The Maine Department of Health and Human Services is urging marijuana users to take steps to prevent children from accidentally ingesting the drug, after a spike in reports to a poison hotline.

Also, the Maine Center for Disease Control and Prevention is promoting a new state website that provides information on such topics as marijuana use during pregnancy, talking to children about drugs, and the ins and outs of legalized recreational cannabis in Maine.

Last year, the Northern New England Poison Center received 16 calls from Maine on its poison control hotline for accidental marijuana ingestion by children 5 years old or younger. While a modest number, that is up from just two calls in 2016 and comes at a time when Maine legalized adult recreational marijuana use and personal possession of cannabis in private.

DHHS officials suggested that accidental ingestion by children – as well as by pets and unsuspecting adults – often involves edible forms of the drug.

“Edibles can be a presented in a variety of different ways, including in the forms of candy, brownies, and other baked goods or sweets, which may entice children to eat them without knowing they contain the drug,” DHHS said in a news release. “Accidental ingestion of marijuana or marijuana products can cause serious health consequences, and young children are at an exceptionally higher risk because of their size and weight.”

The agency recommended that adults store marijuana in a locked and secure location out of sight and reach of children.

Maine is one of eight states where marijuana is legal for adults age 21 and older, although the drug still cannot be sold in the state for recreational purposes and remains illegal under federal law.

There have been few studies on how legalization affects children or adolescents, although several have been conducted in Colorado. A 2016 study, for instance, found that visits to Colorado emergency rooms because of child ingestion roughly doubled in 2014 and 2015 after legalization, while calls to Colorado’s poison center increased five-fold.

Dr. Karen Simone, director of the Northern New England Poison Center that handles calls from Maine, Vermont and New Hampshire, said the spike in child exposure to marijuana in Maine is expected as the availability of edibles increases. While dogs are sometimes tempted to eat marijuana buds or dried material that they find, children are more likely to get into trouble with cannabis edibles.

“Every poison is like that, whether it is Tide Pods or any other poison,” Simone said. “As soon as you have something that is around, if it’s attractive or looks good, kids will get into it.”

Of the 16 calls handled by the hotline, the majority involved children eating chocolate, cookies, brownies or other edibles, and one involved ingestion of oil derived from cannabis. Six of the children were taken to the hospital and another five were already there when the call was placed. Some of the children were so intoxicated they were having trouble staying awake, and one could not even walk.

Simone cautioned adults not to dismiss childhood exposure as “just pot” because children can be affected to a much greater extent, especially by highly potent edibles. An adult user may know to eat a pot brownie in small amounts over a period of time, but children are more likely to eat the item quickly and then suffer greater effects because of their small size and lack of tolerance.

Exposure to cannabis in children can cause common effects such as drowsiness and dizziness, which can lead to dangerous falls, as well as severe vomiting. But it has also been shown to cause seizures and challenge breathing in some instances, Simone said, so she urged parents to call the hotline – 800-222-1222 – even if they choose to do so anonymously because of fear of getting in trouble with the law.

“We don’t want to punish people, we just want them to keep these materials out of reach and call us if they have a problem,” she said.

The Maine CDC, an agency within DHHS, has launched a website, GoodToKnowMaine.com, aimed at providing information as the Maine marijuana landscape shifts after the legalization vote in November 2016. The website avoids the political debate over marijuana legalization while providing easy-to-understand information for expectant mothers and parents of adolescents, as well as the current laws in Maine.

For instance, the “Laws” section explains major provisions such as amounts that individuals can legally possess, ongoing prohibitions on using cannabis in public places and transporting it across state lines, and the penalty for sharing with a minor.

The section for pregnant or breastfeeding women acknowledges that more research into the effects of marijuana on children are needed, but cautions “there is no known safe amount of marijuana to use while pregnant.” The website also seeks to address misconceptions that marijuana’s legalization or its status as a “natural” product implies it is safe for children.

“The fact that it’s legal does not make it safe,” reads the website. “Using marijuana during pregnancy or while breastfeeding may harm your baby, just like alcohol or tobacco.”

Scott Gagnon, a longstanding legalization opponent and spokesman for Smart Approaches to Marijuana Maine, serves on a Maine CDC advisory board that has been discussing the website. Gagnon called the site “an important step” in the implementation of the law, particularly given the numerous changes made by lawmakers over the past year. He also appreciates the focus on the potential health consequences of marijuana use.

“I think the website is great,” Gagnon said. “I like how they divided it into sections to make sure people are educated about the ins and outs of the law. … I think they did a good job distilling what is legal and what is not.”

But Paul McCarrier with Legalize Maine, which is one of the organizations heavily involved in the referendum process and the extensive legislative debate since then, pointed out that the “Laws” section on the DHHS website contains numerous inaccuracies. For instance, the website says individuals can legally possess up to six adult plants and six immature plants. In reality, the law currently allows six adult plants but 12 immature plants. Additionally, McCarrier said Maine law allows possession of 4 ounces of cannabis concentrate, not the 0.5 grams listed on the website.

Emily Spencer, spokeswoman for DHHS, said the news release and website were not prompted by any particular event, “but rather serves as a proactive message” about reducing the risk of accidental ingestion.

“The Good to Know Maine campaign has been in the works by the department for several months,” Spencer said. “We take the health and safety of Mainers very seriously and want to ensure kids are protected from incidents of accidental marijuana ingestion.”