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Reports to poison control show children are at particular risk of accessing marijuana edibles.

When it comes to protecting children from marijuana exposures, Oregon regulators are stepping into relatively new territory.

Scant research exists on safe levels for children. Colorado and Washington – Oregon’s only predecessors in legalization of recreational marijuana – have no data collection system to track the total number of kids who go to the emergency room with an overdose. Oregon regulators have gleaned a small amount of evidence from voluntary reports to Colorado poison control on what levels of THC – the intoxicant in pot – are dangerous to children.

“The problem is the drug is in food products that are attractive and palatable,” said Dr. George Sam Wang, a physician and medical toxicologist at Children’s Hospital Colorado.

From gummy bears to brownies, “no other prescription drug comes in all of these food products,” Wang noted.

Oregon, now in the thick of rulemaking for pot edibles, may have something to learn from trailing Colorado on the road to legalization, said Dr. Rob Hendrickson, medical toxicologist and associate medical director for Oregon Poison Control.

Hendrickson is embarking on a study to calculate safe amounts of THC per kilogram of a child’s body weight. He is relying on voluntary reports of child exposure to come up with data for the study.

“Right now, there is no way to screen emergency room visits so I am going to encourage ERs to contact us about any marijuana exposure, how much was consumed, how it was packaged and how did they get into and come up with a safe amount,” he said.

The outcome of the study could help inform decisions on THC limits when Oregon sets permanent rules for edibles next year, including limits on THS doses and servings per package. The THC limits apply only to recreational marijuana. Medical marijuana has no limits on dosage.

The limit is important because voluntary reports to Colorado poison control show that the number of children, ages 0-5, exposed to THC more than tripled between 2009 and 2013. There were seven reports of children exposed to THC in 2009, the year medical cannabis was legalized, and 24 reports in 2013 when Colorado voters approved recreational use.

Hendrickson plans to model his study after research on a pharmaceutical THC drug, which was used for chemotherapy-related nausea well before medical marijuana was legalized.

Researchers looked at how much THC a patient could tolerate and came up with a number of calculated through a formula based on body surface area. A dosage of more than 4 mg per square meters of surface area caused an 86 percent rate of adverse effects, including sleepiness, paranoia and fast heart rate, Hendrickson said.

“The really disgusting way to think it is that if you peeled off someone’s skin and figured out how much square meters it took up,” Hendrickson said.

From that, Hendrickson calculated that a dose of 10 mg (the limit in Colorado) would produce symptoms in a 2- to 4-year-old. His study will yield safe doses for each kilogram of a child’s weight.

The Oregon Health Authority has approached edible goods with greater caution than its predecessors in legalization.

In temporary rules approved Nov. 13, the health authority set a limit of 5 mg of THC per serving of edible marijuana, half the amount allowed in Colorado and Washington State. Up to 10 servings are allowed in one package of edibles.The temporary rules take effect April 1.

Hendrickson posits that 10 servings per package pose a danger to children and wants the number reduced.

“Think about taking a Hershey bar,” Hendrickson said. “Imagine it has 10 scored rectangular sections and one rectangle is a serving size. Who in the world is going to eat one square of Hershey chocolate?”

Priscilla Lewis, deputy director for Oregon Public Health Division, has justified that allowance with a requirement for resealable, childproof packaging.

As a medical toxicologist, Hendrickson has seen that there is no such thing as childproof.

“The problem is child resistant is designed to delay children getting into them not stop them,” Hendrickson said. “It will take a minute or two for a child to get into a child resistant package. It will give time for mom and dad to turn around and realize what child is doing.”

Colorado requires child-resistant packaging but continues to receives reports of child exposure to marijuana, he said.

A spokesman for the public health division did not respond to requests for additional comment on Hendrickson’s recommendation for fewer servings per package.

But Lewis has indicated the health authority will take into account Hendrickson’s study. She promised lawmakers in November to deliver the study results some time next year.

David McNicoll, chairman of the Oregon Edibles Council, said he disagrees with the state’s dosage limits for edibles but for reasons that differ from Hendrickson’s.

“OREC does not believe that restricting dosage limits is an effective tool for ensuring children do not come into contact with edible marijuana products,” McNicoll said. “Through extensive public education efforts, we believe we can more effectively lower the number of potential exposures.”

The council lobbies for the interests of the marijuana edibles industry and also plans an educational campaign on the safe use of edibles.

Federal prohibition of marijuana has hampered research on the health effects of marijuana on both children and adults.

Legislation earlier this year established an Oregon cannabis research task force to answer questions about credibility of existing research and to find solutions to barriers to research. The group also will explore the possibility of state-funded research grow site. The group meets for the first time Tuesday, Dec. 15.

Hendrickson, who participates in a state marijuana rules-making committee, said an advantage of adopting temporary rules might be the opportunity for revision as researchers learn more about cannabis.

“Hopefully we can get some rule changes and be able to protect kids in the future,” Hendrickson said.

By Paris Achen
Portland Tribune Capital Bureau Reporter
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