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Comment & Response
May 18, 2020

The Importance of Pediatric Safety in Tetrahydrocannabinol Education—Reply

Author Affiliations
  • 1Division of General Internal Medicine, University of Utah, Salt Lake City
  • 2Division of General Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
JAMA Intern Med. Published online May 18, 2020. doi:10.1001/jamainternmed.2020.1394

In Reply We thank Goodnough and Canseco for their thoughtful comments on our Patient Page, “What Should I Know About Medical Cannabis?”1 In their letter, they highlight the potential for pediatric harms through unintentional delta-tetrahydrocannabinol exposure, raising an important safety issue that was not explicitly covered in the Patient Page. Preventing accidental exposure to prescription medications, including medical cannabis, through safe storage practices is a critical part of patient counseling, yet it has proven to be a significant challenge. For example, despite ubiquitous public health messaging surrounding the harms associated with opioid use, more than 70% of postoperative patients who were prescribed opioids reported that they did not keep their medications in a locked container, and fewer than 10% followed recommended protocols for disposing of unused medications.2 Lax storage techniques for medications can have serious consequences, especially in pediatric populations. Of an estimated 23 000 annual emergency department visits related to adverse effects from dietary supplement use, 21% were accounted for by children younger than 5 years.3 As we accumulate data from states that have legalized cannabis for medical and/or recreational use, the consequences of increasing rates of accidental cannabis exposure among children are becoming apparent.4 Unfortunately, as Goodnough and Canseco point out, increased public health outreach and legislative efforts have not yet had their desired effect in mitigating these harms.5

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