New literature review further illustrates the benefits and safety of medical cannabis for pediatric patients

As medical marijuana expands across the United States, more parents are seeking out cannabis as a legal treatment for their children’s health conditions. While the majority of studies on pediatric cannabis use highlight its efficacy in treating epilepsy and autism spectrum disorder (ASD), researchers are beginning to expand their focus to explore its effects on other conditions that commonly affect children, as well as the impacts of different product types.

A new literature review authored by Leafwell in collaboration with Duke University examined recent studies on cannabis use among pediatric patients. Findings demonstrate tremendous promise in treating common pediatric conditions, while further supporting claims about the plant’s relative safety.

Key findings

• This review analyzed recent research on pediatric cannabis use, including 211 articles initially identified, narrowed down to 10 studies meeting strict inclusion criteria.
• Studies included in the final review spanned multiple research types, including 2 randomized controlled trials, 3 single-arm trials, and several others.
• The review covered studies from diverse countries that tested non-pharmaceutical, high-CBD cannabis-based products, rather than regulated pharmaceuticals.
• Studies show that cannabis-based treatments could significantly improve the quality of life for kids with autism spectrum disorder and treatment-resistant epilepsy.
• High-CBD, low-THC cannabis products reported promising results in reducing key symptoms of several conditions, with only mild, manageable side effects.
• Nearly 50% of children in clinical trials for ASD using cannabis-based treatments showed marked improvement in global functioning.
• For families exploring medical cannabis, recent research points to potential relief from chronic symptoms without the severe side effects often seen with traditional medications.
• Pediatric patients with epilepsy saw symptom reductions that could help transform daily life, especially for those resistant to standard treatments.

Pediatric cannabis use in the United States

38 states have legalized medical marijuana, all of which allow minors access to cannabis for qualifying conditions.

Rules for minors are strict, as they are not allowed to visit or purchase from dispensaries or administer cannabis to themselves. Instead, parents or legal guardians of patients below 18 must register as caregivers with the state, to fulfill those duties on their behalf.

Some states, including Colorado, require that patients be diagnosed with a qualifying condition by two physicians before they can register for their state’s medical marijuana program. The list of qualifying conditions can also be more restricted for minor patients.

Further, medical cannabis patients who are minors adhere to restrictions on products as well. Generally, minors can only access high-CBD, low-THC formulas to address their medical needs.

Meanwhile, as cannabis legalization expands, social attitudes toward marijuana are changing. More than ever, cannabis is seen as a valid medical treatment for medical patients, although administering cannabis to minors remains somewhat controversial.

Evidence of the efficacy and safety of medical cannabis among pediatric patients

An increasing number of studies published over the last several decades support the case for cannabis as a treatment for some pediatric conditions while confirming its relative safety. The FDA has approved the medication Epidiolex, a highly purified form of plant-derived CBD prescribed for the treatment of seizures associated with Dravet syndrome, Lennox–Gastaut syndrome, or tuberous sclerosis complex.

Still, despite growing interest in cannabis as pediatric medicine, there have been surprisingly few literature reviews examining evidence of the plant’s efficacy and safety for patients who are minors. Since 2017, only two other reviews have been published, neither of which included studies published over the last five years, during which time medical cannabis use among minors has expanded, and new clinical studies have been released.

Published in the journal Medical Cannabis and Cannabinoids, this review, authored by Leafwell and Duke University, focused on ten studies (narrowed down from 211), all published within the last five years. All of the studies explored the effects of cannabis on pediatric patients with conditions including ASD, treatment-resistant epilepsy, gastrointestinal disorders, and cancer.

The selected studies had to meet strict criteria to be included in the review. For example, the studies needed to focus on cannabis products containing phytocannabinoids like CBD and THC, rather than cannabis-based drugs, and drugs containing synthetic cannabinoids.

Overall, findings within these studies support previous evidence that medical cannabis can be an effective alternative to commonly prescribed pharmaceuticals such as opioids and sedatives, and with fewer risks of side effects. In addition to successfully alleviating patient symptoms, studies indicated generally mild and minimal side effects following cannabis use, with drowsiness and appetite changes among the most commonly reported.

One of the most common findings was an improvement in symptom management and quality of life among pediatric ASD and epilepsy patients, which is consistent with studies published five years ago. One study, in particular, found that 49% of patients showed an improvement in ASD symptoms against 21% given a placebo, based on the Clinical Global Impression – Improvement Scale (CGI-I).

Of all of the studies analyzed, no major adverse effects were reported as a result of consuming cannabis. It’s worth pointing out that most of these studies were based on the administration of high-CBD, low-THC products, and were administered orally or sublingually.

Still, despite such promising results, it must be pointed out that all of the studies analyzed used relatively small sample sizes. Therefore, additional, preferably larger studies are needed to provide a more well-rounded understanding of cannabis’ efficacy and safety profile among pediatric medical patients.

Why is Leafwell’s research so important?

Better Access to Products for Pediatric Patients: By learning about the effects of specific cannabis products on different pediatric conditions, future product development can focus on the needs of these patients, as well as improving product safety and understanding their side effects.

Reduced Social Stigma: We hope to increase awareness that medical cannabis can be both safe and effective for pediatric patients. This can reduce social stigma so that minors have better access to the care they need.

Keeping Families Informed: Our research aims to educate families who struggle to address their children’s medical conditions with conventional treatments.

Conclusion

Research findings over the last five years continue to show the usefulness of medical cannabis in the treatment of numerous pediatric conditions. At the same time, medical cannabis may be a safer alternative to commonly prescribed drugs, as side effects in minors appear to be minimal and mild.

The review illustrates a need for more research into medical cannabis use among young patients. Despite an increase in studies over recent years, there’s still a lot to learn, and knowledge gaps when it comes to dosing, the efficacy of specific product types, and more.

Resources

• FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy: https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
• Medical cannabis for children: Evidence and recommendations: https://pubmed.ncbi.nlm.nih.gov/38586483/
• Marijuana as a Substitute for Prescription Medications: A Qualitative Study: https://pmc.ncbi.nlm.nih.gov/articles/PMC6625880/
• Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-021-00520-5
• Cannabinoids for People with ASD: A Systematic Review of Published and Ongoing Studies: https://pmc.ncbi.nlm.nih.gov/articles/PMC7563787/
• Autism and associated disorders: cannabis as a potential therapy: https://www.imrpress.com/journal/FBE/14/1/10.31083/j.fbe1401001/htm