021","journal-title":"J Neurophysiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2904","DOI":"10.3389\/fimmu.2019.02904","article-title":"The role of opioid receptors in immune system function","volume":"10","author":"Eisenstein","year":"2019","journal-title":"Front Immunol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"16","DOI":"10.18553\/jmcp.2021.27.1.016","article-title":"Economic burden of pediatric prescription opioid poisonings in the United States","volume":"27","author":"Patel","year":"2021","journal-title":"J Manag Care Spec Pharm"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e2024068752","DOI":"10.1542\/peds.2024-068752","article-title":"Opioid prescribing for acute pain management in children and adolescents in outpatient settings: clinical practice guideline","volume":"154","author":"Hadland","year":"2024","journal-title":"Pediatrics"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e2023065137","DOI":"10.1542\/peds.2023-065137","article-title":"Naloxone dispensing to youth ages 10\u201319 years, 2017\u20132022","volume":"154","author":"Terranella","year":"2024","journal-title":"Pediatrics"},{"key":"B18","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1001\/jamapediatrics.2020.1980","article-title":"Association of state-level opioid-reduction policies with pediatric opioid poisoning","volume":"174","author":"Toce","year":"2020","journal-title":"JAMA Pediatr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1001\/jamasurg.2020.5045","article-title":"Guidelines for opioid prescribing in children and adolescents after surgery: an expert panel opinion","volume":"156","author":"Kelley-Quon","year":"2021","journal-title":"JAMA Surg"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1904477\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:39Z","timestamp":1788417639000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1904477\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":19,"alternative-id":["10.3389\/fped.2026.1904477"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1904477","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1904477"}}