Child Maltreatment and Cannabis: Intersection in Pediatric Emergency Department Visits

Cannabis is the most commonly used illicit drug in the world. The use of cannabis continues to evolve, as it is available in a growing variety of forms and changing potencies. At the time of this writing, eleven states and the District of Columbia have legalized recreational cannabis use for adults. Studies of pediatric cannabis exposure after legalization have demonstrated an increase in related emergency department visits. Here we review some of the ways that pediatric cannabis exposure may present to the emergency care clinician, including accidental exposure, intentional exposure, drug facilitated sexual assault, commercial sexual exploitation of children, and caregiver use and impairment. We also review the ways in which substance abuse and child maltreatment intersect and illustrate how these examples of pediatric cannabis exposure should prompt consideration of child maltreatment.