title: Parental cannabis abuse and accidental intoxications in children: prevention by detecting neglectful situations and at-risk families.
abstract: OBJECTIVE
  Cannabis intoxication in toddlers is rare and mostly accidental. Our objectives were to focus on the characteristics and management of children under the age of 6 years who were admitted to our emergency department with cannabis poisoning reported as accidental by parents, and to point out the need to consider accidental cannabis ingestions as an indicator of neglect.
  
  
  METHODS
  The medical records of children hospitalized for cannabis poisoning in a pediatric emergency department from January 2007 to November 2012 were retrospectively evaluated. Data collected included age, sex, drug ingested, source of drug, intentional versus accidental ingestion, pediatric intensive care unit or hospital admission, treatment and length of hospital stay, toxicology results, and rate of child protectives services referral.
  
  
  RESULTS
  Twelve toddlers (4 boys and 8 girls; mean age, 16.6 months) were included. All had ingested cannabis. Their parents reported the ingestion. Seven children experienced drowsiness or hypotonia. Three children were given activated charcoal. Blood screening for cannabinoids, performed in 2 cases, was negative in both, and urine samples were positive in 7 children (70%). All children had favorable outcomes after being hospitalized from 2 to 48 hours. Nine children were referred to social services for further assessment before discharge.
  
  
  CONCLUSIONS
  Cannabis intoxication in children should be reported to child protection services with the aim of prevention, to detect situations of neglect and at-risk families. Legal action against the parents may be considered. Accidental intoxication and caring parents should be no exception to this rule.
authors.affiliation: From the *Poisons Centre and Substance Abuse Treatment Unit and †Pediatric Emergency Department, Children's Hospital, Toulouse-Purpan University Hospital, Toulouse; and ‡Department of Forensic Medicine, Université de la Méditerranée, Marseille, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Pélissier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Claudet
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Pélissier-Alicot
authors.forename: Nicolas
authors.initials: N
authors.lastname: Franchitto
mesh_terms: D002188:Cannabis / Q000506:poisoning*; D002606:Charcoal; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis* / Q000517:prevention & control* / Q000628:therapy; D010287:Parent-Child Relations; D012189:Retrospective Studies; D015813:Substance Abuse Detection
chemical_list: D002606:Charcoal