Trends in Pediatric Marijuana Ingestions Before and During the COVID-19 Pandemic: A Retrospective Analysis from a Tertiary Children’s Hospital

Brittain Robinson, MD
Nick Watkins, MD

The legalization and commercialization of cannabis products, particularly in edible forms such as gummies and cookies, have contributed to a rise in pediatric marijuana ingestions. These products are often indistinguishable from non-THC-containing snacks, making them especially hazardous for young children. The COVID-19 pandemic introduced additional risk factors including increased time spent at home, limited supervision, and elevated caregiver stress. This study aimed to examine changes in ingestion trends before and during the pandemic, and to assess demographic characteristics and clinical outcomes among affected pediatric populations.

We conducted a retrospective observational study of pediatric emergency department (ED) visits for marijuana ingestion between January 1, 2016, and December 31, 2023, at a tertiary children’s hospital in the United States. Cases were included if marijuana ingestion was documented in ICD-10 codes, toxicology reports, or discharge diagnoses. The cohort was divided into pre-COVID and COVID-era groups using March 11, 2020, as the point of data inflection. Trends over time were assessed using linear regression; group comparisons used chi-square testing and one-way ANOVA.

A total of 2,304 cases were identified, with 1,423 (61.7%) occurring during the COVID era. The proportion of ED visits attributed to marijuana ingestion rose from 0.20% in 2016 to 0.70% in 2023 (p = 0.0019). The 0–5-year age group experienced the sharpest increase, from 3.6% of cases pre-pandemic to 10% during the pandemic—representing a 1466% rise with a P value of <0.001. Floor admissions (p = 0.0037) and discharges (p = 0.0016) significantly increased, while ICU admissions remained stable. Disparities were evident: African American children and those covered by Medicaid were disproportionately represented among the cases.

Pediatric marijuana ingestions have increased substantially in recent years, particularly among young children during the COVID-19 era. While most exposures resulted in floor admission or discharge, the rising frequency highlights a growing burden on emergency and inpatient services. Public health interventions—including caregiver education, safer product packaging, and clear labeling—are essential. Addressing racial and financial disparities is also critical to ensure equitable prevention efforts.

1. Analyze trends in pediatric marijuana ingestion before and during the COVID-19 pandemic.
2. Identify demographic disparities associated with these ingestions.
3. Discuss implications for public health interventions aimed at reducing pediatric marijuana exposures.