The data tells us….

I am writing this post as the data-driven, evidence-based pediatrician I have been for my entire career. Someday, when I am feeling a little braver, I will write my thoughts and experiences with CBD oil as the still grieving daughter of a father who died of lung cancer in 2018….when CBD oil was legal in Texas only for the treatment of refractory seizures in children. 

“First, do no harm.” This is the main principle of the Hippocratic Oath, the ethical binding document that is still held sacred by physicians. Notice that it does not say:

“Always do something.”

“Try the newest and most expensive medication or procedure available.” Or

“Follow the latest trend.”

The 2018 Farm Bill legalized the use of products derived from the hemp plant and included cannabidiol (CBD) products in the definition of hemp. This occurred in December 2018. The legal status of Tetrahydrocannabinol (THC), the main ingredient in the marijuana plant, varies state by state. THC is illegal in Indiana, though most of our neighbors including IL and MI have legalized it for medical and recreational use. If I had to take a guess, IN will follow suit in the near future.

Since late 2018, parents have asked me about using CBD oil for the treatment of many conditions including ADHD and anxiety. My answer has not wavered: There is no evidence that CBD products have any benefit in these conditions in children. We think that CBD may be detrimental to the developing brain.

Here is a summary of the evidence regarding the medical uses of CBD and THC products in pediatric patients:

  • THC-derived products are effective in the treatment of chemotherapy-induced nausea
  • CBD is effective in the treatment of refractory seizures in children
  • There is insufficient evidence that CBD or THC are effective in the treatment of spasticity, Tourette syndrome, neuropathic pain, PTSD

Because we know that recreational marijuana use can impair the developing brain including IQ, more research is needed to fully understand the risks and benefits of THC and CBD use in pediatric patients.

Now that CBD is legal, I see it sold everywhere, including at video stores, grocery stores, and gas stations. Some of the claims are far-fetched: It reduces pain! Helps with sleep! Reduces stress and anxiety! Like many supplements, most of these claims are not backed by science. Use with caution. Cannibidiols have not been studied adequately for medical conditions such as ADHD, anxiety, autism, or sleep disorders. Furthermore, CBD can affect the metabolism of other drugs a patient may be taking.

As it usually is in medicine, there is no simple solution to many of the conditions that afflict our children. Until there we have more studies about long-term safety and effectiveness in specific conditions, I cannot recommend the use of cannabidiols in children.

I will write a follow up to this post in the future, not as a pediatrician, but as a daughter who lost her father to cancer a painfully short time ago. Expect a totally different tone.

If your child is a member of Culver Pediatrics Center and suffers from anxiety, ADHD, or other chronic conditions, text me to schedule an appointment to discuss evidence-based options including behavioral interventions and medication management. If your child is not yet part of the Culver Pediatrics family, sign up in the email opt-in below to learn more about our boutique pediatric services.  

Resources:

Contemporary Pediatrics Examining CBD Use in Children