Data from the latest report of the Canadian Paediatric Surveillance Program reveals that were 36 cases of severe illness or injury from cannabis consumption among Canadian youth in 2019. Thirty-four of those cases required hospitalization.

The most common case presentation was unintentional injury due to cannabis exposure, the report notes. A third of all cases were aged 12 years or younger and related to the accidental ingestion of cannabis edibles. The report also highlights eight cases that involved gastrointestinal problems and five cases of “cannabis-related disorder.”

The gastrointestinal problems occurred in youth aged 13 to 18 and were related to cannabis hyperemesis syndrome (CHS), the report states. Little is known about CHS, but it is characterized by periods of nausea and vomiting following chronic cannabis use.

Medical treatment was required for 28 cases in the form of ventilation assistance, IV fluids and observation. Thirteen cases also received mental health treatment. Dr. Richard Bélanger, the study co-lead, told the Canadian Medical Association Journal that the report is “concerning and worrisome.”

“Adolescents who consume [cannabis edibles] on a regular basis, even about three times a week, [can] start vomiting,” Dr. Bélanger said, noting that future research will be focused on cannabis edibles.

The report also highlights 88 cases of illness or injury related to vaping. Twenty-two of those cases required hospitalization with respiratory distress and lung injury, and symptoms of nicotine poisoning, among the most common harms reported.

The data is not complete, said Dr. Nicholas Chadi, an adolescent and addiction medicine specialist in Montreal, telling CMAJ that the survey is the “the tip of the iceberg, in the sense that not all kids will consult with a pediatrician.”

Dr. Chadi said the findings are “a call to action,” for families and health professions as almost a third of pediatricians surveyed reported feeling uncomfortable discussing vaping-related health risks with patients and their families.

“Even today, there are no validated screening tools to ask kids about vaping. I think a large portion of Canadian pediatricians do not know which questions to ask, what to look for or how to prevent engagement in this behaviour,” Dr. Chadi said.