When Virginia first decriminalized cannabis, the Blue Ridge Poison Center, which serves central and southwest Virginia, got 29 calls from people suffering an unexpected reaction to THC – the active ingredient that comes from marijuana plants or labs. By 2023, that number had grown ten-fold to more than 300. The center’s director, Dr. Chris Holstege, was concerned.
"I see the edibles as the most dangerous, because we don’t have good quality control," he explains. "The packaging doesn’t necessarily depict what’s in the products."
Nor can people be sure how much of the drug they’re getting.
"People know exactly the content of alcohol they’re buying. They’re informed when they buy it. There are regulations. There’s quality control," Holstege says.
And eating cannabis is very different from smoking it.
"When you smoke it, the onset is very quick. Our lungs are very good at absorbing it, getting it into the blood stream that goes to the brain. If you ingest it, we may not see peak effects for two hours, and so we’ve had college students and teenagers ingest a product. It has no effect. They then take another one and another one and another one over a two-hour time period, and then they start feeling the effect, and they really overshoot."
They’ve come into emergency rooms suffering anxiety, delusions, a rapid heart rate and falling blood pressure. Some were taking medications – like anti-depressants – that might have interacted with THC. Others had psychiatric conditions made worse by unregulated drugs.
The parents of young children were also calling poison control or heading for hospitals after the kids ate their THC-infused gummies, cookies and other sweets.
"Kids would eat the entire package and we started seeing these children who came in hard to wake them up, not breathing well, their blood pressures would drop, their heart rates would go up," Holstege recalls.
He says one child actually died, and many more were hospitalized.
"Pharmaceutical medications we child-proof. The products with these high content Delta-9 THC and other cannabinoids in them are not child-proofed."
At the emergency department, parents may be reluctant to report that children consumed cannabis – fearful they could lose custody or be prosecuted, and doctors end up doing lots of expensive tests before identifying the problem. Holstege says that’s really not necessary.
"First of all there is confidentiality in the health systems. Poison centers are also a confidential resource, so you want to be honest."
Holstege is also alarmed by the growing presence of hallucinogens being sold in smoke shops, gas stations and convenience stores.
"Including psilocybin, MDMA which is Molly. People will fall from balconies, walk in front of a car as they’re having their hallucinations or have what people consider bad trips."
And laboratories have detected pharmaceuticals from other countries – like Russia – that cause sedation or symptoms like those associated with opiates. In 2013, the United Nations issued a report claiming the world was unable to keep up with the rapidly emerging market for all kinds of drugs.
"They have completely lost control of the synthetic drug market, because these are emerging so fast that we can’t get them off quick enough."
Few hospitals can detect these new chemicals with standard drug tests, and Holstege says no one seems to be enforcing the few legal limits Virginia has imposed.
He argues the Commonwealth should be taxing cannabis and using the proceeds to better protect consumers. In the meantime, UVA has hired an epidemiologist to monitor for new, unregulated substances that pose a threat to the public.
You can reach your area's poison center by calling
(800) 222-1222
This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.
