Medical marijuana risks may outweigh benefits for children: Canadian pediatricians

Although medical marijuana is increasingly used to treat children, the Canadian Paediatric Society (CPS) said Monday more scientific study is needed and there may be more harm than benefit.

A panel of physicians released a statement saying the “evidence is lacking about the overall effect on children.”

“Current considerations around cannabis use for medical purposes in children have been stimulated by recent case reports of its beneficial effect with refractory epilepsy,” said Dr. Michael Rieder, chair of the CPS Drug Therapy and Hazardous Substances Committee.

“However, there is little data to support either the efficacy or safety of cannabis use for any indications in children, and an increasing body of data suggests possible harm, most importantly in specific conditions.”

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READ MORE: Medical pot growers readying oils, now legal in Canada

The physicians said there needs to be large-scale studies to prove the benefits outweigh the risks, adding so far the studies have been small and there has been a lot of anecdotal evidence.

Medical marijuana is used to treat such conditions as chronic pain, multiple sclerosis symptoms and epilepsy.

Health concerns with smoking medical marijuana

The panel also stated if the research shows this is an effective treatment for children, smoking medical marijuana is concerning, and that “a more appropriate and stable dosing form other than smoking should be used.”

“One issue germane to marijuana use for treating children is that it is usually smoked. There are several compelling reasons why smoking is an unacceptable drug delivery system for younger populations. Combustion produces tars and other by-products known to be associated with long-term harmful effects, most notably carcinogenesis. The delivery of drugs by smoking also makes it difficult to control or adjust dosage.

READ MORE: Stigma a barrier to medical cannabis research, advocates say at roundtable

In July, Health Canada gave growers the green light to begin producing the plant-based extracts, which are expected to be approved for sale in the coming months. The approval came after a  Supreme Court ruling that said medical marijuana users should be permitted to consume the drug in other forms, such as oils and edibles, rather than having to smoke dried buds.

Research

Dr. Orrin Devinsky, a researcher at New York University’s Langone Comprehensive Epilepsy Center, has done a safety study on the use of an extract of cannabidiol (CBD).

Devinsky looked at the daily seizure logs of 137 patients, most of them children, who took a drug called Epidiolex – a purified form of CBD – for three months.

The number of seizures decreased by an average of 54 per cent from the beginning of the study to the end, Devinsky reported in April at an American Academy of Neurology conference.

“These results are of great interest, especially for the children and their parents who have been searching for an answer for these debilitating seizures,” Devinsky said at the conference.

However, he cautioned that there’s no way to tell how much of the seizure reduction was due to the placebo effect in which the person’s condition improves because they expect the drug to work.

Similar research by Dr. Kevin Chapman of the University of Colorado recently raised similar questions. Chapman checked records of 58 young patients who used various types of CBD oils and found less than a third reported a significant seizure drop.

READ MORE: Parents treating epileptic girl with marijuana oil want treatment to be legal

Personal Story

For Gwenevere Repetski’s parents, cannabis oil changed their lives.  When Gwen was an infant she was diagnosed with epilepsy. Eventually she was having up to 25 seizures a day.  Medications were not controlling her seizures, according to her parents. So after much research, her father, Alex Repetski, turned to medical marijuana.  Gwen was a young child and couldn’t smoke or vapourize the pot, so her father learned how to make cannabis oil in his kitchen. He then sent the oil to a lab for testing before giving it to his daughter three times a day.

WATCH ABOVE: Alex Repetski’s three year old daughter Gwen has epilepsy. He says her seizures stopped after medicating with cannabis oil. Lama Nicolas spoke with the family in May.

Gwen’s seizures stopped two days after she started receiving the treatment, according to her parents.

The CPS stated that while research is being conducted it has this advice for pediatricians and health care providers:

Canadian Paediatric Society (CPS) recommendations: 

• The use of cannabis for medical purposes in children should be evaluated on a case-by-case basis, and always with comprehensive discussion of potential benefits and risks.
• Smoking marijuana is unacceptable in children for several reasons. Studies of cannabis use for medical purposes in children should explore other ways of delivering it, ensuring safe and consistent concentrations of drug.
• Clinicians who use cannabis to treat children should have specific expertise and training in using potent psychoactive drugs in this population. Before any treatment, clinicians should thoroughly discuss with the family and patient (if possible) both the goals and potential risks of this choice. A strong monitoring strategy should be put in place to test for efficacy and adverse effects.
• The selective use of cannabis for medical purposes in children must not be confused with condoning its recreational use by adolescents. Strategies should be developed to discourage its recreational use among adolescents.

With files from the Canadian Press