Pubdate: Sun, 19 Nov 2017
Source: Chicago Tribune (IL)
Copyright: 2017 Chicago Tribune Company


A case report about the seizure and death of an 11-month-old after
exposure to cannabis has prompted headlines about "the first marijuana
overdose death" this week.

Except that's not what the doctors meant.

"We are absolutely not saying that marijuana killed that child," said
Thomas Nappe, an author of the report who is now the director of
medical toxicology at St. Luke's University Health Network in
Bethlehem, Pennsylvania.

Nappe, who co-authored the report with Christopher Hoyte, explained
that the doctors simply observed this unusual sequence of events,
documented it and alerted the medical community that it is worth
studying a possible relationship between cannabis and the child's
cause of death, myocarditis, or inflammation of the heart muscle.

Their observations appeared in the August edition of the journal
Clinical Practice and Cases in Emergency Medicine as a case report,
which is significantly different from a scientific study or research
report that can be used to establish a causal relationship.

A spokesman for Denver Health wrote in an email that Hoyte would not
be available for an interview late Thursday.

The report states that the child experienced an "unstable motel-living
situation" and the parents admitted to drug possessions, including
cannabis. Nappe said the authors urge parents to be vigilant and keep
cannabis out of reach of children.

The report recommends: "In states where cannabis is legalized, it is
important that physicians not only counsel parents on preventing
exposure to cannabis, but to also consider cannabis toxicity in
unexplained pediatric myocarditis and cardiac deaths as a basis for
urine drug screening in this setting."

The authors added that, "As of this writing, this is the first
reported pediatric death associated with cannabis exposure."

Nappe emphasized that the word "associated" should not be interpreted
as indicating a cause and effect.

Drug policy and health experts also warned against making too much of
the report.

"You just can't make those statements because then what happens is lay
people say, 'Oh my God, did you hear a kid died from marijuana
poisoning?' and it can be sensationalized," said Noah Kaufman, a
Northern Colorado emergency room physician.

"It's not based on reality. It's based on somebody kind of jumping the
gun and making a conclusion, and scientifically you can't do that."

Turns out, that's what happened in previous news reports, much to
Nappe's dismay. Upon hearing that Nappe and Hoyte were not claiming
that the child died from marijuana, Kaufman said "that's more

Jonathan Caulkins, a professor at Carnegie Mellon University's Heinz
College, said that it doesn't strike him as impossible that the death
described in the report could be linked to marijuana.

"Unambiguously, cannabis can accelerate the heart," said Caulkins, who
is not a medical doctor but studies drug policy and markets. He also
agreed that parents should keep marijuana out of reach of their children.

Millions of Americans use marijuana regularly, according to the most
recent National Survey on Drug Use and Health, and addiction treatment
researcher Keith Humphreys said cannabis consumption has "virtually no

The Drug Enforcement Administration states that there have been no
reported overdose deaths from marijuana.

Even if after further studies it turns out that this child's death was
caused by a marijuana overdose, it would be "a very unusual event,"
said Humphreys, a Stanford University psychiatry professor who served
as a senior policy adviser at the White House Office of National Drug
Control Policy during the Obama administration.

"It would not be correct to go from this to a generalized panic about
the lethality of cannabis. It's just not there," Humphreys said.

"This is not an omen of a disaster to come."
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