Pediatricians are seeing a growing demand for prescribing medical cannabis to children

Given the potential for damage to a child’s developing brain and the lack of available evidence, most Canadian pediatricians are reluctant to recommend medicinal cannabis to their patients. However, pediatricians also report that they are receiving more requests for cannabis from parents for an increasing number of conditions.

According to the medical director of the pediatric palliative care unit at the Hospital for Sick Children in Toronto, Dr. Adam Rapoport, the increased demand for medical cannabis for children is primarily being driven by parents. Laura Kelly also agrees with Dr. Adam too and confirms that it’s happening and pediatricians are just catching up.

Kelly is a pharmacologist and scientific director of the national research organization Canadian Childhood Cannabinoid Clinical Trials. Her team is working hard to find answers to questions about cannabis for young people. According to her, the biggest challenge is that adolescent cannabis use has surpassed the supporting evidence.

In a 2017 survey, 50% of pediatricians said they had at least one patient who had used cannabis for medicinal purposes in the previous year. However, cannabis use does not result from prescriptions. Only 4% of pediatricians said they’d approved the use of medical marijuana for one of their patients.

Lack of solid research for many disorders

Since the 2017 survey was completed, many pediatricians like Dr. Daniel Flanders, head of Toronto Kindercare Pediatrics, said parents’ demands for regularity and variety have increased. According to Flanders, he is approached at least twice a week about medical cannabis for children for conditions such as mental disorders, chronic pain, arthritis, ADHD and insomnia.

Meanwhile, only 4% of pediatricians have approved the use of medicinal cannabis for their patients, according to a survey. In addition, there are only a few cases where the science is solid when it comes to children’s cannabis use. A pediatric neurologist in Toronto, Dr. Evan Lewis says there is compelling evidence to support cannabis use in children with certain seizure disorders such as Dravet Syndrome, Lennox-Gastaut Syndrome and tuberous sclerosis.

He cited many highly published randomized controlled trials and a recent comprehensive review of research on medicinal cannabis for complex pediatric seizure disorders. That being said, he claims it essentially extrapolates from the data and relies on weaker supporting data from the literature. That hasn’t stopped some parents and doctors from pushing the boundaries, though. In certain circumstances, says Lewis, it’s a path worth taking.

As things stand, Lewis now prescribes cannabis for various forms of seizures and permits its use in a limited range of circumstances for a variety of ailments. These conditions include migraines, concussions, sleep problems, autism, tics, movement abnormalities, and behavioral problems in adolescents with neurological disorders. It is also used for symptom management in chronic pain disorders, palliative care, spasticity, terminal cancers and ADHD in Canada.

However, Lewis claims that the study is not as comprehensive as he would prefer and in many situations does not exist.

Concerns about dosing

Another challenge with using cannabis for children is that the standard dose has not been established. As a result, experimental cannabis treatments often use pure cannabidiol (CBD), a non-psychoactive component of marijuana. b Because this form of pure CBD formulation is not available in Canada, doctors often recommend medications that contain both CBD and the psychoactive ingredient delta-9-tetrahydrocannabinol (THC).

Meanwhile, Dr. Richard Huntsman, a pediatric neurologist at the University of Saskatchewan, and his team are working to solve the problem of dosing regimens for children with complex seizure disorders. In addition to defining a target dose using oils, his study evaluated blood levels of THC and CBD, which remained low. The oil used in the study had a CBD to THC ratio of 20:1.

“People are really worried about their kids getting high,” says Dr. Richard Huntsman. Still, according to these findings, this is “not that much of a concern,” especially in this community.

Contrary to popular belief, he also discovered that the drug seemed to improve rather than hinder cognitive function. However, he is cautious, pointing out that the research was done on a limited number of children.

Policies under development

Doctors seek help as cannabis situation in Canada changes rapidly. according to dr Christina Grant, co-chair of the Canadian Pediatric Society’s Cannabis Working Group and adolescent health specialist at McMaster Children’s Hospital, the Canadian Pediatric Society intends to release guidance documents this summer.

However, she claims that she regularly advises teenagers at her Hamilton clinic that using cannabis as a form of anxiety or depression treatment is not intelligent. “The effect is the opposite,” she argues, pointing out that one in six children who engage in cannabis involvement, including self-medication, suffers from a cannabis use disorder.

While doctors preempt the guidelines, Kelly says her research consortium has initiated five recent clinical trials of medical cannabis in children and other Canadian research teams are scrambling to catch up. “I absolutely don’t think it’s a panacea. It’s not magic. However, there are some promising areas worth investing in,” argues Kelly.

Conclusion

In recent years, the use of medicinal cannabis has increased, with more and more states legalizing its use for various medical conditions. Under these conditions, pediatricians have noticed a growing demand for the use of medicinal cannabis in children. Medicinal cannabis benefits for children include reducing seizures, reducing chronic pain, and improving symptoms of conditions like autism and ADHD.

However, pediatricians have a responsibility to their patients to keep up to date with the latest research and developments in the medical field. This includes keeping up with the growing body of evidence pointing to the benefits of medicinal cannabis for children. They must remain open-minded and willing to consider this treatment option for their patients in consultation with their families and other healthcare providers.

The use of medicinal cannabis in children is a complex and controversial issue, and pediatricians need to approach it with care and caution. However, pediatricians must also be willing to challenge their biases and consider all options to improve patient health. The growing demand for medicinal cannabis among children reminds us that we must always be open to new possibilities and ready to evolve our practice in the face of new evidence.

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