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THC

These images reveal the striking similarities between real candy and edible products containing THC. Photos from the Suffolk County Department of Health Services

Children are getting into their parents’ supplies of edible marijuana, leading to an increase in illnesses and emergency room visits.

Stony Brook Pediatric Hospital treated 14 children in 2022 and 13 in 2021 — up from about one or two a year before 2020.

Dr. Candice Foy, a pediatric hospitalist at Stony Brook Children’s Hospital. Photo from Stony Brook Medicine/Jeanne Neville

“In the last two years, we’ve seen very high numbers,” said Dr. Candice Foy, a pediatric hospitalist at Stony Brook Children’s Hospital.

The accidental consumption of marijuana among children has increased throughout the country. A study published in the journal “Pediatrics” indicates that calls to poison control centers for children five and under for the consumption of edibles containing tetrahydrocannabinol, or THC — the main ingredient in the cannabis plant — rose to 3,054 in 2021 from 207 in 2017, with over 95 percent of the children finding gummies in their homes.

Amid an increase in adult use of edible gummies containing marijuana, children of a wide range of ages have mistaken them for candy, leading to symptoms that trigger medical concerns from their parents.

Children with THC in their system can have low blood pressure, high heart rates, lethargy and sleep for prolonged periods, Foy said.

One child required a machine to help breathe.

Dr. Jennifer Goebel, emergency room doctor at Huntington Hospital, said the hospital recently saw children who were dizzy and not acting appropriately.

When pediatric patients accidentally consume pot edibles, doctors also need to consider what else they might have in their system, Goebel added.

Dr. Jennifer Goebel, emergency room doctor at Huntington Hospital. File photo from Northwell Health

Significant exposure can “lead to severe hyperactive behaviors, slowed breathing and even coma,” Dr. Gregson Pigott, Suffolk County Health Commissioner, explained in an email.

The health effects of marijuana can last 24 to 36 hours in children. The response may vary based on the amount ingested, the size of the child and metabolic factors, Pigott added.

Unlike naloxone, which health care providers can administer to counteract the effect of narcotics, doctors don’t have the same resources available with accidental marijuana ingestion.

Doctors opt for supportive care. A nauseous child could receive anti-nausea medication, while a child sleeping and not eating or drinking can receive intravenous fluids.

Typically, doctors observe children who consume marijuana for several hours, often releasing them to return home once the symptoms subside.

Hospitals are required to call child protective services during such an incident. Investigators usually find that such consumption is incidental, as parents sometimes leave their edibles in the wrong location.

“A lot of times, CPS will go in there” and, after checking the home, “will close the investigation,” Foy said.

Doctors and local officials urged people who consume such edibles themselves either not to keep them in the house or to put them in places far from other candy or food, such as in an inaccessible spot in the back of a closet.

Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services. File photo

“The Department’s Office of Public Information has issued warnings about keeping edible gummies out of the reach of children through its social media channels,” Pigott explained in an email. “In addition, the New York State Office of Addiction Services and Supports and our partners in prevention promote safe keeping of all THC products, including edibles, out of reach and in secure child safe storage,” such as a lock box.

Goebel cautioned that children are adept at getting to products that appeal to them, mainly if the packaging makes them look like candy.

Many of the pot-related medical issues are “accidental,” Goebel said.

Hospitals have seen a range of children with marijuana symptoms, from as young as one year old to 11, with the vast majority falling between two and four years old, Foy said.

“I don’t think it’s something that a lot of people think about the same way they think about protecting their children from bleach and other chemicals commonly found” in the home, she said. It’s important to “get the message out” and ensure “people are talking about this.”

The Suffolk County Department of Health Services Office of Health Education offers curriculum and teacher training to public and private schools at no cost. The lessons address behaviors that lead to morbidity and mortality in the young, including intentional and unintentional injuries, such as injury caused by children ingesting edible gummies or other edible-infused products, Pigott wrote.

“During parent workshops, we show the similarity between real food items and the THC-containing items that look like the food item to highlight how deceptive and easy it is to mistakenly ingest cannabis-laden products,” he added.

Pictured above, New York State Sen. Dean Murray (R-East Patchogue), left of poster, and state Assemblywoman Jodi Giglio (R-Riverhead), right of poster, along with Republican state legislators. Photo by New York State Senate Photography

This past week in Albany, New York State Sen. Dean Murray (R-Patchogue) and state Assemblywoman Jodi Giglio (R-Riverhead) joined with Republican colleagues from the state Senate and Assembly at a press conference calling for the crackdown on improper and deceptive packaging practices for edible products with THC infusions. 

The lawmakers said there has been a dramatic increase in cases of children mistaking these products for regular candies and snack foods, with dangerous and sometimes deadly results. 

Murray and Giglio have introduced legislation that would target this practice, mandating that THC-infused edibles on the market are marked and packaged plainly and increasing penalties for violators.

An assortment of cannabis products resembling household children's foods and snacks. Photo courtesy the Town of Brookhaven Drug Prevention Coalition

Public officials and drug prevention advocates are sounding the alarm over cannabis products packaged for children.

During a recent Port Jefferson Station/Terryville Civic Association meeting, civic vice president Sal Pitti circulated a flier revealing various cannabis products resembling commonplace children’s foods and household snacks. 

Pitti, who is also active with the Town of Brookhaven’s Drug Prevention Coalition, suggested these products are branded for children and attributes the problem to false advertising.

“We all grew up with Trix and Cocoa Pebbles when we were kids,” he said. “It’s a branding that people know, they recognize and might more easily purchase.”

‘This is going to open up a door to our youth that’s going to hurt them. This is just a bomb that’s waiting to go off.’

—Sal Pitti

Pitti detailed several potential dangers associated with tetrahydrocannabinol, the active ingredient in marijuana commonly known as THC, getting into the hands of young people. He said processed edible cannabis often has exponentially higher THC concentrations, which can get kids hooked on the substance more efficiently and create a gateway to harder drugs.

Recent statistics from the National Institute on Drug Abuse substantiate this claim. Samples analyzed by the U.S. Drug Enforcement Agency since 1995 indicate that today’s cannabis products are nearly four times as potent as those collected in that year.

“They’ve sophisticated this technique to great extents,” Pitti said. “Now they’re making gummies, candies, granola bars, honeys and spreads out of this stuff. But the problem is, in processing all of this, that THC level has gone up dramatically.”

Pitti said packaging highly potent THC products to children signals potentially severe societal harm. “This is going to open up a door to our youth that’s going to hurt them,” he said. “This is just a bomb that’s waiting to go off.”

A crisis for children

Pitti is not alone in these concerns. Suffolk County Legislator Kara Hahn (D-Setauket) has introduced legislation targeting the practice. 

Her bill cites the risks associated with underage THC consumption, such as impaired memory and coordination, and the potential for hallucinations and paranoia among minors. 

In an interview, Hahn suggested marketing cannabis in a manner that makes it desirable to children represents a public safety hazard.

“If it’s intentionally designed to look like candy, the purpose is to confuse the consumer,” she said, adding, “If an adult purchases marijuana gummies that are packaged similarly to candy-type gummies and a young child gets their hands on it and eats it unknowingly, that’s a very dangerous situation for the child.”

Hahn’s bill would require packaging of THC products to be plain, containing clear warning labels and prohibiting the words “candy” or “candies.” She noted that the measure’s goal is to make THC products less enticing to kids.

“The packaging of the products is incredibly important,” the county legislator said, stating the bill would prevent merchants from “mimicking candy wrappers, having logos that are like cartoons or characters or having flavors that are attractive to children.”

Suffolk County Legislator Sarah Anker (D-Mount Sinai), chair of the county’s Addiction Prevention and Support Advisory Panel, has signed on as a co-sponsor to Hahn’s bill. She referred to child-friendly THC packaging as a harmful way for cannabis sellers to market their products.

“These cannabis folks see this as a marketing strategy,” she said. “It’s creating a problem, we know for a fact, and we’re trying to address that.”

State oversight

Marijuana was legalized in New York state in 2021 under the Marihuana Regulation and Taxation Act. The New York State Office of Cannabis Management is the regulatory arm overseeing the licensure, production, sale and taxation of cannabis throughout the state. In an email statement, the office confirmed the uptick in packaging branded for children.

“We have seen illicit sellers marketing products clearly imitating candies and snacks that target children,” said Lyla Hunt, OCM’s deputy director of public health and campaigns. “New York State would never allow those products to be sold in licensed cannabis dispensaries. Our enforcement teams are working every day to shut those sellers down.”

Further compounding the issue, Hunt added that illicit dealers often do not follow the same protocols as their licensed counterparts. “We also have heard reports unlicensed storefronts are not checking ID when selling illicit cannabis products, heightening the importance of shuttering these operators before they can do more harm,” she said.

According to her, OCM has worked to curtail the issue through stringent guidelines, putting forth regulations regarding packaging, labeling and marketing to mitigate this technique. 

“We at New York State’s Office of Cannabis Management are committed to building a safe, regulated cannabis industry for consumers ages 21 and over that also protects those under 21,” the deputy director said.

OCM’s regulations concerning packaging echo several of the items raised in Hahn’s bill, restricting words such as “candy” and “candies” while mandating that packages be resealable, child-resistant and tamper evident. The guidelines also limit the use of cartoons, bubble-type fonts and bright colors on the packaging.

Despite OCM’s approach, Anker said the work of local and state government remains unfinished. “More must be done,” the county legislator said. She added, “This product is legally new to the market, and you need to be aware and do your part as a parent and as a teacher … to protect the kids.”

Vapes, or electronic cigarettes, are becoming more and more popular among young people, despite a lack of research about the health effects. Photo by John Petroski

As a New York State ban on flavored e-cigarettes goes into effect Oct. 4, community members and officials on Long Island are hopeful that this will be a good first step in curbing youth smoking. 

The ban comes in the wake of several deaths experts have linked to e-cigarettes. According to the U.S. Centers for Disease Control and Prevention, more than 450 cases of lung illness nationwide have been associated with e-cigarette products containing nicotine or THC. A number of those cases have occurred on Long Island. 

Vape Shops across Suffolk say the new law will hurt their businesses. File photo by Giselle Barkley

Suffolk County Legislator William “Doc” Spencer (D-Centerport) said he believes the ban is a great first step in limiting access of addictive products to young people. 

“I think [the ban] is wonderful news,” he said. “We have seen a disturbing trend, we know this stuff is not good for you.”

Spencer cautioned that they have to be prepared for the unintended consequences of such a ban, particularly he said he wants to make sure that there are support systems and resources available to addicted individuals who may seek help. 

“I want to make sure there are plans for parents who may have a child who is addicted [to e-cigarettes],” he said. “I will be working with the health department on a plan to deal with this.”

Despite the ban, Spencer believes there’s more to do to curb e-cigarette use and vaping, pointing to the ubiquitous e-cigarette product Juul as another concern. 

“One Juul pod is equivalent to smoking a pack of cigarettes,” he said. “You have kids smoking two or three of these pods.”

The legislator also mentioned that there are a number of loopholes on the state and federal level that he feels still need to be addressed. 

There has been an increase in use of e-cigarettes in middle and high school students in recent years. Port Jefferson School District in particular is hosting a vape seminar at its next school board meeting Oct. 15. District officials are hopeful that the ban prevents further teens from thinking of vaping.  

“Any step in the right direction is a good step,” said Paul Casciano, superintendent of the Port Jefferson School District. “Unfortunately, people, including teens, were duped into believing that vaping was a safe alternative to smoking. There is still much more to be done including discussions about peer pressure and the fear of not fitting into a group.”

Casciano said the district has provided information and held numerous presentations on vaping for students and parents. Last December, the district took part in a county pilot program called Vape Out where high school students watched a presentation on the health hazards of vaping and were given advice on how to refuse a hit. They then shared the lessons they learned with other classmates and students in the middle school. 

“No singular program or curriculum is going to eliminate vaping among teens however constant and consistent messages from many voices may begin to stem the tide.” Casciano said.  

“Any step in the right direction is a good step.”

— Paul Casciano

Vape shop and small business owners have long been opposed to legislation on the sale of e-cigarettes. Back in December 2018, at a public hearing to discuss legislation that would have banned the sale of flavored e-cigarettes in Suffolk County, owners said the issue isn’t the flavors but rather an issue of access and enforcement of the sale of tobacco products to individuals over the age of 21. 

Alex Patel, owner of the Rocky Point Smoke and Vape Shop, is concerned about the looming ban on flavored e-cigarettes as it is a popular item purchased at vape shops. 

 “Of course, it is going to affect our business,” he said. “We could close down.” 

Dr. Rachel Boykan, clinical associate professor of pediatrics at Stony Brook Medicine, said while she is supportive of the new ban, she thought it would be better if it included menthol. 

“We know that youth are attracted to these products because of the flavors; this should decrease their appeal,” she said. 

In addition, Boykan mentioned some ideas to further curb youth smoking.    

“We need to regulate advertising, which teens respond strongly to and which is ubiquitous and unregulated, compared with advertising of cigarettes, which is restricted,” she said. “We need to decrease availability by including e-cigarettes in Tobacco 21 legislation … include e-cigs in the same indoor air laws as combusted tobacco.” 

Boykan said she and her colleagues have dealt with many children who vape and they try to educate them on the harm associated with it. 

“We try to educate them about the risks of the flavorings and heavy metals such as copper, in the aerosol, and the recent severe lung illnesses and deaths — which we don’t yet understand,” she said.

The professor provided some advice to parents if they think their child may be vaping. 

“They may smell a fruity smell, they may notice signs of nicotine addiction such as agitation, anxiety, or if they are using marijuana as well,” she said. “The best approach is to establish trust, ask without judgment and be supportive if a child admits to having a nicotine addiction — and take them to their pediatrician for help.”