Article written by
Dipak HemrajHead of Research and Education
Content reviewed by
Dr. Lewis JasseyMedical Director - Pediatric Medicine
Table of contents
For many, the concept of “medical marijuana” is still an alien one. To apply this concept to children is even more alien to many, as many balk at the idea of giving a child cannabis. However, when you consider the fact that we prescribe addictive drugs like opioids and sedatives to children suffering from severe conditions like cancer or epilepsy, it begins to make sense to be able to recommend medical cannabis. After all, if cannabis does the same job as a more harmful substance but with fewer of the side-effects, then why not utilize it?
Here are some of the most common questions parents have about medical cannabis for minors.
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Will Cannabis Affect My Child’s Brain?
There is no doubt that cannabis can affect growing brains. Tetrahydrocannabinol (THC) in particular can have serious effects on the structure of the brain, as child and adolescent brains are under construction, and the endocannabinoid system (ECS) plays a crucial role in this development. Adding more cannabinoids to this process can disrupt the development of the brain, and potentially cause problems like emotional dysregulation, memory problems and a reduction in white matter.
However, many of these problems are associated with non-medical use, where there is less regard for appropriate dosing. Highly potent, THC-rich varieties are also more likely to be used in such contexts. Those who are suffering from serious conditions that may be due to an endocannabinoid deficiency (i.e. where the body isn’t producing enough of its own naturally-occurring cannabinoids) may actually require THC. Some types of cancer and autism are examples of conditions in minors where cannabis may be beneficial.
Also, there are many compounds in cannabis that are medically useful and are not intoxicating. Cannabidiol (CBD) is one popular example, but there are others like cannabichromene (CBC) and cannabigerol (CBG) which also have anti-inflammatory, nausea-beating and anxiety-dampening properties. These cannabinoids can also be used to tame the psychoactive effects of THC to a certain extent, allowing for lower (but still effective) doses of THC.
Does CBD Affect My Child In Any Way?
CBD is not intoxicating in the same way as THC, and does not have a strong affinity for CB1 receptors in the brain. This means that CBD’s psychoactive effects are felt more due to its interactions with serotonin, dopamine, opioid and other receptors in the body, as well as elevating mood by helping increase the amount of anandamide available in the body. It is technically incorrect to call CBD “non-psychoactive”, but it is certainly not psychoactive in the same manner as THC. In fact, CBD can reduce some of THC’s sedative and negative effects on memory.
This has led many to believe that CBD is generally quite safe for children. And, due to its relatively tolerable effects, there is some good reason for believing this. However, it must be pointed out that there has been no long-term study looking at the effects of CBD on children.
We do know that there are some problems associated with taking too much CBD and liver damage. We also know that, with careful dosing, CBD is of immense use to children suffering from epilepsy or cancer. However, as the study of cannabinoids is still a relatively young science, it is difficult to say for sure what its effects are in the long-term.
It must also be said that long-term use of sedatives and painkillers also has negative effects (perhaps more so than cannabinoids), so once again, we must not treat cannabis differently in this regard.
Will Cannabis Interfere With Other Medications?
Cannabinoids, and CBD in particular, can desensitize liver enzymes. This means that cannabinoids can interfere with the body’s ability to metabolize certain types of medication. THC’s sedative effects can also interact with painkillers. The main types of medication cannabinoids interfere with are:
- Opioids (e.g. tramadol, hydrocodone)
- Benzodiazepines (e.g. lorazepam, clonazepam, alprazolam/Xanax)
- Some types of hay fever or allergy medication, such as Benadryl (Diphenhydramine) and cetirizine (Zyrtec)
- Antidepressants, in particular duloxetine (Cymbalta)
- Blood thinners such as warfarin and aspirin
For more information on the medications cannabinoids can interfere with, check out our article here.
What’s An Appropriate Dose of Cannabis For a Child?
This is difficult to say for sure, as there are few available studies out there looking at appropriate cannabis and cannabinoid dosages for children. Check the article ‘Pediatric Dosing Considerations for Medical Cannabis’ for more precise and detailed information. Our article on appropriate dosing will also help cover the essentials. The main things you will need to consider when dosing cannabinoids for a child include:
- The age of the child.
- The health problem the child is suffering from. Some conditions may require specific cannabinoid ratios at specific dosages (e.g. CBD-rich for seizures and neurological conditions, THC-rich for nausea and chronic pain).
- The method of ingestion. For most, tinctures are the ideal method of ingestion when it comes to children, but another method may be necessary (e.g. suppositories for bowel and stomach cancers).
- Time of day you are using the cannabinoids – you may want to avoid the sedative effects of THC during the day, for example.
- Approach the cannabis plant as a whole, and get an understanding of all the different cannabinoids, including THCV, CBG, CBC and CBN, as well as the terpenes.
- Microdosing is particularly important when it comes to children.
- Different people have different amounts of the natural cannabinoid anandamide in their brains, which can determine how much THC a person can tolerate. Genetic differences can affect how specific drugs are metabolized.
- The other conditions the person is suffering from. Someone suffering from both Tourette’s and ADHD may well have different requirements to those who just have ADHD.
Medical Marijuana For Minors: Overall
So, the main piece of advice we can give when it comes to cannabis is this: treat it as you would any other medication. This means that cannabis may be useful for some conditions, harmful for others, or be neutral and not have any major positive or negative medical effect. Dosage also matters, and some people may require specific ratios at certain times of the day in order to get the most out of their meds.
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