‘A very attractive hazard’: Melatonin, THC, CBD gummies are far from harmless

Gummies, those sugary bears, worms or button-sized candies, seem harmless — but they are far from it.

Florida’s Poison Control Centers are fielding an escalation of calls from people who have become seriously ill from overdoses of melatonin, THC and CBD gummies. Emergency department visits in Florida are rising, too. Reactions include nausea, vomiting, extreme lethargy, tremors, confusion and even trouble breathing.

The increase in gummy overdoses is triggered by availability, new habits formed during the pandemic and inconsistent dosage issues.

Gummies are easy to get and increasingly popular. In Florida, melatonin gummies are sold in grocery stores, drugstores and vitamin shops, while CBD gummies are available in convenience stores and smoke shops and THC products are sold in dispensaries (by prescription).

However, the supplement industry, which includes melatonin, is not strictly regulated, so the dosage on the label may not be consistent with what’s in the bottle or bag.

Melatonin overdoses are up

A 2023 study in the Journal of the American Medical Association looked at 25 brands of over-the-counter melatonin gummy bears and found that 88% had a dosage inconsistent with their labeling. Some were lower and some were as much as 3½  times higher than the labeled dose.

That should give Floridians pause, especially with the increasing use of melatonin triggered by sleep-disrupting stress and anxiety during the pandemic. The Sleep Foundation found an increasing number of parents are giving melatonin to children to help them fall asleep, unaware of the risks.

“You don’t know what you are getting,” said Dr. Heidi Cohen, with Joe DiMaggio Children’s Hospital in Hollywood. “They say a milligram amount, but you don’t know if that is what is in there. Too many milligrams can make you excessively sleepy and it can even be toxic for children. There have been deaths tied to melatonin overdosing.”

So far in 2023, Florida’s Poison Control Centers have tracked 996 calls about melatonin-related illness, with 75% of these being for children ages 5 or younger. This accounts for a slight increase in pediatric cases (2.6%)  from the previous year,  said Wendy Blair Stephan, Health Education Coordinator for the Florida Poison Information Center.  Stephan said Florida’s Poison Control Centers also have logged another 47 cases of exposure to “melatonin combined with other substances.”

Nationally,  a study released by the Centers for Disease Control and Prevention found over the last 10 years, more than 4,000 kids were hospitalized from melatonin overdoses; five children required ventilation and two died.

“My first question is why is the child not sleeping without an aid … what is the problem?” Cohen asked. “That problem needs to be addressed with your pediatrician. You should not be just haphazardly medicating children to sleep,”

Marijuana gummies are the most dangerous

Just as popular and even more problematic are gummies with Cannabidiol (CBD) and  Tetrahydrocannabinol  (THC) gummies, which are edible formulations of hemp and marijuana.

Calls to Florida’s Poison Control Centers about edible formulations of marijuana (containing THC) from Florida have risen consistently year over year since 2018 as availability increases. So far this year, Florida’s Poison Control Centers have received 226 calls about exposures to these edible formulations of marijuana with 36% having occurred in children 5 or younger.

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Doctors say marijuana gummies are problematic for both adults and children.

For adults, edibles can take up to two hours to take effect, so a common mistake is for someone to get impatient for the high to kick in and take more,  then overdo it. Overdose symptoms include rapid heartbeat, trouble breathing and delirium. For some people, the gummy ingredients could interact with other medications.  “Everyone reacts differently,” said West Boca Hospital emergency room doctor Charles Jeanpierre.  “People do not usually die from too much cannabis, but they can get very sick and require hospital care.”

Across the country, children are mistaking marijuana gummies for candy, and gobbling down too many. Because of the potency packed into some THC gummies, a small child who ingests them can be getting a fivefold overdose, pediatricians say.

While too many vitamin and melatonin gummies can have harmful effects in children in rare cases, those symptoms are generally mild compared to the serious systemic effects being seen in the ERs with THC in little ones, says Stephan at the Florida Poison Information Center-Miami.

“I think it’s concerning,” she said.

“In 2023, we’re seeing a 12% increase in cases of 0 to 5-year-olds, and 30% in the 6- to 12-year-old age group compared to last year,” she said. “This suggests that parents and grandparents still don’t realize that these products pose a very attractive hazard.”

More than 7,000 confirmed cases of kids younger than 6 eating pot edibles were reported to the nation’s poison control centers over a recent five-year period. The U.S. Food and Drug Administration recently issued a warning to parents after learning of increasing cases of elementary-aged children coming into the hospital after consuming what they thought was candy.

South Florida emergency room doctors see the problem firsthand

“We are seeing the kids come in intoxicated, confused, unable to respond to questions, and there’s a risk of when kids come in like this that they can stop breathing,” said Cohen at Joe DiMaggio.. “We run tests and urine screenings and find THC.”

Jeanpierre, medical director of the pediatric ER at West Boca Medical Center, regularly sees children who have gotten into their parents’ gummies.

The ones who take THC gummies tend to have the most severe symptoms, he said. They come to the ER with nausea, vomiting, dizziness, difficulty breathing, and even an increase in heart rate. “We give them support treatment such as oxygen, anti-nausea medication, IV fluids or medication to drop the blood pressure.”

Jeanpierre said only the children who ingest large amounts of THC are sick enough to be admitted to the ICU.

His advice for parents: if your child eats too many gummies or if you notice your child acting strangely, call poison control. In South Florida that number is 800-222-1222.

Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.