Cannabis in Paediatrics
Cannabis, otherwise known as marijuana, is a complex and multifaceted plant that is comprised of a wide variety of compounds. Among these compounds are two notable ones—THC (Tetrahydrocannabinol) and CBD (Cannabidiol). Each of these compounds has a different impact on the human body and mind, prompting diverse physiological responses. THC is the primary psychoactive ingredient in cannabis, which means it’s the component responsible for the ‘high’ that users experience. On the other hand, CBD is non-psychoactive and is recognized for its potential medicinal applications. The unique combination of these two compounds, among others, gives cannabis its characteristic effects, which can range from pain relief to alterations in mood and perception. Interestingly, it’s not just adults who use cannabis; some children and young people may also use it, primarily for medical purposes. This usage, however, is usually under the strict supervision of a healthcare professional. The range of medical conditions for which it is used is quite extensive, encompassing conditions such as epilepsy, chemotherapy-induced nausea and vomiting, chronic pain, and spasticity. Epilepsy, a neurological disorder, can cause unpredictable seizures and can affect a person’s safety, relationships, work, driving and so much more. The cannabinoids present in cannabis, particularly CBD, have been found to reduce the frequency and severity of seizures, especially in treatment-resistant forms of epilepsy. During chemotherapy, a cancer treatment, patients often experience severe nausea and vomiting. This can result in a decreased quality of life and additional health problems. Cannabis, specifically its THC component, can help alleviate these chemotherapy-induced symptoms, making the treatment more bearable for patients. Chronic pain, an issue that plagues many young people and children, is another condition for which cannabis might be used. Whether the pain arises from conditions such as juvenile arthritis or fibromyalgia, cannabis can offer relief where traditional painkillers fall short. Spasticity, a condition usually associated with disorders like multiple sclerosis, cerebral palsy, and spinal cord injury, causes muscle stiffness and restricts free movement. Some studies suggest that medical cannabis can help to ease these symptoms, offering young people a chance to regain some normalcy in their lives. However, despite these potential benefits, it’s critical to understand that cannabis is not a panacea. It’s not a cure-all for every ailment, and it has its own set of potential risks and side effects, especially for children and young people. These can include cognitive impairment, potential addiction, mental health issues, and other physiological effects. It’s important to remember that the use of cannabis, particularly in children and teenagers, should always be undertaken with comprehensive medical guidance and supervision. This ensures that its use is safe, effective, and beneficial in the long run.
Some of the potential benefits of cannabis in paediatrics are:
It may reduce the frequency of seizures in some types of drug-resistant epilepsy, such as Lennox Gastaut syndrome or Dravet syndrome12.
It may improve the quality of life for some children suffering from conditions such as severe epilepsy, autism spectrum disorder, or cancer34.
It may alleviate pain and discomfort from conditions such as neuropathic pain, spasticity due to multiple sclerosis, or palliative care56.
Some of the potential risks and side effects of cannabis in paediatrics are:
It may impair memory, attention, and reaction time, which can affect learning and development78.
It may interact with other medications, such as antiepileptic drugs, antidepressants, or opioids, and cause adverse reactions9 .
It may cause dry mouth, drowsiness, dizziness, nausea, or increased heart rate.
It may increase the risk of psychosis or paranoia in some individuals, especially those with a history of mental illness or a family history of schizophrenia .
Therefore, children and young people who are interested in using cannabis for medical purposes should consult with their doctors before trying it. They should also have a clear diagnosis and a treatment plan that is monitored by a specialist clinician. They should avoid smoking cannabis, as it can damage the lungs and worsen respiratory conditions. They should also be aware of the legal status of cannabis in their area and follow the local regulations.
1: Dravet Syndrome (TA614) | NICE 2: Lennox Gaustat Syndrome (TA615) | NICE 3: Cannabis-derived medicinal products – questions and answers | RCPCH 4: Medical cannabis in schools: The experiences of caregivers | PCH 5: Is the medical use of cannabis a therapeutic option for children? – CPS 6: Medical Cannabinoids in Children and Adolescents: A Systematic Review | Pediatrics 7: Marijuana and the Pediatric Population | Pediatrics 8: Cannabinoids in Pediatrics | NCBI 9: Is the medical use of cannabis a therapeutic option for children? – CPS : Medical Cannabinoids in Children and Adolescents: A Systematic Review | Pediatrics : Marijuana and the Pediatric Population | Pediatrics : Cannabinoids in Pediatrics | NCBI
Learn more:
1. cps.ca
2. bing.com
3. rcpch.ac.uk
4. rcpch.ac.uk
9. bing.com
There are some examples of cannabis working in paediatrics for certain conditions, such as epilepsy, cancer, or spasticity. However, these examples are mostly based on anecdotal reports, case series, or small trials, and they do not provide conclusive evidence for the efficacy or safety of cannabis in children and young people. Here are some of the examples:
Epilepsy: Some children with severe forms of epilepsy, such as Lennox Gastaut syndrome or Dravet syndrome, have reported a reduction in seizure frequency and severity after using cannabis products that contain CBD (cannabidiol), a non-psychoactive compound. For example, a study of 120 children with Dravet syndrome found that CBD reduced the median monthly convulsive seizure frequency by 39%, compared with 13% with placebo1. However, CBD also caused some adverse effects, such as diarrhea, vomiting, fatigue, and abnormal liver function tests1. In the UK, CBD is licensed as an adjunctive therapy for these two epilepsy syndromes and can be prescribed by specialist clinicians2.
Cancer: Some children with cancer have used cannabis products to relieve symptoms such as pain, nausea, vomiting, or appetite loss caused by chemotherapy or the disease itself. For example, a survey of 303 parents of children with cancer in Canada found that 29% had administered or considered administering cannabis to their child during cancer treatment3. However, there is no clear evidence that cannabis can cure cancer or enhance the effectiveness of conventional therapies. Moreover, cannabis may interact with some anticancer drugs and affect their metabolism4.
Spasticity: Some children with spasticity due to conditions such as cerebral palsy or multiple sclerosis have used cannabis products to improve their muscle tone and movement. For example, a trial of 25 children with spastic quadriplegic cerebral palsy found that THC (tetrahydrocannabinol), a psychoactive compound in cannabis, improved spasticity scores and quality of life scores after 5 months of treatment5. However, THC also caused some side effects, such as drowsiness, irritability, and euphoria5. In the UK, THC is licensed for symptom improvement in adult patients with spasticity due to multiple sclerosis, but not for children2.
These are just some of the examples of how cannabis may work in paediatrics for some conditions. However, more research is needed to confirm the benefits and risks of cannabis use in children and young people. If you want to know more about the evidence on cannabis in paediatrics, you can read the scoping review by Pawliuk et al. or the policy statement by the American Academy of Pediatrics
1: Cannabidiol in patients with seizures associated with Lennox-Gastaut … 2: Medicinal cannabis for children and young people – RCPCH 3: Medical cannabis use in pediatric oncology: A single-center survey … 4: Cannabinoids in Pediatrics | NCBI 5: Tetrahydrocannabinol treatment in chronic childhood … – NCBI : [Efficacy and safety of paediatric medicinal cannabis use: A scoping …] : [Marijuana and the Pediatric Population | Pediatrics]
Learn more:
1. rcpch.ac.uk
5. doi.org
6. rcpch.ac.uk
10. doi.org
According to some web sources, there are some children who have used cannabis products for medical purposes, such as epilepsy, cancer, or spasticity, and have experienced positive outcomes. However, these examples are mostly based on anecdotal reports, case series, or small trials, and they do not provide conclusive evidence for the efficacy or safety of cannabis in children. Here are some of the examples:
Named after the city of her birth, Charlotte Figi was a young girl who was plagued by a particularly severe form of epilepsy known as Dravet syndrome. This rare and debilitating condition typically manifests during the first year of life and is characterized by frequent, prolonged seizures that are often triggered by hot temperatures or fever. For Charlotte, this translated into hundreds of convulsive episodes a week, a life-threatening situation that put a tremendous strain on her small, fragile body and seriously impeded her quality of life. In their desperate quest to find a solution, Charlotte’s parents stumbled upon a type of cannabis oil that was rich in cannabidiol (CBD), a non-psychoactive compound, and contained only trace amounts of tetrahydrocannabinol (THC), the psychoactive ingredient that gives marijuana its “high”. This specific combination was theorized to potentially have therapeutic benefits for individuals with certain neurological disorders, including epilepsy. With nothing to lose and everything to gain, Charlotte began her regimen of this specialized CBD-rich cannabis oil, and the results were nothing short of miraculous. They observed a dramatic reduction in the frequency of her seizures, a change that not only significantly improved Charlotte’s quality of life but also provided a beacon of hope for others suffering from similar conditions. Charlotte’s remarkable journey and her success with medical cannabis quickly captured national attention. She became the central subject of a groundbreaking CNN documentary entitled ‘Weed’, produced by the internationally recognized neurosurgeon and medical reporter, Dr. Sanjay Gupta. This powerful documentary brought Charlotte’s story, and the potential benefits of medicinal cannabis, to a broad audience, significantly raising awareness, and triggering a much-needed dialogue about the potential benefits and controversies surrounding medical marijuana. The documentary’s impact was immense; it effectively challenged the stigma traditionally associated with cannabis use and opened the eyes of many to the potential therapeutic benefits of this oft-misunderstood plant. So profound was the impact of Charlotte’s story that a unique strain of medical cannabis was named in her honor – Charlotte’s Web. This strain, high in CBD and low in THC, is now used by many patients across the world to manage symptoms of many different ailments, serving as a legacy to the brave little girl who changed the way we view medical cannabis. Today, Charlotte’s story continues to inspire and influence the global debate on the use and legalization of medical cannabis. Her life serves as a poignant testament to the potential of cannabis as a legitimate and life-changing medical treatment, a conversation that undoubtedly will continue for many years to come.
Billy Caldwell is a young lad who was diagnosed with a devastating form of epilepsy that refused to bow to the might of existing traditional medications. With the kind of epilepsy he had, the standard treatment methods, a range of anticonvulsant drugs, were not functioning as anticipated. His condition was stubbornly resistant, rendering him vulnerable to severe, life-threatening seizures. This boy’s life was a battlefield, a constant struggle against an invisible and merciless enemy. In the quest for an effective treatment approach that could alleviate the frequency and severity of Billy’s seizures, his mother, Charlotte Caldwell, turned to a unique remedy. This came in the form of cannabis oil, a substance that was gaining popularity for its potential benefits in managing various health conditions, including epilepsy. This oil contained both Cannabidiol (CBD) and Tetrahydrocannabinol (THC). CBD is a non-psychoactive compound that has been linked to several therapeutic benefits without causing a ‘high,’ whereas THC is the psychoactive compound often associated with the euphoric effect of cannabis. With this ray of hope, Billy and his mother embarked on a journey to Canada, where the use of medical cannabis was legal and widespread. In Canada, they were able to access the cannabis oil, and Billy began his new treatment. Miraculously, following the introduction of this unconventional therapy, Billy’s seizures showed significant improvement. The frequency of his attacks reduced, and their severity was notably ameliorated. The positive change in Billy’s condition was a testament to the therapeutic potential of cannabis oil in treating resistant forms of epilepsy. However, their triumph was short-lived. Upon their return to the UK, where the laws surrounding the use of cannabis were more stringent, they faced a significant setback. The authorities confiscated their supply of cannabis oil at the airport. UK laws at that time did not recognize the medicinal use of cannabis, irrespective of its effectiveness in situations like Billy’s. The confiscation of the oil meant an abrupt cessation of Billy’s treatment, causing his condition to relapse and worsen. His seizures returned, more severe and frequent than before, leaving him and his mother in an agonizingly helpless situation. Billy’s ordeal sparked an uproar among the public, leading to a massive outcry for change in the UK’s cannabis laws. It was not only their fight but also represented the struggle of thousands of individuals who could potentially benefit from medical cannabis. The public pressure led to a significant breakthrough. In an unprecedented move, Billy was granted an emergency license to use the cannabis oil by UK health authorities. This was a landmark decision in the UK’s history of drug control policies, indicating a shift in the perception towards medical cannabis. This license allowed Billy to resume his treatment, bringing immense relief to him and his family. In conclusion, Billy Caldwell’s story represents a complex intersection of personal struggle, medical innovation, and societal norms. It highlights the potential of cannabis as a therapeutic agent, the rigidity of drug laws, and the power of public outcry in bringing about change. Despite the challenges faced, Billy and his mother’s resilience have paved the way for a paradigm shift in the UK’s approach to medical cannabis.
Alfie Dingley, a young boy hailing from the United Kingdom, suffered from a rare and severe form of epilepsy. This debilitating condition made him a victim to a harrowing number of seizures, causing him to experience up to 150 episodes of convulsions every month. Imagine the distress this put not only on the young boy but also his loved ones, witnessing his continual struggle, unable to offer any real relief to his suffering. In search of a remedy, Alfie and his caring mother embarked on a journey to the Netherlands, a country known for its progressive views on alternative medicine. Their quest led them to a specific form of cannabis oil, a natural concoction that contained both cannabidiol (CBD) and tetrahydrocannabinol (THC). These two primary active constituents of cannabis have been known to have therapeutic effects on certain medical conditions, including epilepsy. Once they discovered this miraculous treatment, the transformation was nothing short of astounding. Alfie’s seizures drastically reduced, going from a horrifying 150 episodes to a much more manageable one or two seizures every month. The relief this brought to Alfie and his family was indescribable. The cannabis oil therapy was undeniably life-changing, proving to be a beacon of hope to the young boy and his family. However, upon their return to the UK, they were met with a harsh reality. While the Netherlands has a liberal stance on cannabis use for medical purposes, the UK’s stringent laws posed significant legal obstacles. Accessing the cannabis oil, the very solution that had offered so much relief to Alfie, became a Herculean task. This dilemma forced the family into a complex legal battle against the state’s traditional health policies, all in a desperate bid to secure Alfie’s health and wellbeing. This struggle went on for a considerable time, during which the family campaigned tirelessly, rallying for a change in the laws regarding medical cannabis use. Their sustained efforts finally bore fruit when, after an uphill battle, Alfie was granted a special license. This license was not just a piece of paper; it was a ticket to Alfie’s improved health, a testament to the family’s resilience, and perhaps, above all, a symbol of hope for others battling similar health conditions. This special license allowed Alfie to continue using the cannabis oil therapy under the UK’s legal framework. This monumental decision represented not only a victory for Alfie and his family but also a significant step towards more compassionate and progressive health policies in the UK.
These are just some of the examples of how parents have reported benefits of medicinal cannabis in children for some conditions. However, more research is needed to confirm the benefits and risks of cannabis use in children. If you want to know more about the evidence on cannabis in paediatrics, you can read the scoping review by Pawliuk et al. or the policy statement by the American Academy of Pediatrics.
1: Charlotte Figi: US girl who inspired medical cannabis oil dies – BBC News 2: The Inside Story Of Cannabidiol – What Are The Benefits Of CBD? 3: Medicinal cannabis: how two heartbreaking cases helped change law | Cannabis | The Guardian 4: Medical cannabis ‘saved my life’ – BBC News 5: Cannabis for kids: a medicinal miracle or ‘gross negligence’? | Society | The Guardian : [Medicinal cannabis use to be reviewed by government – BBC News] : Efficacy and safety of paediatric medicinal cannabis use: A scoping … : Marijuana and the Pediatric Population | Pediatrics
Learn more:
2. bbc.com
4. bbc.co.uk
7. bbc.com
9. bbc.co.uk
Medical marijuana is a term that refers to the use of cannabis products that contain THC (tetrahydrocannabinol) and/or CBD (cannabidiol) to treat certain medical conditions, such as epilepsy, cancer, or chronic pain. Medical marijuana is legal in some countries and states, but it is still illegal in others. Medical marijuana is not intended for recreational use or for anyone under the age of 18 (or 21 in some places).
Talking to your children about medical marijuana can be challenging, especially if you or someone you know uses it for medical purposes. You may have questions about how to explain the benefits and risks of medical marijuana, how to set clear rules and expectations, and how to prevent or address any misuse or abuse of cannabis by your children.
Here are some tips on how to talk to your children about medical marijuana:
Educate yourself and your children. Before you start the conversation, make sure you have accurate and balanced information about medical marijuana, such as what it is, how it works, what conditions it can treat, what side effects it can cause, and what the legal status is in your area. You can use Bing to search for reliable sources of information, such as Cannabis Use and Youth: A parent’s guide or Is Cannabis Harmful for Children & Teens? AAP Policy Explained. Share this information with your children and encourage them to ask questions and express their opinions.
Be honest and respectful. If you or someone you know uses medical marijuana, be honest with your children about why and how you use it. Explain that medical marijuana is a medicine that can help some people with certain conditions, but it is not a cure-all and it may not work for everyone. Respect your children’s feelings and concerns, and avoid making judgments or comparisons. For example, do not say things like “I use medical marijuana because I have pain, but you don’t need it because you are healthy” or “Your uncle uses medical marijuana because he is sick, but your cousin uses it for fun and that is wrong”.
Set clear rules and expectations. Even if you or someone you know uses medical marijuana, make sure your children understand that it is not for them. Explain that medical marijuana is only for adults who have a prescription from a doctor and a licence from the government. Tell them that using medical marijuana without a prescription or a licence is illegal and can have serious consequences. Also tell them that using medical marijuana for recreational purposes or sharing it with others is not acceptable and can be harmful. Create family rules together, such as keeping medical marijuana locked away, not using it in front of children, or not driving while under the influence of cannabis.
Keep the conversation going. Talking to your children about medical marijuana should not be a one-time event, but an ongoing dialogue. As your children grow older, they may encounter new situations and challenges related to cannabis use, such as peer pressure, curiosity, or misinformation. Keep an open communication with your children and check in with them regularly. Listen to their thoughts and feelings, praise their good choices, and offer support and guidance when needed.
Learn more:
3. samhsa.gov
4. bing.com
6. nida.nih.gov