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How to spot a cannabis overdose

Although overdoses aren’t commonly associated with cannabis, consuming too much of the drug can lead to hospitalization and cause accidents resulting in serious injury or death.

With the impending legalization of recreational marijuana, physicians in Canada are already seeing an increase in emergency room visits by patients overdosing on the drug.

For example, the cases in Ontario have more than tripled in the last three years to nearly 1,500 last year, according to data from the Canadian Institute for Health Information.

Medical expert Dr. Julielynn Wong explained that cannabis overdoses are most often caused by people taking too many edibles, which are food products infused with THC – the primary psychoactive ingredient in marijuana.

“Edibles pose a high risk overdose because unlike smoked marijuana, edibles take a longer time to take effect so people may consume more to feel the effects faster and this can lead to an overdose or serious injury or death,” she told CTV’s Your Morning on Friday.

Wong said many edibles users can be caught off guard by the “delayed, stronger, and longer lasting effects” if they’re more accustomed to smoking or vaping cannabis.

How to recognize a cannabis overdose:

If you suspect you or someone you know is experiencing an overdose from cannabis, these are the signs to watch for, according to Wong.

  • Severe nausea or vomiting
  • Increased heart rate and blood pressure
  • Chest pain
  • Anxiety
  • Paranoia
  • Panic attacks
  • Extreme confusion
  • Loss of contact with reality
  • Seizures

Wong said cannabis overdoses can often lead to dangerous situations that may result in serious injury or death, such as a car accident or a fall.

What to do in the case of an overdose:

If you suspect you or someone else is overdosing on cannabis, Wong said it’s important to call your local poison control centre, healthcare provider, the emergency department of your nearest hospital, or 911.

If the person overdosing is awake, Wong said they should try to take small sips of water to drink. Do not try to force the person experiencing the cannabis overdose to vomit, she advised.

How to prevent an overdose:

Wong said the most obvious way to prevent a cannabis overdose is to avoid consuming the drug, especially if you’ve been drinking alcohol or taking prescription medication. However, if you do want to take edibles, she said it’s best to start with a small dose.

“Do not consume more than the recommended serving amount of 10 milligrams of THC, which is the active ingredient in marijuana,” she advised. “Make sure you read the package labels so you know how much THC is in the edible you’re consuming.”

It’s also a good idea to have someone with you when you consume an edible, according to Wong. She said edibles can sometimes take two or more hours before you will feel the effects so it’s important to be patient.

Wong also reminded cannabis users to store edibles in child-proof containers that are out of the reach of children and pets.

Edible marijuana products are displayed for sale at a Weeds Glass & Gifts medical marijuana dispensary in downtown Vancouver on May 1, 2015. (THE CANADIAN PRESS/Darryl Dyck)

Doctors debate whether baby died from marijuana overdose

Two poison control doctors from Colorado claim that a patient they treated, an 11-month-old baby boy, died from an overdose of marijuana. The report has ignited controversy — marijuana has not previously been shown to cause a fatal overdose— but some medical experts say the drug might have played a role in the boy’s death.

The child showed up in a Colorado hospital in 2015, barely conscious after having a seizure. The boy was intubated in the emergency room, but his heart began to fail.

“The kid never really got better,” Dr. Christopher Hoyte of Colorado’s Rocky Mountain Poison & Drug Center to NBC News’ KUSA. “And just one thing led to another and the kid ended up with a heart stopped. And the kid stopped breathing and died.”

Doctors debate fatal marijuana overdose of 11-month-old boy

Hoyte had been on duty at the poison control center and had been called in to help with the case. After learning that the child’s urine and blood tested positive for marijuana, he and Dr. Thomas Nappe set out to understand whether the drug had actually caused the death. They reported their findings in a journal article in March.

“We just wanted to make sure that we’re not going to call this a marijuana-related fatality if there was something else that we could point at,” Hoyte said. “And we looked and couldn’t find it.”

Their report concluded: “As of this writing, this is the first reported pediatric death associated with cannabis.”

Officially, the baby boy died from myocarditis, an inflammation of the heart muscle. In children, the condition is often caused by a virus that reaches the heart muscle, but doctors ruled out viral infection as the cause.

Dr. Noah Kaufman, an emergency specialist who reviewed the report, doubts the findings. “That statement is too much,” Kaufman told KUSA. “Because that is saying confidently that this is the first case. And I still disagree with that.”

Other experts believe that the drug might have played a role in the boy’s death.

“I don’t doubt that a kid that age could get really sick from eating those,” said Dr. Andrew Stolbach, a medical toxicologist and emergency room physician at the Johns Hopkins Hospital. “Certainly you see that with synthetic cannabinoids: People develop a fast heart rate and become really agitated, sometimes to the point where the temperature goes up.”

While the heart muscle does indeed have receptors for cannabinoids, that doesn’t mean marijuana would cause myocarditis, said Yasmin Hurd, director of the Addiction Institute at the Icahn School of Medicine at Mount Sinai in New York City.

It’s very likely that the boy had a problem with his heart before ingesting marijuana, Hurd said. “And [the drug] could have been the last straw.”

Edibles and children a ‘scary’ mix

While Hurd wouldn’t pin the boy’s death on the drug, she does believe that marijuana is becoming a problem for children and young people, especially since the amount of THC — the active ingredient contained in edible products — can vary wildly.

Recreational cannabis use was legalized in Colorado in 2014. Since then, the number of emergency room visits by young people has quadrupled, according to University of Colorado researchers. Children are getting access to the drug from parents, grandparents, neighbors, friends, babysitters or other relatives. Most of the time, kids eat food containing marijuana and experience symptoms like drowsiness, dizziness, vomiting, agitation, dangerous heart rates and seizures.

“A lot of the emergency room visits are due to edibles, which can have very, very high concentrations of THC,” Hurd said.

The mix of edibles and kids, “is a really scary scenario,” Stolbach said. “They can look like candy and they’re supposed to taste like candy. So of course a kid is going to be curious.”

Linda Carroll is a regular contributor to NBCNews.com. She is co-author of “The Concussion Crisis: Anatomy of a Silent Epidemic” and “Duel for the Crown: Affirmed, Alydar, and Racing’s Greatest Rivalry.”

Linda Carroll is a regular health contributor to NBC News and Reuters Health. She is coauthor of “The Concussion Crisis: Anatomy of a Silent Epidemic” and “Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings.”

Mom admits lapse in not taking kids who ate pot-infused chocolate to hospital earlier

Physician surprised 2-year-old Brandon girl had seizure after eating cannabis

A Brandon, Man., mom whose two children were taken to hospital long after eating part of a cannabis-infused chocolate bar says she would have handled the situation differently if she'd known how badly her two-year-old daughter would react.

And while one doctor says he's surprised by the girl's physical reaction, another says children should be taken to hospital immediately if a parent thinks they've consumed a cannabis edible.

"I would never want it to happen again," the mother of the two children told CBC News at her home on Tuesday.

The woman, whom CBC News has agreed not to identify because she fears for her safety and that of her children, said she still isn't sure how her kids got into the chocolate on the morning of Feb. 2.

The single mom said her son, 5, and daughter, 2, woke up around 9 a.m. She said she had woken up earlier, but fell asleep again after bringing her third child into bed with her earlier in the morning.

She said she didn't wake up again until she heard noise elsewhere in the home, and discovered what had happened.

"I had called my mom [after] it happened and she came over to help me through it," she said.

Edibles, medications in cupboard

The woman said her son somehow got into a kitchen cupboard above the stove where the edibles, along with other medication such as antidepressants and antibiotics, were kept.

Purchasing or selling edible cannabis products is still illegal in Canada, but making them at home is allowed under the current legislation. The woman said she had the edibles in her home because they help with her post-traumatic stress disorder.

Her son took the chocolate bar — which she says contained 750 mg of THC — back to the family's living room, where he and his sister ate some of it.

The woman doesn't know how her son climbed on the counter and reached the cupboard in the first place. She said the kids didn't get into the other medications and she's not sure exactly sure how much chocolate the kids ate.

"I always keep that stuff up and out of reach," she said, when asked if it could have been left out on a counter by accident. "I would never intentionally put my kids at risk of getting into anything."

She said she and her mom observed the kids. Both seemed tired and the boy threw up, but they otherwise appeared to be fine, she said.

Six hours later, around 3 p.m., she said her daughter had a seizure and an ambulance was called.

The girl was taken to hospital in Brandon and later transferred to the children's hospital in Winnipeg, just over 200 kilometres east, after suffering more seizures and swelling in her brain, according to the woman. The girl was kept in a coma with a breathing tube until Sunday.

"I was just hoping that she would be OK," said the woman. "I was scared … what if she didn't pull through? I knew for her I had to be strong and it was just really terrifying for me."

The girl's condition improved and she was discharged on Feb. 5.

Range of possible effects on children

James MacKillop, who has studied cannabis as the director of the Peter Boris Centre for Addictions Research and the DeGroote Centre for Medicinal Cannabis Research in Hamilton, said while adverse reactions can occur, seizures and swelling of the brain are atypical symptoms from consuming too much cannabis or edibles.

"I am surprised by the report of seizures, which are not a common symptom of cannabis overdose," he told CBC News in an email. "Seizures have been reported in relation to synthetic cannabinoids," he said, but those are not typically in edibles.

"In general, cannabis and particularly CBD from cannabis has been associated with anticonvulsant properties," he added.

But Dr. Margaret Thompson, an emergency physician and medical director of the Manitoba, Ontario and Nunavut Poison Centres, told CBC News the girl's symptoms aren't uncommon, especially for someone who has never consumed cannabis before or for someone so young.

"The dose makes the difference," said Thompson, who is also a toxicologist. "Depending on how much cannabis is in a particular edible, you might expect no symptoms all the way up to seizures."

Thompson said people may also experience depressed breathing, low blood pressure or even fall into a coma.

First-time users, including children, are more susceptible, said Thompson, but she doesn't known of any case where a child has died because of cannabis consumption.

"Any person who is naive to the effect of cannabis will [feel] an effect that is maybe not expected by them," she said.

"Certainly a two-year-old would not know what this high feeling is. They would not be able to describe it to a parent."

The Addictions Foundation of Manitoba has, in the past, said parents should be proactive by talking to kids about cannabis and its effect early on, rather than waiting until there is an issue.

'Error in judgment'

Thompson said children should be taken to hospital as soon as possible after consuming products like edibles.

The mother of the affected children said if she had known her daughter would react that badly, she would have taken the kids to the hospital much sooner.

"How can you know what you're supposed to do when it's your first time doing this?" she said.

"I thought I just had to wait it out. That was my own lapse in judgment," she added. "I don't give any excuse [for] that."

She said Child and Family Services did investigate the incident, along with Brandon police, but no charges have yet been laid. Police earlier called the situation an "unfortunate incident."

The woman said she will keep the edibles locked up in her bedroom from now on and urges other parents to do the same.

"I really hope other people that have this stuff in their house learn from this."