Should We Prescribe Weed To Kids?

Illustrated by Marcel George.
Mia, a nine-year-old epileptic girl in Calgary, can have up to 100 seizures a day. But, for over 18 months, she hadn't had a single one, thanks to a new medication: marijuana oil administered orally through a dropper. This week, Mia's story hit the internet — because Alberta Children's Hospital has begun denying her access to the drug. We know that medical marijuana can be used legally in 23 states to help patients deal with a variety of illnesses. But while medical marijuana for adults is slowly gaining acceptance, its use by pediatric patients remains highly controversial. Yet for many epileptic children, marijuana therapy is the only thing that works. It's not just Mia: There's 5-year-old Haleigh, 11-year-old Sam, and 7-year-old Sophia. All of these kids have epilepsy so severe that the traditional methods of managing their seizures — often upwards of 20 or 30 per day — haven't been effective. Charlotte, who now has a strain of marijuana named after her, began having seizures at just three months. These kids' parents are trying to make medical marijuana both legal and accessible for their children.
But the evidence that marijuana and compounds extracted from it can be used to treat seizures (in kids and adults) is still in its early stages. Crucially, most studies looking at cannabinoids for the treatment of seizures have been done using a marijuana extract called cannabidiol (CBD) or with pot strains with particularly high CBD content. Unlike THC, CBD does not produce the same type of high traditionally seen with marijuana. The science here is promising, albeit pretty old — a study from 1977, for example, suggested CBD could be used as an anticonvulsant (or to enhance the effects of some antiepileptic drugs) in rats. Though other (more recent) studies have confirmed that cannabinoids can be helpful for animals with seizures, the evidence in humans is, so far, scarce and much less convincing. "There is a body of animal research that suggests that it might be useful to evaluate the efficacy of cannabinoids for treatment of epilepsy in humans," a 2014 Cochrane Review concluded. But "none of the existing clinical research is of sufficient quality or size to answer this question." Rather than working in the brain like THC does, CBD activates CB2 receptors, which are found in higher concentrations in immune system tissue (like your tonsils) than the brain. Weed containing both THC and CBD has effects all over. And, earlier this year, a trial of CBD-containing drug Epidiolex in 137 children over 12 weeks showed promising results: Those who completed the study experienced a 54% decrease in seizures. Still, feeding pot to kids — even just an extract — is definitely a gray area the medical marijuana camp hasn't had to fully contend with yet. Studies looking into potentially negative side effects of pot use (including changes in IQ) often claim these are more serious if users are smoking the stuff in their teenage years. Although studies done on just CBD (not the stuff in your average joint) don't tend to show the same adverse effects, there's plenty left to find out. "The question for parents is often, Okay, we know there aren't randomized controlled trials yet, but our daughter is having these seizures now, and it's really ruining her life," says David Casarett, MD, author of Stoned: A Doctor's Case for Medical Marijuana. "These are parents who are doing their best to help their kids. They're going to doctors and specialists and trying new medications again and again," he continues. "For those parents, I think it's entirely reasonable to try a drug like CBD oil that may or may not be effective, but which many parents swear by and which (as far as we know) is pretty safe." So Mia's parents aren't exactly way out in left field. But, as with most things concerning medical marijuana, more research needs to be done to find out for sure if CBD is both as safe and as magical a cure as it seems to be.

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