Children & Marijuana #3: Will Medical Dosing Harm My Child?
Does medical marijuana do more harm than good in children? The debate seems never ending.
It’s difficult to say whether or not marijuana is linked to harmful consequences in children. But, that hasn’t stopped medical professionals and the general public alike from expressing concern. In this Children & Marijuana segment, we’ll look at the potential impacts of pediatric marijuana use. We’ll then show you some very intriguing studies that provide a different perspective on the matter. Specifically, this article will address the question: will medical cannabis harm my child?
Will medical cannabis harm my child?
There is very little data available on the long-term implications of pediatric cannabis. Given the sensitivity of the subject matter, virtually no longitudinal or clinical studies have been done to test the herb’s impact over time.
But, the implications of the gap in research swings both ways. We don’t know for sure that marijuana is safe for children to use, but we don’t know that it causes significant harm either. The same is true about many other medications that are currently given to children. Opioid painkillers like oxycodone and morphine are frequently given to kids undergoing chemotherapy. As Judy Rollins, Ph.D. and Rn, points out,
“While some experts caution that the effects of the drug on child development are unknown, others point out that the same is true for other medications used to fight pain and nausea that are currently given to children with cancer, as well as for powerful antipsychotic drugs that are used in long-term treatment of childhood mental illness.”
Data simply aren’t there right now. Since research is largely missing, parents who opt to give their children medical marijuana are taking a certain amount of risk.
Yet, if your child is severely ill, the questionable risks associated with medical cannabis may be nothing in comparison to giving your kid their life back. Regardless of your decision, here are some of the major concerns from medical marijuana skeptics.
Some areas of concern
Dosing is probably one of the most difficult things about medical cannabis. Fortunately, edibles manufacturers like EdiPure and Dixie Elixirs are making products with specific concentrations of cannabis materials. In Washington State, for example, you can buy a package of EdiPure gummy candies that contain 10mg of THC each.
The big question is: how do you know how much to give your child? No one has a definite answer. The standard dose for an adult is thought to be 10 to 25mg of active THC. There is no such set standard for children. Further, if a child is suffering from a severe medical condition, they may need more than the standard dose to cope with the pain of chemotherapy or to put an end to seizures.
Without firm dosage information readily available, we have no idea whether or not there is a safe amount to give. Your dosage will also vary significantly if you’re giving your child a product containing THC versus one containing only CBD. Yet, there’s no official guideline to tell you exactly how much your child should be taking.
The only way to deal with dosage issues is to work very closely with your child’s doctors and your dispensary. A quality dispensary or compassion clinic will be able to walk you through which products are available, which ones have been laboratory tested, and what you should look for after your child has taken the recommended dose.
Predisposed to marijuana abuse
One of the primary arguments against pediatric cannabis is addiction. Young people are far more likely to become addicted to abusable substances. A 2008 report found that those who began using marijuana under the age of 18 were four to seven times more likely to develop a marijuana use disorder. A “use disorder” occurs when you become dependent on the herb to perform daily tasks like falling asleep.
Here’s the catch: while marijuana is linked to dependence, so are many of the other drugs given to children with debilitating diseases. As Times writer, Maia Szalavitz points out,
“Although marijuana can be addictive, addiction rates are often lower than those to opioid drugs, and discontinuing opioids is associated with severe physical withdrawal symptoms not seen with marijuana.”
Drugs like benzodiazepines are also often given to children with autism and other brain disorders. Benzodiazepines have fairly high rates of abuse and dependency, which is why they’re typically recommended only as short-term treatment options.
Another big point of contention is that medical marijuana may cause changes in the developing brain. It’s unclear what the overall impact of these changes might be. In adults, recent studies have shown that marijuana use is not correlated with brain damage. Young people, however, may experience some changes.
A 2013 study published in Pharmacology found that those who smoked cannabis under the age of 16 had increased impulsivity when compared to non-smoking controls. This change was not found in those who began smoking much later.
In teenage brains, some worry that use of the drug might slow down school performance. As neuroscientist Dr. Francis Jensen explains in an interview with NPR’s Fresh Air,
“Not only does the teen brain have more places for the cannabis to land, if you will, it actually stays there longer. It locks on longer than in the adult brain. There were studies done that showed that several days out, there is still impaired learning and memory say in experimental adolescent animals compared to adults, where it’s a more fleeting effect.”
We shouldn’t be quick to jump to conclusions, however. Another recent study pooled data from over 2,200 teens and found that there was no significant difference in the IQs of marijuana smokers and non-smoking controls. Cigarettes, however, did impair learning and cognition.
The other side of the debate
With the big concerns out of the way, we can move onto the other side of the debate. Parents opting to use pediatric cannabis for their children have it a little rough. While there are obviously times when medication is an absolute necessity, certain treatments deemed healthy and appropriate can actually cause a substantial amount of harm. Christy Shake, mother of now 12-year-old Calvin experienced this firsthand. She writes in her blog,
“My kid was only three years old when his (now former) neurologist prescribed his first benzodiazepine, clonazepam, brand name Klonopin. It was meant as a bridge drug, to be used only for a couple of weeks while he titrated to therapeutic levels of two other anticonvulsants, one of which, if increased too quickly, can cause a life-threatening rash.
Instead, Calvin remained on Klonopin for over three years and the only way he came off of it without suffering debilitating withdrawal symptoms, including scores of extra seizures, was to transition to a benzodiazepine derivative, clobazam, brand name Onfi, which he has been taking for over four years.
While on extremely high doses of three anticonvulsants, Onfi, Banzel and Keppra, Calvin’s behavior was often off the wall. Everything was difficult: sleep, changing his diaper, feeding him, walking him around, soothing him, even driving in the car. When he became anorexic, his behavior barely tolerable, I started weaning him from the Banzel and began investigating medical marijuana.”
Calvin was born with an unknown neurological condition that resulted in cerebral palsy, epilepsy, and a host of other medical problems. Epilepsy and cerebral palsy are qualifying conditions for medical marijuana in many states.
Once Shake made the switch to cannabis, the difference was nearly immediate. After six months, she was able to ween him almost entirely off of the benzodiazepines. Calvin’s care team also noticed a significant improvement. Shake even received a thank you from Calvin’s teacher because the improvements allowed him to pay attention in class and focus on learning songs. Shake writes,
“I lamented that it is going to take another six to nine months to get him entirely off of it safely and without causing him too much suffering from withdrawal. And it’s the cannabis, I realize, that is allowing us to wean the benzo.”
There’s no contest. We need compassionate pediatric medicine.
All about ethics
The debate about whether or not parents should be allowed to give their children medical marijuana has been going on for quite a while. Back in 2003, Peter Clark made a case for the child’s right to medical cannabis. “Medically,” begins Clark, “to deny physicians the right to prescribe to their patients a therapy that relieves pain and suffering violates the physician/patient relationship.”
“Therefore, in the patient’s best interest, patients and parents/surrogates have the right to request medical marijuana under certain circumstances, and physicians have the duty to disclose medical marijuana as an option and prescribe it when appropriate. The right to an effective medical therapy, whose benefits clearly outweigh the burdens, must be available to all patients, including children.”
Fortunately, though long-term data is still lacking, there are a few studies that might help pave the way for movement on the pediatric cannabis front. Here are a couple of studies of interest.
A CBD study
Recent trials of the GW Pharmaceuticals drug, Epidiolex may also shed some light on the impacts of cannabinoid medicines. Epidiolex is an up and coming seizure drug made of purified CBD. In a study lead by researchers at the New York Langone Medical Center, Epidiolex was tested in 137 patients. In the trials 36.5% of patients reported seizure reduction. Of those patients, CBD treatment reduced the total number of seizures by 54%. The majority of the study participants were children. The maximum doses being 25 mg/kg to 50 mg/kg per day.
These findings are quite promising, but researchers are unsure if the reduction was actually due to the CBD or due to the placebo effect. The trial was not double-blind, so patients knew exactly what they were taking.
The success rate of this CBD drug is pretty impressive, but the treatment wasn’t completely without side effects. 79% of patients reported negative side effects, including sleepiness, fatigue, and diarrhea. These side effects were not significant enough to cause people to drop out of the study. Only around 3% of participants decided to discontinue.
A Jamaican example
Pediatric medical marijuana is very closely monitored in the United States. But, what about in rural Jamaica? Jamaicans have a fairly long history of using cannabis in daily life. While the herb is illegal on the island, there is a decent population of people that rely on the healing properties of the plant.
This makes rural Jamaica a great place to look at the long-term health implications of marijuana use. Dr. Melanie Dreher, RN, did just that. She looked at the implications of marijuana use in Jamaican schoolchildren.
This comes as a shock to many in the U.S. and Canada, but, some Jamaican parents give their children ganja tea as a way to fortify their health. That’s right, children are specifically given marijuana teas for their own benefit.
Dr. Dreher explains that the tea “has symbolic value for the Jamaican homemaker in producing hard-working, healthy children who excel in schoolwork.”
In a study published in 1983, Dreher and her team studied the impacts of Jamaican children who were regularly given marijuana teas and tinctures. She examined 80 children in two different working-class communities.
Overall, she could not determine if the ganja tea actually caused the children to perform better in school. But, she did find that many of the non-ganja using children were less academically successful than those who drank the tea an average of two to three times per week.
There were other interesting benefits as well. As reported by Pete Brady of Cannabis Culture,
“Women who were actively engaged in producing, buying, selling and administering marijuana often had the best-run households and the smartest children. One mother, a Rastafarian named Pansy, had her oldest child selling marijuana when Pansy was not at home. Yet, Pansy’s children were ranked by teachers and principals as among the most intelligent, diligent and well-behaved of all students; they were ranked at the top of their classes.”
Though extremely interesting, this anthropological study is not a full examination of the long-term cognitive impacts of pediatric medical marijuana. Dreher pointed out that the ganja tea given to children was carefully dosed by the mother in an age-dependent fashion. Young children may only have one fresh marijuana leaf steeped in hot water. The overall psychoactivity of this concoction is questionable, and may not be very strong.
Medical marijuana in pediatrics is a sensitive topic. No one wants to give a child something that might be harmful. Yet, as many mothers argue, some of the greatest visible harm seems to come from the pharmaceutical cocktails given to severely ill children. Pharmaceutical drugs have gone through a formal process of clinical trials, cannabis has not. Until we have sufficient trials, parents who opt for pediatric cannabis are between a rock and a hard place. Regardless, there’s no doubt that the herb has been a true life-saver for children and adults alike.
Until we have sufficient trials, parents who opt for pediatric cannabis are between a rock and a hard place. Regardless, there’s no doubt that the herb has been a true life-saver for children and adults alike.
Do you know a child who has been helped my medical cannabis? Share your story with us on social media or in the comments below. We’d love to hear from you!