Published March 6 2023
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Twice in recent weeks, 911 had to be called for Westchester high school students who had reactions to substances. Both times, there was speculation or rumors that fentanyl was the culprit.
But the likely cause was marijuana.
This was no surprise to experts who say that marijuana has quickly become a major health concern among minors, much more so than fentanyl, which remains a scourge to adults who use hard drugs.
With recreational marijuana now legal in New York and dispensaries starting to open, marijuana has quickly become so ubiquitous that many kids don't view it as a drug.
Dr. Jamil Rizqalla, associate medical director of the emergency medicine department at Montefiore Nyack Hospital, said that minors in the emergency room will often say no when he asks them if they use drugs. But they'll say yes when he asks if they use marijuana.
In Yonkers, police have seen more calls about kids getting sick from THC gummies, said Dean Politopoulos, the department's public information officer.
"We're gravely concerned," said Kyle Belokopitsky, executive director of the New York State PTA.
It was pot, not fentanyl
Fears about fentanyl have risen because of the substance's connection to overdose deaths.
So fentanyl quickly entered the conversation when students became ill in New Rochelle and Pelham.
In New Rochelle, after a student was administered Narcan in January, school officials initially feared that fentanyl was involved. But it turned out the student had been vaping what they believed to be marijuana, and police later said the student didn't have opioids in their system. Narcan is a life-saving medication used to reverse opioid overdoses and doesn't cause harm to someone who didn't take opioids.
And in February, after four Pelham students ate marijuana edibles in a school bathroom and were taken to the hospital, a fake Instagram account spread rumors that fentanyl was involved. The superintendent soon said the district did not believe fentanyl was a factor.
Fentanyl primarily remains a threat to adults, Rizqalla said.
"Most of the fentanyl overdoses we see are heroin abusers where fentanyl was cut in," he said.
But marijuana on its own has become a real problem that is landing minors in the hospital, he said. It's easily accessible, whether kids get it on the street or from an adult who buys it legally from a dispensary.
The problem with edibles
The accidental ingestion of edible marijuana is fast becoming a problem.
"Many edibles look like candy," said Dr. Ivan Miller, director of emergency medicine at Westchester Medical Center. "They are candy, and so it's not surprising that we're seeing really young children ingesting them by accident."
And it's not just kids who are accidentally eating weed gummies. Adults are mistaking them for similar candy without THC, Miller said.
Edibles can also contain a lot of THC − more than what someone is used to taking. Even taking an edible to get high on purpose can land kids in the emergency room.
The number of edible cannabis ingestions in kids younger than 6 rose from 207 in 2017 to 3,054 in 2021, according to a study out of the Southern Illinois School of Medicine. Of 7,034 exposures between 2017 and 2021, 22.7% of patients were admitted to the hospital.
The study noted there were eight states plus Washington D.C. in January 2017 that allowed recreational cannabis use. By May 2022 the number rose to 18 states plus Washington D.C.
Is too much marijuana dangerous?
Consuming too much marijuana is usually not life threatening, but it is a hallucinogen so people react to it differently, Rizqalla said.
"We've seen cases of patients using either excessive amounts of marijuana or synthetic marijuana that have had acute psychotic breaks, have developed psychiatric illness that they've not experienced in the past," Rizqalla said.
It can make people dizzy, disoriented and confused, and symptoms can last as long as 24 hours, Miller said. When someone unintentionally eats a THC product, its effects, which can take hours to develop, can be scary.
'There won’t be a cannabis Joe Camel'
In February, Belokopitsky submitted her concerns on behalf of the PTA to the New York State Cannabis Control Board, which is responsible for regulating the state's cannabis industry.
She asked the agency to focus on protecting kids in several ways: Increasing the distance between cannabis businesses and youth facilities, making products less attractive to kids, and increasing penalties for business that advertise or sell to kids.
The PTA was among five statewide groups, including the state's Association of County Health Officials and Academy of Family Physicians, that sent another letter the same day expounding on those requests.
Lyla Hunt, deputy director of public health and campaigns for the state Office of Cannabis Management, said in an email that state regulations around packaging, labeling, and marketing are designed to ensure legal products are only marketed to adults.
"That means no regulated edibles will come in packages that imitate products marketed toward young people —there won’t be a cannabis Joe Camel in New York," she said.
Legal dispensaries will never sell products that look like candy and target children, Hunt said, but illicit sellers do. The agency's enforcement teams are working to shut them down, as well as unlicensed storefronts that don't check IDs.
Hunt also noted the agency's partnership with the state's poison control centers to improve data collection.
"Products should be stored and locked, out of reach and out of sight of young people and pets. It’s not enough to just store them out of reach – kids and pets are resourceful," Hunt said.
The facts about fentanyl
It's well documented that drugs are being laced with fentanyl, and the outcome is often fatal.
Synthetic opioids like fentanyl accounted for 78% of overdose fatalities in New York in 2021, according to a November report from the state comptroller. There were over 5,800 drug overdose deaths in the state.
"Fentanyl is a scourge," Miller said. "There's no question about it."
But the majority of fentanyl access they see is in adults, more specifically those using heroin.
In Yonkers, Politopoulos said there had been one instance in the last three years where a kid died from a fentanyl overdose. A 15-year-old took a painkiller in pill form and didn't realize it contained fentanyl. "It's overwhelmingly adults we see accessing fentanyl," he said in an email.
Fentanyl overdoses typically happen when someone is "trying to get high but not realizing that the active molecule in the powder that they're injecting or snorting is much more potent than they thought," Miller said.
Rizqalla sees parents regularly bringing their children in for a drug screening, worried that the alcohol or marijuana their kid consumed was laced with fentanyl or another opioid. Often by the time the results come back, the child has been given IV fluids and is ready to leave.