Medical cannabis for children: Evidence and recommendations

Abstract

Interest in using cannabis products for a medical purpose in children under the age of 18 years is increasing. There are many medical cannabis products available that can include cannabidiol (CBD) or delta-9-tetrahydrocannabinol (THC), or both. Despite many therapeutic claims, there are few rigorous studies to inform the dosing, safety, and efficacy of medical cannabis in paediatric clinical practice. This statement reviews the current evidence and provides recommendations for using medical cannabis in children. Longer-term (2-year) reports support the sustained tolerability and efficacy of cannabidiol therapy for patients with Lennox-Gastaut and Dravet syndromes. CBD-enriched cannabis extracts containing small amounts of THC have been evaluated in a small number of paediatric patients, and further research is needed to inform clinical practice guidelines. Given the widespread use of medical cannabis in Canada, paediatricians should be prepared to engage in open, ongoing discussions with families about its potential benefits and risks, and develop individualized plans that monitor efficacy, reduce harms, and mitigate drug-drug interactions.

Keywords: CBD; Cannabinoids; Children; Delta-9-tetrahydrocannabinol; Medical cannabis; Pharmacotherapy.

Figure 1.

Overview of different types of cannabis products available in Canada. *Regulated under the Cannabis Act, 2018. CBD cannabidiol; DIN Drug identification number; GMP Good manufacturing practices; GPP Good production practices; THC delta-9-tetrahydrocannabinol. References (10,11)