April 25, 2026
2 min read
Key takeaways:
- New York enacted a cannabis packaging law in 2023 to make products less enticing to children.
- Accidental ingestions continued to rise after the packaging law went into effect.
BOSTON — A New York law that required cannabis products be sold in child-resistant packaging did not reduce the number of accidental ingestions among kids, according to a presenter at the Pediatric Academic Societies annual meeting.
As more states have legalized recreational marijuana, exposures among children have increased rapidly, especially edible cannabis products.
The requirement for cannabis products to be in child-resistant packaging did not reduce the number of children who accidentally ingested edibles. Image: Adobe Stock.
“The most serious symptoms associated with pediatric cannabis consumption are hypoventilation, unresponsiveness/lethargy and seizure-like activity,” Annamarie Fernandes, MD, FAAP, FACP, assistant professor of medicine and pediatrics at Golisano Children’s Hospital at the University of Rochester Medical Center, told Healio. “These symptoms are nonspecific and seen in other concerning conditions, such as sepsis, so they have required a broader medical workup with sometimes invasive tests such as bloodwork, lumbar puncture, CT of the head and an EEG until the toxicology reports have results.”
New York legalized cannabis for medical use in 2014 and recreational use in 2021, Fernandes noted. The law from 2021 addressed licensing of dispensaries, but it did not include provisions related to child-resistant packaging. Fernandes said legislators amended the law in 2023 to require child-resistant packaging, a visible THC symbol and a warning for children. The amendment also stated that packaging could not include cartoons, bright colors or other imagery that could be enticing to children.
Fernandes and colleagues investigated whether the new packaging laws were linked with fewer pediatric ingestions. They gathered accidental cannabis intoxication records for 174 children (age range, 7 months to 10 years) that occurred between Jan. 1, 2010, and May 9, 2025, at a pediatric hospital in New York.
Fernandes and colleagues did not see any accidental ingestions before medical cannabis was legalized in 2014. The bulk of them (86.5%) occurred after recreational cannabis was legalized in March 2021. In 2017, 2018 and 2019, there was only one accidental ingestion per year. There were 14 accidental ingestions per year in 2021 and 2022, and cases increased to 18 per year in 2023 and 2024.
Notably, the researchers learned that 96% of the products involved in accidental ingestions were edible, kid-friendly items, including gummies, candies, chocolate and baked goods.
According to the researchers, 50% of children were hospitalized, and 22% needed intensive care. Fernandes said it was particularly concerning that severity increased after the packaging law went into effect, compared with before (P = .002).
Fernandes said she was not surprised that accidental cannabis ingestions continued to rise after the packaging laws were enacted.
“There were interviews from police that felt they did not have enough authority based on the legislation,” she said. “It seemed the content of the law was an improvement, but with over 8,000 unlicensed cannabis shops in New York City alone, the enforcement plan was not detailed enough.”
To prevent accidental ingestions, Fernandes suggested selling products in child-resistant packaging similar to medications, including larger THC content labels and giving more authority to law enforcement to impose fines or make arrests in unlicensed dispensaries.
Pediatricians already discuss cannabis storage with their patients’ caregivers, but Fernandes said it could help if internal medicine physicians also talk to their patients about locking up cannabis products.
“Most of our patients resided in a home with reported household cannabis consumption, but a portion of the ingestions reported only cannabis use from family friends or relatives,” she said.
For more information:
Annamarie Fernandes, MD, FAAP, FACP, can be reached at pediatrics@healio.com.
Sources/Disclosures
Source:
Fernandes A, et al. Poster 226. Have New York State Packaging Laws Prevented Tots from Getting into Pot? Presented at: Pediatric Academic Societies Annual Meeting; April 24-28; Boston.
Disclosures:
Fernandes reports no relevant financial disclosures.
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