Researchers from the Center for Injury Research and Policy at Nationwide Children’s Hospital and the Central Ohio Poison Center identified 41,612 unintentional recreational-drug ingestions involving children under 6 during the 25-year study period. The cases were recorded in the National Poison Data System, a database maintained by America’s Poison Centers from calls to the national Poison Help Line and other poison centers. Because the system captures real-time exposure reports from across the country, it provides an important surveillance tool for detecting emerging hazards, although it reflects reported cases rather than every exposure occurring in the population.

The overwhelming majority of incidents occurred in private residences, accounting for 96 percent of the reports. Most involved a single recreational substance, and 58 percent affected children younger than 3. That age distribution is consistent with well-established developmental behavior: toddlers become increasingly mobile, explore their surroundings intensively and frequently place unfamiliar objects in their mouths. They also lack the ability to distinguish a drug product from food, candy or a household item. In this setting, a brightly colored edible or an open container left on a table can become an immediate poisoning risk within seconds.

Cannabinoids accounted for 85 percent of all reported ingestions, making them by far the most common category. Edible marijuana products represented nearly half of all incidents, and the rate of cannabinoid exposures increased 2,349 percent from 2015 to 2024. The study recorded the first marijuana-edible ingestion in 2013, after which the rate rose rapidly. By 2019, edible products had surpassed other cannabis preparations as the leading form of cannabinoid exposure among young children. The pattern coincides with the expanding legalization and commercial availability of cannabis in multiple states, though the study was designed to describe the trend rather than establish legalization as its sole cause.

The danger posed by edibles is linked to both their formulation and their appearance. Gummies, candies, baked goods and other products may resemble familiar foods, while a single package can contain multiple servings and a concentrated amount of delta-9-tetrahydrocannabinol, or THC, the primary psychoactive cannabinoid in cannabis. Young children can consume an unknown quantity before an adult notices. Unlike inhaled cannabis, which produces an immediate sensory warning and a relatively rapid onset of effects, edible products are processed through the gastrointestinal tract and liver. This can delay the appearance of symptoms, making it difficult for caregivers to estimate how much has been absorbed or whether the child is worsening.

Although 51 percent of the children experienced no or minor effects, 5 percent suffered a major effect, defined in the poison-center system as symptoms that are life-threatening or result in significant disability or disfigurement. The study recorded six deaths, all among children younger than 3. Children in that age group were also more likely than those aged 3 to 5 to experience a major effect, require hospital admission or be transferred to a critical care unit. These outcomes demonstrate that many exposures are not merely brief episodes of drowsiness or confusion. Depending on the substance and dose, pediatric poisoning can produce respiratory depression, severe changes in consciousness, seizures, cardiovascular instability or the need for intensive monitoring and supportive treatment.

Cannabis was not the only substance category associated with the findings. Stimulants accounted for 8 percent of ingestions, psychedelics including psilocybin for 4 percent, opioids for 3 percent and dissociative agents for less than 1 percent. Although they were less common than cannabinoid exposures, opioids, stimulants and dissociative substances were more likely to result in admission to a critical care unit than the other categories combined. That difference illustrates why the total number of exposures alone does not capture the full public-health burden. A relatively infrequent substance can create a disproportionate risk if it has a narrow margin between an accidentally ingested amount and a dose capable of disrupting breathing, circulation or brain function.

The researchers say the concentration of incidents in the home points to prevention measures that can be implemented immediately. Recreational drugs should ideally be kept out of homes where young children live or visit. When that is not possible, products should be stored high up, out of sight and out of reach, preferably in a locked location. Adults should also avoid using recreational drugs around children, who naturally imitate caregiver behavior and may become interested in products that appear familiar. If a child may have swallowed a recreational drug, caregivers should contact Poison Help at 1-800-222-1222 for immediate guidance rather than waiting for symptoms to develop; emergency medical services should be called when the child is unconscious, having trouble breathing, seizing or rapidly deteriorating.

The study also identifies responsibilities for manufacturers and policymakers as the market for cannabis and other recreational products continues to evolve. Researchers recommend opaque, child-resistant packaging, clear labeling, limits on the total dose per serving and restrictions on the number of servings in a package. Single-serving designs could reduce the amount available during one unnoticed encounter, while packaging that does not mimic candy or other children’s foods could make products less attractive to toddlers. The national poison-center data show how quickly a new exposure pattern can emerge when a psychoactive product becomes common in the home. Preventing the next wave of pediatric poisonings will require household vigilance, rapid medical advice and safety standards designed around the capabilities—and vulnerabilities—of very young children.