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Insufficient evidence to support pediatric medicinal marijuana use

PHILADELPHIA — The use of cannabis products in the pediatric population for a variety of conditions, including seizures and psychiatric illnesses, has not been sufficiently supported by research to justify its use in this population, according to a recent presentation at the annual meeting of the American Association of Nurse Practitioners.

“There’s a level of complexity with this topic. You have a Schedule I drug, and you have kids,” Teri Moser Woo, PhD, RN, ARPN, CNL, CPNP, FAANP, from Pacific Lutheran University, said in the presentation. “Trying to get something like this through the Institutional Review Board and the Drug Enforcement Agency is incredibly difficult. These studies need special safes to store medicine, inspection of the safe, assurance that no one could get into the drug … you can see the issue in trying to get something approved like this for human subjects.”

To review this history of medicinal cannabis use and the current evidence available to support use in the pediatric population, Woo discussed times in which cannabis was commonly used until its criminalization in 1937. Despite its criminalization, it remained in the United States Pharmacopeia as a classified medical drug until 1942. 

Currently, 26 states and the District of Columbia have made medicinal cannabis legal, and regulated recreational use is legal within Washington state, Oregon, Maine, California, Massachusetts, Colorado, D.C., Nevada, and Alaska. In these states, the use of cannabinoid (CBD) medications may be used including a pediatric dosage of dronabinol for chemotherapy-associated emesis. However, the appropriate dosages of CBD oil and other modalities have not been established for pediatric patients, and many studies that have been conducted were run by parents.

One of Woo’s major concerns is that parents who may be administering cannabis to their children may not be disclosing this information to their doctors for fear of losing their child. According to her, the doctor needs to know this information to effectively treat their child. Other major concerns include knowledge of how certain strains of cannabis affect various parts of the brain to counteract specific symptoms, as well as appropriate dosing.

“I do think in showing that it works or that it doesn’t work, more people will be using it, especially with these very complex pediatric seizures. Some neurologists find that it works for some kids,” Woo said in the presentation. “There’s a lot of side effects to some of those medications, so parents are willing to try anything, and if it works to decrease seizures, they’ll continue. I think that as we get more good studies, there will be more acceptance to the use of medical marijuana in pediatric patients.” — by Katherine Bortz

Reference:

Woo TM, et al. Medical marijuana use in children: Evidence vs. myth. Presented at: American Association of Nurse Practitioners National Conference; June 20-25, 2017; Philadelphia.