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Background <p>Ingestion of delta-8 tetrahydrocannabinol (Δ8THC) by young children is recognized as a public health concern and is commonly encountered by healthcare providers; however, a better understanding of Δ8THC toxicity in this age group is needed. The objective of this study is to investigate the relationship between body weight-based doses of ingested Δ8THC and clinical outcomes among children &lt; 6 years old.</p> Methods <p>Using data from the National Poison Data System, we analyzed single-substance Δ8THC ingestions reported to United States poison centers to investigate the dose-response relationship between Δ8THC dose and clinical outcomes, including severe and prolonged toxicity, followed by receiver operator characteristic (ROC) curve analyses.</p> Results <p>There were 232 cases (median age: 3.0 years, 51.7% female) and the median ingested Δ8THC dose was 6.7&#xa0;mg/kg. CNS depression (75.5%) was the most common related clinical effect. There was a dose-response relationship between dose and CNS depression severity. Children who ingested a dose in the top quartile (&gt; 17.0&#xa0;mg/kg) had 3.43 times (95% CI: 1.44–8.14) greater odds of experiencing severe toxicity and 5.02 times (95% CI: 2.05–12.29) greater odds of prolonged toxicity than those who ingested a dose in the lowest quartile (&lt; 2.4&#xa0;mg/kg), with prolonged toxicity demonstrating a similar dose-response relationship. During ROC curve analyses, a dose cutoff of 2.3&#xa0;mg/kg yielded a sensitivity of 91% with a specificity of 31% for identifying severe toxicity (area under the curve [AUC] = 0.64) and a sensitivity of 91% with a 37% specificity for identifying prolonged toxicity (AUC = 0.62). A dose cutoff of 1.7&#xa0;mg/kg yielded a sensitivity of 98% with a specificity of 28% for identifying severe toxicity and a sensitivity of 93% with a 30% specificity for identifying prolonged toxicity.</p> Conclusions <p>Despite limitations of NPDS data and inconsistent quality control and labeling of Δ8THC products, the findings of our study are similar to those previously described for delta-9 tetrahydrocannabinol ingestions among young children. We found that a 1.7&#xa0;mg/kg dose cutoff value for Δ8THC had a high sensitivity for identifying severe or prolonged toxicity associated with Δ8THC ingestions among children &lt; 6 years old; however, it was associated with a high number of false positives.</p>

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Investigation of the toxic dose of ingested delta-8 tetrahydrocannabinol among young children

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Ryan S. Garay,
  • Hannah L. Hays,
  • Jaahnavi Badeti,
  • Natalie I. Rine,
  • Christopher E. Gaw,
  • Leah K. Middelberg,
  • Gary A. Smith

摘要

Background

Ingestion of delta-8 tetrahydrocannabinol (Δ8THC) by young children is recognized as a public health concern and is commonly encountered by healthcare providers; however, a better understanding of Δ8THC toxicity in this age group is needed. The objective of this study is to investigate the relationship between body weight-based doses of ingested Δ8THC and clinical outcomes among children < 6 years old.

Methods

Using data from the National Poison Data System, we analyzed single-substance Δ8THC ingestions reported to United States poison centers to investigate the dose-response relationship between Δ8THC dose and clinical outcomes, including severe and prolonged toxicity, followed by receiver operator characteristic (ROC) curve analyses.

Results

There were 232 cases (median age: 3.0 years, 51.7% female) and the median ingested Δ8THC dose was 6.7 mg/kg. CNS depression (75.5%) was the most common related clinical effect. There was a dose-response relationship between dose and CNS depression severity. Children who ingested a dose in the top quartile (> 17.0 mg/kg) had 3.43 times (95% CI: 1.44–8.14) greater odds of experiencing severe toxicity and 5.02 times (95% CI: 2.05–12.29) greater odds of prolonged toxicity than those who ingested a dose in the lowest quartile (< 2.4 mg/kg), with prolonged toxicity demonstrating a similar dose-response relationship. During ROC curve analyses, a dose cutoff of 2.3 mg/kg yielded a sensitivity of 91% with a specificity of 31% for identifying severe toxicity (area under the curve [AUC] = 0.64) and a sensitivity of 91% with a 37% specificity for identifying prolonged toxicity (AUC = 0.62). A dose cutoff of 1.7 mg/kg yielded a sensitivity of 98% with a specificity of 28% for identifying severe toxicity and a sensitivity of 93% with a 30% specificity for identifying prolonged toxicity.

Conclusions

Despite limitations of NPDS data and inconsistent quality control and labeling of Δ8THC products, the findings of our study are similar to those previously described for delta-9 tetrahydrocannabinol ingestions among young children. We found that a 1.7 mg/kg dose cutoff value for Δ8THC had a high sensitivity for identifying severe or prolonged toxicity associated with Δ8THC ingestions among children < 6 years old; however, it was associated with a high number of false positives.