Nappe, who co-authored the report with Christopher Hoyte, explained that the doctors simply observed this unusual sequence of events, documented it and alerted the medical community that it is worth studying a possible relationship between cannabis and the child’s cause of death, myocarditis, or inflammation of the heart muscle.
Their observations appeared in the August edition of the journal Clinical Practice and Cases in Emergency Medicine as a case report, which is significantly different from a scientific study or research report that can be used to establish a causal relationship.
A spokesman for Denver Health wrote in an email that Hoyte would not be available for an interview late Thursday. But he told the Cannabist Friday that, “We’re not saying definitively that marijuana caused the myocarditis. All we are saying is we didn’t find any other reasons. So we need to study this further.”
The report states that the child experienced an “unstable motel-living situation” and the parents admitted to drug possessions, including cannabis. Nappe said the authors urge parents to be vigilant and keep cannabis out of reach of children.
The report recommends: “In states where cannabis is legalized, it is important that physicians not only counsel parents on preventing exposure to cannabis, but to also consider cannabis toxicity in unexplained pediatric myocarditis and cardiac deaths as a basis for urine drug screening in this setting.”
The authors added that, "As of this writing, this is the first reported pediatric death associated with cannabis exposure.”
Nappe emphasized that the word “associated” should not be interpreted as indicating a cause and effect.
Drug policy and health experts also warned against making too much of the report.
“You just can’t make those statements because then what happens is lay people say, ‘Oh my God, did you hear a kid died from marijuana poisoning?’ and it can be sensationalized,” said Noah Kaufman, a Northern Colorado emergency room physician.
“It’s not based on reality. It’s based on somebody kind of jumping the gun and making a conclusion, and scientifically you can’t do that.”
Turns out, that’s what happened in previous news reports, much to Nappe’s dismay. Upon hearing that Nappe and Hoyte were not claiming that the child died from marijuana, Kaufman said “that’s more responsible.”
Jonathan Caulkins, a professor at Carnegie Mellon University's Heinz College, said that it doesn’t strike him as impossible that the death described in the report could be linked to marijuana.
“Unambiguously, cannabis can accelerate the heart,” said Caulkins, who is not a medical doctor but studies drug policy and markets. He also agreed that parents should keep marijuana out of reach of their children.
The Drug Enforcement Administration states that there have been no reported overdose deaths from marijuana.
Even if after further studies it turns out that this child’s death was caused by a marijuana overdose, it would be “a very unusual event,” said Humphreys, a Stanford University psychiatry professor who served as a senior policy adviser at the White House Office of National Drug Control Policy during the Obama administration.
“It would not be correct to go from this to a generalized panic about the lethality of cannabis. It’s just not there,” Humphreys said.
“This is not an omen of a disaster to come.”