Amy Enochs was texting with other parents, all wondering why their central Ohio elementary school had gone into lockdown, when the school called. Several fourth graders, including Ms. Enochs’s daughter, had eaten marijuana gummies and were being taken to the hospital with racing pulses, nausea and hallucinations.
A classmate had found the gummies at home and mistaken them for Easter candy.
Ms. Enochs recalled hyperventilating that spring day three years ago. “I was scared to death,” she said, her voice breaking. “It was shock and panic.”
As legalization and commercialization of cannabis have spread across the United States, making marijuana edibles more readily available, the number of cannabis-related incidents reported to poison control centers has sharply increased: from about 930 cases in 2009 to more than 22,000 last year, data from America’s Poison Centers shows. Of those, more than 13,000 caused documented negative effects and were classified by the organization as nonlethal poisonings.
These numbers are almost certainly an undercount, public health officials say, because hospitals are not required to report such cases. More than 75 percent of the poisonings last year involved children or teenagers.
“I definitely have seen floridly psychotic 2-year-olds just waiting for the marijuana to leave their system because they got into someone’s gummies,” said Dr. Shamieka Virella Dixon, a pediatrician at Atrium Health Levine Children’s Hospital in Charlotte, N.C.
To better understand the rise in cases, The New York Times examined data from the national Poison Centers, surveyed regional centers and more than 200 doctors, reviewed court records, and interviewed physicians and public health experts. The Times identified dozens of children across the country who had consumed cannabis products from stashes belonging to relatives or friends and were hospitalized with paranoia, vomiting or other symptoms of poisoning.
In most instances of cannabis exposure, the physical effects were not severe, according to the poison control data. But a growing number of poisonings have led to breathing problems or other life-threatening consequences. In 2009, just 10 such cases were reported to poison centers; last year, there were more than 620 — a vast majority of them children or teens. More than 100 required ventilators.
Dr. Robert Hendrickson, an emergency physician and professor at Oregon Health & Science University, said that in recent years he has treated more patients for cannabis poisoning, including a toddler who ended up in the I.C.U. after eating a cannabis cookie. “The child had a seizure and then was put on a ventilator” and had several more seizures, he said.
Four deaths since 2009 have been judged by America’s Poison Centers as likely caused by cannabis poisoning. One involved a child or teen and was accidental. The other deaths involved intentional misuse or abuse, the organization said. Data from 2024 has yet to be finalized.
Each year, tens of millions of Americans use cannabis, most without problems. But in interviews, emergency physicians, pediatricians, toxicologists and other doctors expressed concern about the growing public perception that T.H.C., the intoxicating component in cannabis, is completely safe. As cannabis products proliferate, including those with hemp-derived T.H.C. that is legal in many states where marijuana isn’t, adults can unwittingly expose children to risk. Most of the reported cannabis exposures last year were deemed unintentional.
“We’re seeing a lot of accidental overdoses just because of the packaging,” said Dr. Stephen Sandelich, a pediatric emergency physician and assistant professor at Penn State. He said he had intubated several children who had ingested cannabis products.
At the hospital in central Ohio in 2022, Ms. Enochs arrived to find her fourth-grade daughter hallucinating.
“Her eyes were rolled back in her head, and she was completely out of it,” Ms. Enochs said. The girl was convinced that the school was infested with aliens and that she had superpowers, her mother recalled.
Her classmate had found the gummies, each containing 50 milligrams of T.H.C., at home in a kitchen cabinet. They belonged to the girl’s father, who later pleaded guilty to inducing panic and obstructing official business, and no contest to drug possession. He was given probation and ordered to pay a fine and restitution.
At least 38 cannabis-related poisoning cases have led to charges filed against parents and other caregivers, The Times found.
Ms. Enochs said that in the aftermath of the incident, her daughter felt unsafe at school and was afraid to go to sleep at night. Now, three years later, she has recovered physically, but the “mental scar” remains, her mother said. “The memories are still there.”
The toxicity of cannabis depends largely on the potency of the product and the size of the person. A high enough dose of T.H.C. can be so sedating that a person’s tongue blocks his windpipe, or it can trigger a seizure that requires intubation. But in general, an adult would have to consume a very large amount of cannabis to get that ill, doctors said: It might take hundreds or even thousands of milligrams of T.H.C. to cause severe side effects in a 150-pound adult — but far less for a child.
“It can be just devastating to watch a child in that state,” said Dr. Laurén Murphy, an emergency physician and medical toxicologist at Temple University Hospital in Philadelphia.
The city’s poison control center said cases involving young children had become “almost a daily occurrence,” including some who had breathing problems or fell into a coma.
Generally, doctors said, people recover within days if they are treated effectively, but the symptoms — and the memory of them — can be frightening.
About three years ago, at a shop in Florida that sold treats both with and without T.H.C., Rebecca Villarreal’s 3-year-old son Emilio picked out a cake pop labeled “kid friendly,” she said. He ate it and soon fell asleep. Then, she recalled, “he woke up screaming.”
The toddler appeared to be hallucinating, shrieking about spiders in his throat. The family rushed to the hospital and soon learned that the cake pop had been incorrectly labeled and contained 100 milligrams of T.H.C.
Emilio stayed for several hours, trembling and unable to do much more than sleep or stare into space. He recovered the next day, but the family was badly shaken.
Though most of the documented poisonings involved children, adults — particularly older adults — are not immune. A study published last year found that after Canada legalized the sale of cannabis, the number of emergency room visits among people ages 65 and older shot up.
The lead researcher on the study said older adults may be prone to overdose for a variety of reasons, including slowing metabolisms, potential interactions with medications and far greater potency than the marijuana of their youth.
Most states have potency limits for T.H.C. edibles, but many physicians said the caps were too high — often 100 milligrams per package. At least one state, Michigan allows foods with 200 milligrams. And doctors and public health officials have criticized packaging and marketing that might appeal to children.
Cannabis lobbyists in some states have resisted additional restrictions, warning lawmakers that this could send consumers to the illegal market and deprive states of tax revenue. As public health advocates have sought more protections, they have been up against an industry that sometimes downplays or rejects evidence of harm. And some existing rules are vague or unevenly enforced.
Dr. Hendrickson served on a committee about a decade ago that helped set Oregon’s limit to 50 milligrams per package. He said it was meant to protect children: Even if a child managed to eat the whole package, the effects were less likely to be life-threatening.
In 2022, the limit in Oregon doubled.
For a toddler, Dr. Hendrickson said, that could mean “the difference between being really sleepy and spending the night in the E.R. — and being on a ventilator.”
Carson Kessler and Alex Lemonides contributed reporting.
Danielle Ivory is a Times investigative reporter. She has reported on a variety of topics, including gun deaths, the Covid pandemic and the war in Ukraine.
Megan Twohey is an investigative reporter at The Times. Her work has prompted changes to the law, criminal convictions and cultural shifts.
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