Unintentional ingestion of recreational drugs among young children, 2000–2024

BACKGROUND: Previous studies of pediatric recreational drug exposures have often been limited in scope. Given the rapidly changing recreational drug supply and the related unintentional ingestion of these drugs by young children, a comprehensive study that includes recent data about these exposures is needed. The objective of this study is to investigate the characteristics and trends of unintentional ingestions of recreational drugs by children < 6 years old. METHODS: Using a retrospective cohort study design, National Poison Data System data from 2000 to 2024 were analyzed. United States Census Bureau data were used to calculate population-based ingestion rates. Rate ratios (RRs) with 95% confidence intervals (CIs) were calculated to assess the magnitude of relationships between key characteristics and outcomes, such as highest level of health care received and medical outcome. RESULTS: There were 41,612 unintentional ingestions involving recreational drugs among children < 6 years old reported to United States poison centers from 2000 to 2024. Most were among children < 3 years old (57.6%), involved a single substance (95.9%), and occurred in a residence (96.4%). Although 50.6% of children experienced no or minor effects, 5.0% had a major effect and there were six deaths. Children < 3 years old were more likely to experience a major effect (RR: 1.54; 95% CI:1.39-1.71) or be admitted to a critical care unit (RR: 1.23; 95% CI: 1.16-1.30) than children 3-5 years old. Cannabinoids accounted for 84.7% of ingestions, followed by stimulants (8.4%), psychedelics (3.5%), opioids (2.8%), and dissociative agents (0.6%). Ingestions involving opioids (RR: 2.60; 95% CI: 2.36-2.86), stimulants (RR: 2.16; 95% CI: 2.01-2.31), and dissociative agents (RR: 1.59; 95% CI: 1.23-2.06) were more likely to be admitted to a critical care unit than the other substance categories combined. The recreational drug ingestion rate per 100,000 US children < 6 years old increased 3,307% from 1.05 in 2000 to 35.91 in 2024, with a rapid increase beginning in 2013, especially involving edible marijuana and psilocybin products. CONCLUSIONS: The recreational drug ingestion rate among children < 6 years old reported to United States poison centers increased substantially from 2000 to 2024. Additional efforts are needed to prevent these unintentional ingestions in this vulnerable population.