How to protect trick-or-treaters from cannabis edibles, allergens, and more this Halloween

It’s a standard safety measure that parents regularly conduct after their children finish trick-or-treating: checking the kids’ Reese’s Pieces and Mars bars and Nerds Ropes to make sure none have been opened or tampered with.

But some Halloween dangers are closer to home — and more likely to occur than the threat of someone maliciously tampering with candy, poison control centers around the Philadelphia region are warning.

Poison hotlines are receiving more calls about kids who have eaten cannabis edibles, which sometimes come in packaging that mimics popular candies and appeals to young kids. And children most often find them in a parent’s or friend’s home, not secreted in their trick-or-treat bags.

“The vast majority of the time it happens in our own homes, when kids get into our own products,” said Anthony Jaworski, a clinical toxicologist at the poison control center at Children’s Hospital of Philadelphia.

That’s not to say that parents shouldn’t take precautions with the candy their kids bring home. It’s always safest to sift through your children’s Halloween haul before allowing them to dig in, experts say. But they also want parents to secure potentially dangerous substances already in the home that kids could mistake for candy.

On a recent Halloween, the New Jersey Poison Control Center and Rutgers New Jersey Medical School helped care for a child who was hospitalized with nausea, vomiting, and difficulty breathing after he swallowed cannabis edibles he found in a babysitter’s coat pocket.

The center’s managing director, Bruce Ruck, has never seen a case of a child ingesting marijuana that had been handed out while trick-or-treating. But he worries about what kids could get into at a time when lots of candy is in the house.

“I am worried about parents or anyone who have [edible cannabis] around their house,” he said. “We worry that the child will see it and assume that it’s like a lot of other things in the house.”

New Jersey’s poison center has fielded 100 calls so far this year for children under 5 who have ingested cannabis.

Most children hospitalized after ingesting cannabis recover within a day or two. Depression of the central nervous system, which can cause slurred speech, coordination trouble, and drowsiness, is the most common side effect, according to a study in the journal Pediatrics that analyzed thousands of cannabis ingestions between 2017 and 2021. More serious symptoms include slowed breathing or heart rate.

Recreational marijuana is legal in New Jersey. It is illegal in Pennsylvania, but residents can buy hemp derivatives like delta-8 THC, said to produce a milder high than delta-9 THC, the main cannabinoid in marijuana.

Delta-8 exists in something of a legal gray area but has historically been subject to fewer regulations than recreational or medical marijuana. Sometimes it’s sold in gas stations and convenience stores. (A new law in New Jersey has banned delta-8 sales outside of licensed dispensaries, and minors can no longer buy it.)

And the packaging of many delta-8 products can resemble popular candies.

“Sometimes the packages look like traditional candies, like Lucky Charms or Nerds,” Jaworski said. “I always say avoid buying these products to begin with.”

“If you do have cannabis products at home, treat them like medicines, and keep them locked away,” he said.

Two years ago, the Drug Enforcement Administration issued a warning about “rainbow fentanyl,” a colored form of the deadly synthetic opioid. The DEA said it was being marketed to children and young people. The warning caused a national uproar, with news outlets and legislators warning that kids could find fentanyl in their trick-or-treat bags.

The DEA later clarified that officials didn’t believe trick-or-treaters were at risk. And the panic may have obscured the real dangers of fentanyl, which has caused hundreds of thousands of overdose deaths and is sometimes pressed into the shape of pharmaceutical pills that can fool unsuspecting users into thinking they’re taking a safer drug.

As with edible cannabis, most young children who accidentally ingest opioids do so at home, with drugs — prescription or otherwise — that belong to their parents or grandparents.

“I can confidently say that it’s not around our Halloween candy,” Jaworski said. But he added that anyone with opioids in the home should consider also having naloxone, the opioid overdose-reversing drug, nearby.

If family members are stopping by for the holiday, make sure any medicines they bring are stored in bottles with child-resistant caps, and not left in a purse or suitcase where a young child could grab them.

Parents should follow the long-standing guidance to throw out any candy they find that appears to have been opened. Chocolates that have melted should also be tossed to avoid food poisoning.

Keep an eye on your trick-or-treat route, and don’t let kids pick up any wrappers — Jaworski has found discarded delta-8 wrappers on the street near his house in Center City — or eat any berries or mushrooms growing along the route. “It’s mushroom season right now, and we don’t want kids picking poisonous plants or mushrooms along the way,” he said.

The New Jersey poison center also fields calls about glow sticks: “If they break, they can get into the eyes and cause irritation. If you swallow them, you might get a sore throat, and maybe vomiting,” Jaworski said.

Ruck also advised parents to be aware of allergens that could harm children. Parents should make sure face paints and other Halloween cosmetics don’t have ingredients that could irritate their kids’ skin.

And, for children with food allergies, parents should go through their bag to check for potential allergens, as well as keep handy an EpiPen if a child uses one.

If you suspect your child has eaten an allergen, a cannabis edible, or another harmful substance, call the poison control hotline at 1-800-222-1222, which will connect you to the poison control center nearest you.

“It’s faster to call us than to go on social media platforms looking for stuff. We’re all health-care professionals and we’re all willing to help,” Ruck said.