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Medical, recreational marijuana in pediatrics: What PCPs need to know

SAN FRANCISCO — While studies indicate medical marijuana may help relieve symptoms associated with a variety of conditions, there is essentially no formal research on its medicinal use among children and adolescents, according to a presenter at the 2016 AAP National Conference & Exhibition.

Seth Ammerman, MD, FAAP, a clinical professor at the Stanford University Lucile Packard Children’s Hospital, explained that although there are anecdotal reports of the successful use of medical marijuana to treat attention deficit disorder, anxiety and depression, anorexia, autism, chronic pain and post-chemotherapy nausea, its use remains untested.

“Go online, and you will see thousands and thousands of testimonials to the benefit of marijuana and listing all the benefits, from treating autism to depression,” Ammerman said. “However, the issue for us, I believe, is that there are no published studies on the use of medical marijuana in adolescents. So, from my point of view, I think it’s hard to recommend it.”

Although Ammerman noted the existence of “a few” published studies on the use of medical marijuana for seizure disorders among children, all of them are based on parent reports.

On counseling parents about medical marijuana for children and adolescents, Ammerman recommended the following:

• Examine past and current treatments for the child’s health issue;
• Acknowledge there may be potential perceived benefits from medical marijuana;
• Likewise acknowledge the lack of quality care for medical marijuana;
• Discuss the lack of published evidence regarding the use of medical marijuana among children;
• Discuss healthier and better researched alternatives, as well as adolescent brain development and the risk for addiction; and
• Emphasize role-modelling behavior regarding the parents’ medical or recreational marijuana use.

Ammerman also discussed recreational marijuana use among both parents and their children, stating that although “occasional use” may be benign for adults, that is not the case for adolescents due to the potential alteration of normal brain development and potential for addiction.

He stressed that the parents’ actions are often more important than their words, and that parents who use recreational or medical marijuana should not do so in the presence of their children. Ammerman also said physicians should counsel patients to never drive under the influence of marijuana.

“It’s very important to talk to parents about role modelling,” he said. “I have a lot of parents who come in and say they smoke marijuana recreationally, and they say, ‘But it’s benign, right?’ Now, for them, it may be benign. Like with alcohol, they are probably fine doing it in moderation. However, if you’re using marijuana, your kids are much more likely to use marijuana. So, I counsel parents to not use it around their child, and to make sure it is indeed moderate, at most.” – by Jason Laday

Reference:

Ammerman S. Medical and recreational marijauana: What pediatricians need to know; AAP National Conference & Exhibition; Oct. 22, 2016, San Francisco.

Disclosure: Ammerman reports no relevant financial disclosures.