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Cannabidiol exposures in the United States, National Poison Data System, July 2014-June 2021.
Clin Toxicol (Phila). 2023 02; 61(2):123-130.CT

Abstract

INTRODUCTION

There has been an increase in the interest and availability of products asserting to contain cannabidiol (CBD).

OBJECTIVE

To describe demographic and clinical patterns in cases involving CBD exposures documented by the America's Poison Centers (AAPCC).

METHODS

We extracted human exposure cases involving CBD from the U.S. National Poison Data System between July 2014 and June 2021. We described monthly case counts and data on demographics, exposure reason, clinical effects, medical outcomes, and co-exposures, overall and by U.S. Food and Drug Administration (FDA) approval status.

RESULTS

We identified 6,496 cases, of these, 85.2% involved exposures to non-FDA approved CBD. The monthly number of cases peaked at 336 in March 2021. Cases often occurred in children ages 2-12 years (36.2%). Although in this age group unintentional exposures represented most cases (94.1%), we identified therapeutic errors (3.9%), intentional use (3.0%), and adverse reactions (1.6%) in cases involving exposures to non-FDA approved CBD. Among the 5,248 (80.8%) cases involving exposure to a single product, we identified 44 major medical outcomes, all related to exposures to non-FDA approved CBD. The most frequent clinical effects included neurological, cardiac, and gastrointestinal effects. Among the 1,248 (19.2%) involving exposure to more than one product, the most frequent co-exposures included stimulants and street drugs, sedatives-hypnotics, antipsychotics, and analgesics.

CONCLUSIONS

This case series identified an increasing trend in CBD exposure cases managed by AAPCC. It showed serious medical outcomes in temporal association with exposure to non-FDA approved CBD products. Our findings also suggest both unintentional and intentional use of non-FDA approved CBD in children. Consumers should keep these products out of reach of children and exercise caution when purchasing and using non-FDA approved CBD products.

Authors+Show Affiliations

Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36537670

Citation

Perez-Vilar, Silvia, et al. "Cannabidiol Exposures in the United States, National Poison Data System, July 2014-June 2021." Clinical Toxicology (Philadelphia, Pa.), vol. 61, no. 2, 2023, pp. 123-130.
Perez-Vilar S, Karami S, Long K, et al. Cannabidiol exposures in the United States, National Poison Data System, July 2014-June 2021. Clin Toxicol (Phila). 2023;61(2):123-130.
Perez-Vilar, S., Karami, S., Long, K., & Leishear, K. (2023). Cannabidiol exposures in the United States, National Poison Data System, July 2014-June 2021. Clinical Toxicology (Philadelphia, Pa.), 61(2), 123-130. https://doi.org/10.1080/15563650.2022.2156881
Perez-Vilar S, et al. Cannabidiol Exposures in the United States, National Poison Data System, July 2014-June 2021. Clin Toxicol (Phila). 2023;61(2):123-130. PubMed PMID: 36537670.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cannabidiol exposures in the United States, National Poison Data System, July 2014-June 2021. AU - Perez-Vilar,Silvia, AU - Karami,Sara, AU - Long,Karen, AU - Leishear,Kira, Y1 - 2022/12/20/ PY - 2022/12/21/pubmed PY - 2023/3/21/medline PY - 2022/12/20/entrez KW - CBD KW - Cannabidiol KW - National Poison Data System KW - cannabis KW - cannabis-derived products KW - poison control center SP - 123 EP - 130 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 61 IS - 2 N2 - INTRODUCTION: There has been an increase in the interest and availability of products asserting to contain cannabidiol (CBD). OBJECTIVE: To describe demographic and clinical patterns in cases involving CBD exposures documented by the America's Poison Centers (AAPCC). METHODS: We extracted human exposure cases involving CBD from the U.S. National Poison Data System between July 2014 and June 2021. We described monthly case counts and data on demographics, exposure reason, clinical effects, medical outcomes, and co-exposures, overall and by U.S. Food and Drug Administration (FDA) approval status. RESULTS: We identified 6,496 cases, of these, 85.2% involved exposures to non-FDA approved CBD. The monthly number of cases peaked at 336 in March 2021. Cases often occurred in children ages 2-12 years (36.2%). Although in this age group unintentional exposures represented most cases (94.1%), we identified therapeutic errors (3.9%), intentional use (3.0%), and adverse reactions (1.6%) in cases involving exposures to non-FDA approved CBD. Among the 5,248 (80.8%) cases involving exposure to a single product, we identified 44 major medical outcomes, all related to exposures to non-FDA approved CBD. The most frequent clinical effects included neurological, cardiac, and gastrointestinal effects. Among the 1,248 (19.2%) involving exposure to more than one product, the most frequent co-exposures included stimulants and street drugs, sedatives-hypnotics, antipsychotics, and analgesics. CONCLUSIONS: This case series identified an increasing trend in CBD exposure cases managed by AAPCC. It showed serious medical outcomes in temporal association with exposure to non-FDA approved CBD products. Our findings also suggest both unintentional and intentional use of non-FDA approved CBD in children. Consumers should keep these products out of reach of children and exercise caution when purchasing and using non-FDA approved CBD products. SN - 1556-9519 UR - https://www.unboundmedicine.com/medline/citation/36537670/Cannabidiol_exposures_in_the_United_States_National_Poison_Data_System_July_2014_June_2021_ DB - PRIME DP - Unbound Medicine ER -