How We Came to Treat Kids with Cannabinoids
Though giving underage kids marijuana sounds more like a scene from an afterschool special than a legitimate medical practice, you might be surprised to learn that all the recent buzz surrounding cannabidiol (CBD) began with a powerful, marijuana-based drug developed explicitly for—yup—children.
CBD is a compound (one of hundreds) found in the cannabis plant, that by itself does not cause a “high” like its sister-compound, THC (far more famous for its starring role in stoner movies, D.E.A. busts, and the D.A.R.E program). Recently, CBD has jumped to the front of the line for all kinds of promising new research in clinical trials, including those in pediatrics.
One such trial, and a series of trials after, forever changed a decades-long ban on marijuana in medical research and drug approval. The evidence collected in these studies took a federally-criminalized street drug—and, as of June of 2018—turned it into Epidiolex ®, the first-of-its-kind, FDA-approved cannabis-derived medication.
CBD (cannabidiol) for Dravet & Lennox-Gastaut Syndromes
Surprisingly, this wasn’t a medication for treating pain, cancer, or addiction (though, maybe don’t blink). It wasn’t even a drug for treating adults. It was to relieve the pain and suffering from two of the most severe kinds of drug-resistant epilepsy in children—Dravet syndrome, and Lennox-Gastaut syndrome (LGS). These childhood conditions begin in the first few years of life and are characterized by seizures that don’t ever get better, even after trying all the anti-epileptic drugs (AEDs) on the market. And even alternative therapies such as the ketogenic diet, high doses of steroids, and surgery.
The effectiveness of Epidiolex® was studied in three randomized, double-blind, placebo-controlled clinical trials, where CBD was shown to reduce the number and severity of seizures (some kids would suffer up to 40-50 per day). Overall CBD was able to reduce the number of seizures in as many as 84% of children taking the drug—and in a few cases, the drug stopped them altogether (compared with placebo).
On YouTube, you can witness the effect of cannabinoids on kids in real time, administered mid-seizure via a nasal spray. Grateful parents who, until recently, had to fear criminal charges, litigation, or even threat of having their kids taken away, offer testimonials of gratitude for not having to hide that part of their family. Now a safe, clearly-effective alternative exists for their epileptic kids—albeit, one that looks and smells a whole lot like a college dorm room. Still, the results are hard to deny.
Of course, as with any kind of treatment for kids, safety is paramount. But one reason CBD (cannabidiol) is so great for children, and populations most sensitive to side effects (including seniors and pets) is that CBD has very few side effects. And though CBD does have potential for drug interaction, its effect on our bodies seems similar in strength to that of a glass of grapefruit juice. According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…To date, there is no evidence of public health related problems associated with the use of pure CBD.”
CBD is safe for kids, but how to pick the right one?
So, safe enough for kids…yet, still lumped in with illegal marijuana by the federal government (and therefore, at times, unnecessarily tied into the legalization debate). While not incorrect, this kind of attention distracts from the potential of CBD, and all hemp-derived products for that matter. Thankfully, 2018’s Farm Bill has made all hemp legal, though the exact restrictions of CBD products could depend on the state you live in. But generally-speaking, hemp-derived CBD can be found just about everywhere in the U.S. right now, at least online,
Trouble is, it’s hard to know what you’re buying. The hemp and CBD industry is completely unregulated.
Trouble is, it’s hard to know what you’re buying. The hemp and CBD industry is completely unregulated. For parents looking for CBD oil for their kids (which, depending on potency could run you over $100 per 5 ounce bottle, or half as much somewhere else for a near-identical product)—it’s not legality or even safety you have to worry about right now—it’s dosing and consistency. One study found that up to two-thirds of CBD products were mislabeled. And while not specifically dangerous (there’s never been a single recorded overdose death from CBD or any other cannabinoids), this ‘anything-goes’ attitude towards CBD production makes efficacy harder to prove, and fans harder to keep.
Problems with dosing and labeling might be giving parents something to think about, along with the fact that more research is needed to further prove—or disprove—CBD’s safety, efficacy, dosage, administration, and side effects (in both kids and adults). But surely, along the way, the medical community will be paying close attention.
Last year when Epidiolex® came out, FDA commissioner Scott Gottlieb released a statement saying, “This approval serves as a reminder that advancing sound development programs that properly evaluate active ingredients contained in marijuana can lead to important medical therapies.”
A-men to that. For a plant more famous for being part of our country’s drug culture than a treatment for childhood disease—this surprising news about the FDA’s first marijuana-based drug might be just one of many surprises about cannabis and CBD still to come.
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