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PORTLAND, Ore. (Portland Tribune) — It’s unlikely someone could fatally overdose on marijuana, according to the U.S. Centers for Disease Control and Prevention.

But for some, high doses of marijuana can and do lead to serious health problems, including anxiety and panic attacks, psychotic thinking and hallucinations, doctors say. Marijuana use can also cause unintentional injuries from falls or car crashes, which can be fatal.

Calls to poison control centers in the United States related to intentional misuse and abuse of marijuana by school-age children have increased by 245% in 20 years, according to a recent study by researchers at OHSU. Additionally, the study showed that such calls have been more common than those for alcohol for years.

The findings may reflect how changing marijuana laws across the country are affecting health care systems, the researchers said. They noted that the study provides insight into trends in substance misuse among youths, which remains a national public health challenge.

“This information is important because it will allow researchers to better understand the trends and make recommendations to improve clinical care and interventions aimed at reducing substance misuse among youth,” said Adrienne Hughes, lead author of the study and assistant professor of emergency medicine at OHSU, in a post on the hospital’s website.

Researchers analyzed nearly 340,000 cases of intentional substance misuse and abuse among kids ages 6 to 18 reported to regional poison control centers between 2000 and 2020. The reports included data for substance type, delivery method, patient demographics, reported clinical effects, treatments, management sites and health outcomes.

Researchers distinguished between “intentional misuse” and “intentional abuse,” according to the study, which was published online Dec. 5 in the journal Clinical Toxicology. Cases involving someone using a “substance for reasons other than the pursuit of a psychotropic effect” were considered intentional misuse. Intentional abuse differed in that the “patient was likely attempting to gain a ‘high,’ euphoric effect or some other psychotropic effect, including recreational use.”

Intentional abuse was more common than misuse, with 57.4% of all cases classified as abuse.

More than 80% of all reported cases occurred in kids aged 13 to 18, the data show.

The study revealed also that widely available substances, including over-the-counter medications, household products and commonly prescribed pharmaceuticals, were the most commonly misused or abused substances.

The study didn’t focus on marijuana-related cases solely, but the researchers highlighted the trends related to marijuana.

Between 2000 and 2009, cases involving marijuana were relatively stable, researchers found. In 2011, such cases began to rise steadily, followed by a dramatic increase between 2017 and 2020.

The increase in marijuana cases was particularly notable when compared to those for alcohol, which have declined steadily in recent years. Marijuana cases surpassed alcohol cases for the first time in 2014, according to the study. Since then, marijuana cases have exceeded alcohol cases every year, and by a greater amount each year than the prior.

The trends may reflect the impact on youths of marijuana legalization in states across the country, the researchers said. While marijuana use is restricted to adult use, legalization has rendered it more accessible and contributed to a perception that it’s completely safe, they said.

Voters in Oregon legalized recreational marijuana in 2014. It’s now recreationally legal in 21 states and Washington D.C., according to the National Conference of State Legislatures.

Additionally, the findings reflect the emergence of alternative marijuana consumption methods, including edibles and vaporizers, the researchers said. Edible marijuana products had the highest average monthly increase in case rates, the data show.

While smoking marijuana typically results in an immediate high, edibles take longer to elicit an effect, which may lead people to consume greater amounts and experience unexpected and unpredictable highs, the researchers noted.

“Edible and vaping products are often marketed in ways that are attractive to young people, and they are considered more discrete and convenient,” Hughes said. “These findings highlight an ongoing concern about the impact of rapidly evolving cannabis legalization on this vulnerable population.”