Emergency Department Presentations of Cannabis-Related Neuropsychiatric Toxicity in Children and Adolescents

Authors

• Caddisy Bachman, Michigan State University College of Human Medicine Medical Student
• Reed Stevens, Michigan State University College of Human Medicine Medical Student
• Casey Obrien, Michigan State University College of Human Medicine Medical Student
• CJ Whitford, Michigan State University College of Human Medicine Medical Student
• Andi Nations, Michigan State University College of Human Medicine Medical Student
• Nawal Bennet, Pulmonary and Acute Health Research Operations - Corewell Health West
• Brain Lewis, Emergency Medicine - Corewell Health West
• Jason Seamon, Orthopedic Surgery - Corewell Health West
• Jeffrey Jones, Emergency Medicine - Corewell Health West

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Legalization and increased availability of cannabis in Michigan in 2018 have led to a marked increase in emergency department (ED) visits associated with the drug's neuropsychiatric effects. This study describes the prevalence, clinical features, and disposition of cannabis neuropsychiatric toxicity in pediatric ED patients.

This retrospective cohort study analyzed consecutive children (< 19 years) diagnosed with cannabis toxicity at seven Michigan EDs (three rural, three university-affiliated, one children's tertiary center) from November 2018 to March 2024. Data included demographics, clinical features, and outcomes for those with neuropsychiatric symptoms (NPS group) versus other forms of cannabis toxicity. Chi-squared and t-tests were used to compare groups on key variables.

Of 936 children evaluated for cannabis toxicity, 444 (47.4%) had NPS as the chief complaint, while 492 (52.6%) had other toxicity, mainly intoxication (49.0%) or hyperemesis (38.5%). NPS presentations included acute anxiety (23.4%), somnolence (21.0%), depression (10.8%), aggression/mania (9.2%), hallucinations (6.1%), delusions (5.9%), seizures (5.4%), ataxia (4.7%), paranoia (3.8%), and suicidal ideation (3.2%). Eleven percent required sedation/restraint; one-third were admitted, transferred to psychiatry, or jailed. Compared to the other cohort, NPS patients were more often female (57.0% vs. 48.8%, P=0.01), consumed edibles (29.7% vs. 15.2%, P< 0.001), had preexisting mental health issues (15.3% vs. 9.1%, P=0.004), and polysubstance abuse (22.5% vs. 16.7%, P=0.025).

Neuropsychiatric toxicity represents nearly half of all pediatric emergency department visits related to cannabis use following legalization in Michigan. Affected patients were more likely to be female, ingest edible cannabis, and have pre-existing mental health conditions or polysubstance use. Acute presentations ranged from anxiety and somnolence to severe psychiatric symptoms requiring sedation or psychiatric admission. These findings underscore the growing burden of cannabis-related neuropsychiatric emergencies in youth and highlight the need for targeted prevention.

Recommended Citation

Bachman C, Stevens R, Obrien C, Whitford CJ, Nations A, Bennet N, Lewis B, Seamon J, Jones J. Emergency department presentations of cannabis-related neuropsychiatric toxicity in children and adolescents. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1880