emergency room

[1]. In 2018 Michigan legalized the use of marijuana for adults. Since this law took effect, increased availability and use of cannabis have led to an increase in emergency department (ED) visits, as well as complaints about the drug's neuropsychiatric effects [2]. High doses of cannabis can be associated with undesired effects such as paranoia, psychotic-like symptoms, and panic attacks, depending on the content of its principal active constituent, D9-tetrahydrocannabinol (THC), and that of cannabidiol, a constituent with anti-anxiolytic properties [3]. Higher concentrations of THC relative to cannabidiol, as demonstrated in many commercial products, are associated with increased incidence of psychotomimetic symptoms [4,5]. Various studies in adults with acute THC exposure have shown a dose-related reduction in performance at laboratory tasks measuring memory, divided and sustained attention or concentration, reaction time, and tracking and motor function [3,6-9]. Less is known regarding the acute effects of THC in the pediatric population, and much of the

data that currently exist involve retrospective reviews of large, coded data sets [10-12]. The purpose of this study was to describe the prevalence, clinical features, and disposition of cannabis neuropsychiatric toxicity in a community-based study.