• Symptoms of Cannabis Poisoning 
• Poison Control Calls
• Cannabis Emergency Department Visits
• Cannabis ED Visits vs. Poison Control Calls
• Discussion
• References

 

This analysis seeks to better understand and contextualize trends in cannabis poisonings over time.

Let’s start by understanding what the symptoms and effects of cannabis poisonings involve.

Symptoms of Cannabis Poisoning

A review of unintentional exposures by adults^[1] indicated,

Common presenting symptoms included dizziness, dry mouth/mucous membranes, confusion, vision changes, paresthesia, nausea/vomiting, speech difficulties, anxiety, and somnolence. Hypertension, memory impairment, lethargy, incoordination, and tachycardia were frequent...

A study of unintentional exposures by children^[2] indicated,

Common symptoms of paediatric cannabis exposure include drowsiness, tachycardia, ataxia, and vomiting. More serious effects, like hypotension, coma, respiratory depression, and seizure, occur in less than 3.5% of cases, with some requiring intensive care and invasive measures such as intubation.

A discussion of cannabis poisoning resolutions will be discussed later in the analysis. Next, let’s see what patterns in calls to poison control centers involving cannabis look like.

Poison Control Calls

California Cannabis Poison Control Calls

The California Department of Public Health (CDPH) published statistics on California-related calls to the California Poison Control System (CPCS) between 2016 and 2024.^[3] Calls are reported based on several categorizations including:

• Intention of cannabis exposure, where categories include: 
  • Intentional: “… [A]cute toxicity resulting from deliberate misuse or overdose of cannabis products… Intentional self-harm involving cannabis typically results from deliberate ingestion or inhalation of cannabis in amounts exceeding safe limits. This may involve concentrated products, edibles, or other forms of cannabis, with the explicit intent to cause harm.^[4]Other descriptions of poisonings involving intentional use suggest that the this label includes individuals who intended on consuming cannabis but unintentionally consumed too much, that is, they did not necessarily intend to cause self-harm.
  • Unintentional: “… [A]ccidental (unintentional) instances where the exposure was not intentional, as opposed to deliberate misuse or abuse… Accidental cannabis poisoning typically results from consuming edibles with high THC content, inhaling concentrated cannabis products, or mistakenly ingesting cannabis products, especially by children or inexperienced users.”^[5]
  • Unknown/other
• Modes of use, which are not mutually exclusive, include
  • Dried Plant (Flower)
  • Edible Preparation (Edibles)
  • Concentrated Extract (Extracts)
  • E-cigarettes (Vapes)
  • Unknown/Other, which includes unknown, oral capsule or pill, topical, undried plant, or other preparation

“These categories when combined may not equal the total number of calls because of missing mode information for some calls and some calls being about more than one product.”

• Age Group:
  • 5 and under (5-)
  • 6 through 19 (6 – 19)
  • 20 and older (20+)

Calls by Intention

The data indicate that total calls increased annually from 850 in 2016 to 2,234 in 2023, then remained stable between 2023 and 2024 (Figures 1 and 2). Calls for unintentional use increased early on but have leveled off to about 60% of total calls, with intentional use relatively stable over the period and accounting for about 30% of calls (Figure 3).

Figure 1

Figure 2

Figure 3

Takeaways:

• Calls increased by about 160% between 2016 and 2024.
• Calls have stabilized over more recent years.
• About 60% of calls are due to unintentional use.

Calls by Intention and Age Group

Total calls for all three age groups increased over time, most dramatically for the 5- group (406%) and least dramatically for the 20+ group (72%) (Figures 4 and 5). Shares for the three different age groups have converged over time, with that for the oldest group (20+) decreasing over time, that for the youngest group (5-) increasing over time, and that for the middle group (6 – 19) remaining steady (Figure 6). Essentially all of the calls for the youngest group involve unintentional use, as do about 40% of calls from the 6 – 19 group and 30% of calls from the 20+ group (Figure 7).

Figure 4

Figure 5

Figure 6

Figure 7

Takeaways:

• Calls for all age groups have increased over time, with shares converging over the most recent years.
• Calls by children 5 and under increased by about 400% between 2016 and 2021 but have remained steady since then. 
• Calls by young children are all associated with unintentional use, while roughly 40% of calls for 6 – 19 year-olds and roughly 30% of calls for adults are for unintentional use.

Calls by Form of Use

The vast majority of all calls (about 80%) involve flower or edibles (Figures 8 – 10). Numbers and shares of calls associated with all forms other than edibles have been steady for half a dozen years (Figures 9 – 10). Calls for edibles increased through 2023 then leveled off (Figure 9). 

Figure 8

Figure 9

Figure 10

Takeaway:

• The vast majority of calls (about 80%) involve flower (about 25%) or edibles (about 55%).
• Calls for edibles increased during Covid.

Calls by Form of Use and Age Group

Calls involving edibles were similar in magnitudes and growth rates for all three age groups between 2016 and 2019, at which points calls for the youngest group (5-) grew more rapidly for the next two years than those for the other two age groups, before leveling off and perhaps declining more recently (Figure 11). Increases in cannabis consumption during Covid, particularly edibles and flower, ^[6] [7] likely contributed to the large increase in calls for young children involving edibles. Over the past five years, the youngest age group (5-) has accounted for roughly 40% of edibles calls with 30% for each of the other two age groups (Figure 12).

Figure 11

Figure 12

Calls involving flower decreased over earlier years but have been stable for the past half-dozen years (Figure 13). The oldest age group (20+) has accounted for roughly half of flower calls, with the 6 – 19 group accounting for roughly 30% of flower calls, and the youngest group (5-) about 20% (Figure 14).

Figure 13

Figure 14

Takeaways:

• Calls for edibles increased between 2016 and 2021 (for young children) and 2022 (for older children and adults) before leveling off over recent years.
• Shares of calls for edibles have converged over time for all age groups.
• Calls for flower decreased between 2016 and 2019 for all age groups before leveling off over recent years.
• A larger share of calls for flower involve adults (about 45%) than children or teens.

Summary of Trends in California Cannabis Poison Control Calls

To summarize, total calls increased annually between 2016 and 2023, then remained stable between 2023 and 2024. The numbers of calls for the three different age groups have all increased over time, but at different rates, with all leveling off and converging in more recent years.

For several years now, unintentional use has accounted for roughly 2/3 of calls overall, broken into 100% of calls for the 5- group, about 40% of calls for the 6 – 19 group, and about 30% of calls for the 20+ group.

Also for several years now, about 80% of calls involve either flower (about 25%) or edibles (about 55%). The youngest age group has accounted for more of the edibles calls, roughly 40%, with roughly 30% for each of the other two age groups, while the oldest age group has accounted for more of the flower calls, roughly 45%, with roughly 27% for each of the other two age groups.

Having information on total numbers of calls may be suggestive, but more context is needed, including: 

• Numbers of cannabis poisonings relative to total cannabis use,
• Numbers of of cannabis poisonings relative to numbers of poisonings of other substances, and
• Numbers of cannabis poisonings relative to population size.

Let’s get some more context.

California Cannabis Poison Control Calls per Unit Sales

Additional context can be provided by comparing numbers of poison control calls for cannabis to cannabis unit sales. In particular, we can ask: how many units of cannabis are sold for each call to the poison centers: Is it a thousand units sold per call, ten thousand units, or a hundred thousand units?

By combining the California DCC’s reported sales data with the California Poison Control data, we can estimate the number of poison control calls per unit of legal market sales over time. Note that the sales data only capture legal market sales, while poison control calls presumably involve problems from ingesting cannabis from any source, legal or illicit. Furthermore, it is commonly believed that the illicit market is significantly larger than the legal market. Indeed, a 2024 DCC Report indicated that 1.43 million pounds of cannabis is grown annually in licensed markets while 11.4 million pounds are grown in illicit markets.^[8] It follows that the prevalence rates calculated using only legal market sales will significantly overstate the prevalence of poison control calls relative to total use, perhaps by a factor of 9. 

California Legal Market Sales

The California Department of Cannabis Control reports annual sales data (revenues and unit sales) for California’s licensed cannabis market.^[9] Total revenues and unit sales by product category are displayed, respectively, in Figures 15 and 16

Figure 15

Figure 16

Total sales revenues in California’s legal market  peaked in 2021 and have been slowly declining since then. This drop is due to three main factors:

• Stagnating unit sales of Flower, though unit sales of Vapes and Edibles, and perhaps Pre-rolls, especially Infused Pre-rolls, continue to increase (Figure 15),
• Decreasing prices,^[10] and
• Shifts out of legal markets into illicit markets.

California Legal Sales per Poison Control Call

Combining the sales data with the poison control data yields estimates of the number of unit sales of legal market cannabis per poison control call displayed in Figure 17. 

Calls for vape use are relatively uncommon, with roughly 750,000 vapes sold in legal markets per poison control call each year between 2022 and 2024. 

Calls for flower use are the second least prevalent. Flower calls have been decreasing over time relative to units sold in legal markets, or equivalently, unit sales per call have been increasing, from 154,000 units in 2019 to 220,000 units in 2024 (a 43% improvement). Calls for extracts and concentrates are the third least prevalent, and also decreased over time relative to units sold, from about 81,000 units per call in 2019, to about 123,000 in 2024 (a 53% improvement). Calls involving edibles are the most prevalent, but also improved over time, by about 38%, from about 30,000 units per call in 2019 to 38,000 in 2024 (Figure 18). 

Takeaways:

• Numbers of poison control calls relative to total amount of legal cannabis product sales:
  • Are significantly overstated by the analysis presented herein, since illicit product sales are not included, 
  • Are largest for cannabis edibles and smallest for flower, and
  • Have been decreasing over time for all product categories.

Figure 17

Figure 18

National Poison Control Calls

The National Capital Poison Center^[11] reports the number of total poison center calls for various categories by age group. After providing some context to the poison control calls for cannabis use in California by comparing them to California’s cannabis market sales, the next step is to compare poison control calls for cannabis to those for other substances. To do this, we need to either use calls to poison control centers for cannabis use nationally or, since that information is not readily available, to project the poison control calls for California up to the national level.

National Poison Control Calls: All Substances

Let’s start with getting a better understanding of the nature of poison control calls made at the national level. Figure 19 displays the top ten substance categories involved in calls separately for children (5-) and adults (20+). Four substances are the subject of calls for both children and adults: cleaning substances, analgesics, antihistamines, and pesticides. After pulling in total population counts, we see that pediatric poison control calls per cohort are almost eight times more common than adult calls.

Takeaways:

• Most poison control calls involve a relatively small number of common substances.
• Poison control calls are much more common for children than adults.

Figure 19

National Poison Control Calls: Cannabis vs. Other Substances

Now let’s compare crude estimates of poison control calls for cannabis using California data projected to the national level – which assumes calls in California are representative of those in other states – to calls for other substances. Figure 20 presents estimates of total 2024 US cannabis poison control calls under these assumptions. These estimates suggest cannabis calls may constitute perhaps 0.8% of pediatric calls and 0.5% of adult calls.

Takeaways:

• Cannabis-related poison control calls represent a small fraction of all poison control calls, less than 1% for both children and adults.
• Cannabis-related poison control calls affect only a tiny fraction of the child and adult populations.

Figure 20

Cannabis Emergency Department Visits

Numbers of Cannabis-Involved ED Visits

Poisoning involving cannabis and other substances are handled not only by poison control centers, but also by emergency departments, which begs the question: While there might be relatively few poison control center calls involving cannabis, does the same hold true for emergency department visits? 

The CDC conducted a study of emergency department (ED) visits involving cannabis by people under 25 years of age between 2019 and 2022.^[12] Estimates of weekly ED visits involving cannabis indicate that ED visits increased between 2019 and 2022 for all three age groups. Specifically, Figures 21 and 22 illustrate how ED visits involving cannabis tripled for children 10 and under, increased by about 62% for 11 to 24 year-olds, and increased by about 5% for 15 to 24 year-olds. The analysis also indicates that the number of ED visits by 15 to 24 year-olds far exceeded visits by the middle group, which in turn exceeded visits by the youngest group.

Adding some context, the number of ED visits involving cannabis were only a small portion of total ED visits for each of the respective age groups, on the order of 0.01% - 0.03% for children ten and under, 0.22% - 0.38% for teens aged 11 to 14, and 1.13% - 1.27% for ages 15 – 24 (Figures 23 – 24).

Finally, when considered relative to population sizes, the number of ED visits involving cannabis affected from 0.003% - 0.008% of the youngest group, 0.03% - 0.05% of the 11 to 14 group, and about 0.3% of the 15 – 24 group (Figure 24).

Figure 21

Figure 22

Figure 23

Figure 24

Takeaways:

• Cannabis-related ED visits involving children and young adults are most prevalent for 15 – 24 year-olds and least prevalent for children ten and under.
• Cannabis-related ED visits involving children and young adults increased between 2019 and 2022, tripling for young children, increasing about 60% for 11 – 14 year-olds, and increasing modestly, by about 5%, for 15 – 24 year-olds.
• Despite the increase in ED visits over the period, cannabis-related visits involve very small portions of all ED visits and of the population.

Disposition of Cannabis-Involved ED Visits

It’s important to understand not only the numbers of cannabis-related ED visits but also how those visits were resolved. A study by Oregon researchers and health authorities examined this issue.^[13] They concluded,

Adults with cannabis-attributed ED visits were more likely to use an ambulance but less likely to be admitted to the hospital and had shorter hospital lengths of stay once admitted.

When compared to patients with non-cannabis-attributed ED visits, children with cannabis-attributed ED visits were older (>=12 years old), more likely to arrive by ambulance and have much longer ED lengths of stay (10 hours longer on average), but were no more likely to be admitted to the hospital.

Similarly, another study by FDA researchers of ED visits involving cannabis-related poisonings^[14] reported, “Healthcare encounters involving cannabis poisoning increased while remaining lower [in numbers], and having fewer admissions/deaths, than selected, other substances,” including heroin, cocaine, benzodiazepines, and alcohol.

Takeaway:

• When overconsumed, cannabis is less toxic for adults and no more toxic for children than other substances.

Cannabis ED Visits vs. Poison Control Calls

A comparison of cannabis related ED visits with poison control calls suggests that there are more poison center calls than ED visits for young children, while the reverse is true – there are more ED visits than poison calls – for adults (Figure 25). If calls to poison control centers generally involve less extreme situations, then the patterns suggest that overconsumption of cannabis by young children is less severe than that by adults. Alternatively, the pattern may suggest that people with young children are more inclined to use poison control services than EDs, while teens and adults are more inclined to use EDs than poison control.

Figure 25

Discussion

Cannabis poisonings have received a good amount of attention in the research and also in the press. Most of the press reports emphasize the large increases in cannabis poisonings as more states have legalized its use. For example, the New York Post just published an article by the Post Editorial Board, “Poisoned tots and other ugly consequences of Albany’s bungled weed legalization,”^[15] reporting:

Skyrocketing child ER admissions for marijuana poisonings are the latest sign of how poorly then-Gov. Andrew Cuomo and the Legislature’s leaders thought through pot legalization.

The state Department of Health just reported that cannabis-poisoning-related emergency-room visits have doubled, from roughly 1,200 in 2016 to nearly 2,400 in 2024.

And the rise in ER admits was over 1,600% for toddlers, as pot-poisoning (i.e., edibles and candies) incidents exceeded those involving Tylenol, aspirin and other painkillers combined.

Certainly, no poisonings are good. At the same time, many reporters and researchers sensationalize the problem by failing to provide proper context. This analysis presents information on cannabis poisonings within a fuller context, by understanding the size of the problem relative to all poisonings reported in poison control center calls and emergency department settings.

Data on cannabis poisonings over time in California and nationally indicate that the number of calls increased between 2016 and 2024, with the largest increases involving younger children, but numbers have stabilized in recent years while the total (legal and illicit market) cannabis use by the population continues to increase, that is, poisonings are becoming a smaller problem relative to all cannabis use. 

Poisonings involving children are particularly distressing. Yet, these problems are perhaps better understood as a parental control problem than a cannabis problem. As for the intentionality of use, essentially all calls by young children involve unintentional use – they did not know what they were consuming. For older children, teens and adults, it appears that the majority knew they were consuming cannabis but unintentionally consumed too strong of a dose. The vast majority of cannabis-involved poison control calls involve either flower (which is more of a problem for adults than children) or edibles (which is a problem for both children and adults, but more so for children), with the poisonings involving edibles being a much larger problem than those for flower. 

Edibles and dosing continue to be central concerns. Perhaps these are education problems – industry educators continue to stress that new consumers should “start low and go slow” – but it seems this advice is not as far reaching or as impactful as we would like. Regulators often respond to both problems by calling for caps on THC content. However, it doesn’t take much for new consumers or those with low tolerances to overdo it, even with low-dose products. A large problem is the delayed onset of effects in edibles (the immediacy of onset of effects for flower surely contribute to the relatively small numbers of flower-induced poisonings): New consumers try one gummy and after a few minutes of no effects, consume more. By the time the effects finally kick-in, they become overpowering. New technologies – namely, nanoemulsions – are helping to address this problem. However, the taste appeal of cannabis-infused confections makes it difficult for even knowledgeable consumers to eat just a single portion. 

Noteworthy is the fact that within the context of all poison control center and emergency department poisonings, problems involving cannabis represent a very small fraction, less than 1% for both children and adults. And compared with poisonings of other substances, cannabis is less toxic for adults and no more toxic for children than other substances.

Further context is provided by noting that a nontrivial portion of cannabis poisonings involve other substances – alcohol, prescription drugs (especially opioids, benzodiazepines, and/or barbiturates), and illicit drugs (e.g., methamphetamine, cocaine, heroin) – in which case it is not so much a cannabis problem per se but rather a substance problem. For example, one study that examined poison center data for Oregon and Alaska between 2015 and 2017^[16] noted, “Oregon/Alaska Poison Center received 68,433 total calls during the study period,” of which 323 (0.5%) involved human exposures and 70 (22.7%) involved multiple substances. This study confirms not only that cannabis poisonings are a small portion of all poisonings but that many cannabis poisonings involve individuals with more general substance abuse problems. 

And finally, many of the poisonings surely involve either synthetic compounds (e.g., HHC or THC-O), or conversion compounds (i.e., compounds derived by converting CBD into other psychoactive cannabinoids), and/or other illicit market products.^[17] Conversion compounds are controversial and illegal in many jurisdictions, while synthetic compounds are generally illegal. Those who condemn legal cannabis activity on the grounds that illegal cannabis activity is undesirable, if not dangerous, are misplacing their outrage and are ignoring the crucial difference between a well-regulated market and a criminal one.

In short, cannabis poisonings are, indeed, a problem, but not nearly the problem reporters and researchers make it out to be.

References

^[1] Massart A, Wills T, Kapuria M, et al. Unintentional ingestion of psychoactive cannabis products among adults: A scoping review. The American Journal of Medicine. 2026;139,718-730.e1 https://www.amjmed.com/article/S0002-9343(26)00144-0/fulltext

^[2] Malta G, Albano GD, Lavanco G, Brancato A, Cannizzaro C, Argo A, Contorno S, Plescia F and Zerbo S. Acute cannabis intoxication among the paediatric population. Front. Toxicol. 2025;7:1558721. https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2025.1558721/full

^[3] Cannabis-Related Calls to the California Poison Control System, 2016–2024. CDPH.​​​https://www.cdph.ca.gov/Programs/CCDPHP/sapb/cannabis/Pages/Cannabis-Poison-Control-System-Calls-Dashboard.aspx

^[4] T40.712A Poisoning by cannabis, intentional self-harm, initial encounter. GenHealth.ai. https://genhealth.ai/code/icd10cm/T40.712A-poisoning-by-cannabis-intentional-initial-encounter

^[5] T40.711 Poisoning by cannabis, accidental (unintentional), initial encounter. GenHealth.ai. https://genhealth.ai/code/icd10cm/T40.711A-poisoning-by-cannabis-accidental-unintentional-initial-encounter

^[6] Chong WW et al. A Scoping Review on the Medical and Recreational Use of Cannabis During the COVID-19 Pandemic. Cannabis Cannabinoid Res. 2022 Oct 12;7(5):591–602. https://pmc.ncbi.nlm.nih.gov/articles/PMC9587770/

^[7] Wadsworth, E., Bilario, B., & Islam, M. (2022). Self‑reported impact of the COVID‑19 pandemic on cannabis use in Canada and the United States. Drug and Alcohol Dependence Reports, 4, 100073.

^[8] Downs D. (2025 Nov 3). By the Numbers: 2025 Cannabis Harvest Report. Leaf Nation. https://leafmagazines.com/learn/2025-cannabis-harvest-report-by-the-numbers/

^[9] Monthly Sales Summary Report. California Department of Cannabis Control. https://www.cannabis.ca.gov/resources/data-dashboard/daily-sales-customer-type-item-category-report/

^[10] Department of Cannabis Control. (2025). California cannabis market outlook: Executive summary (2024 report). chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://abp.assembly.ca.gov/system/files/2025-03/4-california-cannabis-market-outlook-executive-summary.pdf

^[11] https://www.poison.org

^[12] Centers for Disease Control and Prevention. “Cannabis-Involved Emergency Department Visits Among Persons Aged 10–44 Years — United States, September 2020–September 2022.” Morbidity and Mortality Weekly Report. 2023 July 14;72(28). https://www.cdc.gov/mmwr/volumes/72/wr/mm7228a1.htm

^[13] Hendrickson RG, Dilley JA, Hedberg K, Jeanne TL, Love JS, Thompson JA & Choo EK. The burden of cannabis-attributed pediatric and adult emergency department visits. Acad Emerg Med. 2021;28:1444-1447. https://onlinelibrary.wiley.com/doi/10.1111/acem.14275

^[14] Conrad SW, Greene CR, Pan GD, Callahan CL, Meyer TE & Radin RG. United States Healthcare Encounters for Poisoning Involving Cannabis Relative to Other Substances. Am J Drug Alcohol Abuse. 2026;52(1): 98–109. https://pubmed.ncbi.nlm.nih.gov/41642795/

^[15] Post Editorial Board. Poisoned tots and other ugly consequences of Albany’s bungled weed legalization. New York Post. 2025, Jul 17. https://nypost.com/2026/07/17/opinion/poisoned-tots-and-other-ugly-consequences-of-albanys-bungled-weed-legalization/

^[16] Noble MJ, Hedberg K & Hendrickson RG. Acute cannabis toxicity. Clinical Toxicology. 2019;57(8),735–742. https://www.tandfonline.com/doi/full/10.1080/15563650.2018.1548708

^[17] Takakuwa KM & Schears RM. The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review. International Journal of Emergency Medicine. (2021) 14:10. https://www.researchgate.net/publication/349190344_The_emergency_department_care_of_the_cannabis_and_synthetic_cannabinoid_patient_a_narrative_review