Pediatric Hemp-Derived Cannabinoid and Δ9-Tetrahydrocannabinol Exposures: A National Poison Data Study.

OBJECTIVE

To characterize unintentional pediatric exposures to hemp-derived cannabinoids (eg, Δ8-tetrahydrocannabinol [THC], Δ10-THC, tetrahydrocannabinol-O-acetate) and evaluate how these exposures compare with those following Δ9-THC, the primary psychoactive component of cannabis.

METHODS

We conducted a retrospective analysis of the National Poison Data System for single-substance exposures to cannabis edibles reported to contain either Δ9-THC or to hemp-derived cannabinoids in children ≤5 years from January 1, 2023, to December 31, 2024. Clinical effects, interventions, and outcomes were compared using chi-square tests.

RESULTS

During the study period, 9667 Δ9-THC and 2169 hemp-derived cannabinoid cases were identified. In univariate analyses, hemp-derived cannabinoid ingestions were associated with higher rates of respiratory depression (5.9% vs 4.6%; P = .01) and hypotension (3.87% vs 2.97%; P = .03) compared with Δ9-THC exposures. Vasopressor use was more frequent in the hemp-derived cannabinoid group (0.37% vs 0.13%; P = .02), yet rates of central nervous system depression, seizures, and intubation were similar. Children exposed to hemp-derived cannabinoids had higher critical care admission (11.3% vs 8.58%; P < .001) and overall admission rates (28.35% vs 26.13%; P = .03). No deaths were reported.

CONCLUSIONS

Pediatric exposures to hemp-derived cannabinoids were associated with similar or greater clinical severity and health care utilization than Δ9-THC exposures. The lack of dose regulation for hemp-derived products may contribute to these findings. Prospective studies capturing dose data are needed to clarify risk and inform policy.