What Do Doctors Say About Pediatric Cannabis Consumption?
Parents and pediatric doctors are often in a legal grey zone when it comes to prescribing cannabis for kids. For some, the lack of clear guidelines is too much to take that leap.
According to a recent survey, almost 40 percent of U.S. high school students have tried cannabis. From this figure, close to 10 percent first consumed cannabis before the age of thirteen. It has also been reported that children aged between the ages of 12-17 increasingly perceive that cannabis use is beneficial. This is recreational use, of course, and fails to touch upon the number of pediatric patients that are benefitting from cannabis for medical purposes.
How Many Kids Are Using Medical Cannabis?
In early 2017, the American Academy of Pediatrics (AAP) published a report highlighting the risks of pediatric use of cannabis. The report prompted more and more parents to start pushing their doctors to weigh in on the issue. The AAP’s report, which had been published in the journal Pediatrics, highlighted risks associated with damage to the developing brain, including IQ, memory and planning ability.
While in Toronto, a survey revealed that about half of pediatric doctors have treated a child on cannabis for medical purposes. The questionnaire for the Canadian Paediatric Surveillance Program found that 419 of 835 respondents had a patient that used either authorized or unauthorized cannabis for some sort of medical relief.
The research also showed that more than a third of respondents — or 316 doctors — said they had been asked by a parent or adolescent patient to prescribe cannabis.
The principal investigator, Richard Belanger, voiced his astonishment at the number of young cannabis users in Canada. He pointed out that both doctors and their patients need more information on cannabis use in the pediatric population.
What About Under-Age Recreational Use?
According to Dr. Sheryl Ryan, a Yale University pediatrics professor, cannabis “is the drug of choice” for many of her teen patients in New Haven, Connecticut. She cautioned that today’s cannaibis is potent and may be risky for young people.
CHICAGO (AP) an influential doctor’s group has also voiced their concerns on teen cannabis consumption amid increasingly lax laws and attitudes. The concerns they have raised have to do with the developing brain, an issue that has been recently challenged.
The prefrontal cortex is the region of the brain that controls judgment and decision-making. It does not complete development until the early 20s, and this has raised concerns about how chronic cannabis use may affect the developing brain and later functioning.
So, Is There Something to Worry About?
Some studies examining youth who regularly consume cannabis (defined as 10–19 times/month) have shown significant changes across a number of brain regions including those affecting memory (hippocampus) and planning (prefrontal cortex). These are some of the results that have fuelled concerns on pediatric cannabis use.
Dr. Stephanie Schofield, while addressing the Ada Noon Rotary Club meeting, discussed pediatric use of cannabis:
“While some of the early evidence is really, really promising, without the ability to perform robust studies — because it’s illegal — and without knowing any long-term follow-up, it’s really hard to know which conditions would be best treated with medical marijuana and those (for) which other treatments may be more appropriate and consistent with what we know.”
Cannabis is Helping Kids
The doctor went further to explain that cannabis was often called upon when conventional treatments do not provide desired results in patients, citing intractable seizures as an example. She asked the audience to picture their child battling a seizure disorder, and then imagine that traditional treatments were not providing relief.
It is such scenarios that have caused parents and doctors alike to turn to alternative treatments, such as cannabis. Dr Schofield added that most pediatric research on use of cannabis has focused on the treatment of seizures in children. And results have shown a lot of positivity with anywhere between 30 to 90% of children with seizure disorders finding relief from cannabis treatment.
Emma Jones, MD, (the pediatric palliative care team at the Dana-Farber Cancer Institute and Boston Children’s Hospital) was one of the first physicians to register with the state so that she could provide qualifying young patients’ access to cannabis in the hopes of easing symptoms such as nausea and pain. This is after cannabis was legalized in Massachusetts. Since then, she has continued to offer medical cannabis certifications to pediatric patients with advanced cancer and other life -limiting illnesses.
Autism is also another condition that has received much attention when it comes to cannabis treatment. Self harm and violent behavior are common characteristics of autistic children. As a result, frustrated families have turned to cannabis which promises behavioral changes for the children of parents who have tried this route. Families can only do this with the help of a pediatrician who will allow them to gain authorized access to medical cannabis.
The American pediatric association recognizes that “parents may choose to administer cannabis to children with severely debilitating or severe chronic conditions when other standard therapies have proven inadequate or in compassionate care/end-of-life care situations and that they may seek support for this practice from their child’s pediatrician.”
However, even in such extenuating circumstances, there still remains a challenge as cannabis is illegal under federal law. Therefore, a pediatrician is limited under the law to freely prescribe medical cannabis to pediatric patients. Even in states where recreational cannabis is permissible, pediatric patients are still locked out. This is further compounded by lack of adequate research to support the safety and efficacy of medical cannabis for pediatric use.
In the face of this lacking, it is left up to individual medical providers to become experts on the scientific research and the legal ramifications of pediatric prescription of cannabis. Some pediatricians are not willing to take on this risk, but, fortunately, everyday more and more are.