Benzodiazepines are the first-line agents for management of agitation and use of antipsychotics may also be considered Cannabis and Synthetic Cannabinoid Receptor Antagonists CLINICAL PEARLS Cannabis poisoning in young children is due largely to edible products Adolescents may develop toxicity when exposed to unexpectedly potent cannabis, or with too-rapid ingestion of multiple serving sizes of edible products Synthetic cannabinoids are inherently more dangerous due to unpredictable chemical content and clinical effects The toxicity of synthetic cannabinoids is distinct from cannabis toxicity Current Evidence The unique characteristics of synthetic cannabinoids are discussed later in this section With the exception of ethanol, marijuana remains the most popular psychoactive drug of abuse As legalization of recreational cannabis becomes more common, poisoning exposures are likely to increase The flowering tops of the female Cannabis sativa plant contain the highest concentration of the primary psychoactive constituent, tetrahydrocannabinol (THC) In the 1970s, most marijuana contained approximately 1% to 2% THC by weight More recently, products may contain upward of 20% THC by weight, and may take users by surprise, leading to a greater degree of altered mental status than previously Another growing dimension of cannabis exposures involves edible products, which are responsible for the preponderance of poisonings in young children Marijuana is now sold in many different formulations The bud, or flower, is the most familiar and can be smoked in a variety of ways Concentrates and extracts are highly concentrated liquids produced by chemical and mechanical extraction of alkaloids from the plant matter; these can be solidified into wax folds, “dabs,” or resins Marijuana may also be incorporated into various edible products, including baked goods, and candies Hashish is the concentrated resin of marijuana With the recent decriminalization of marijuana in a number of states and the growth of the marijuana edibles industry, there has been a rise in the number of unintentional exposures in young children Marijuana is occasionally laced with other psychoactive substances, including PCP and cocaine