The legalization of marijuana has been front and center in community conversation, and there has been a lot of talk about what legalization could mean for children and adolescents with chronic or severe illness. For parents, it is important to understand that legalization does not mean greater or immediate access to potentially effective treatment for children with certain medical illnesses. In fact, legalization could make everything more complicated. You may have questions, and we want to help answer some of them.
What Is Medical Marijuana?
Medical marijuana is marijuana used to treat a medical condition as recommended by a physician. Marijuana is the common name for the plant cannabis sativa, and its two primary components are cannibidiol (CBD) and tetrahydrocannabinol (THC). In Ohio, one may only legally possess medical marijuana by obtaining it through a registered dispensary after a patient has gotten a recommendation from a physician who possesses a certificate to recommend it. All other forms of medical marijuana are strictly prohibited in Ohio.
As medical marijuana products become more common, the opportunities for unintentional exposures also increases. If a family are considering the use of medical marijuana for anyone in the home, they should choose products with child-resistant packaging and packaging that is not see-through. If any marijuana product is kept in a household, it should be kept up, away and out of sight of children – preferably in a locked cabinet. With edibles and infused products especially, curious children can mistake them for child-friendly candy or food. This poses a significant risk for harm.
What About CBD?
It’s important to clarify that CBD is not marijuana, but rather a chemical found in it, and it does not contribute to getting “high.” CBD is the active ingredient in the medication Epidiolex™, which was rigorously studied and approved by the FDA for the treatment of seizures associated with severe forms of epilepsy – Lennox-Gastaut syndrome and Dravet syndrome, specifically. Epidiolex™ is not the same as other products that claim to contain CBD. Epidiolex™ is not medical marijuana; it is FDA-approved and is regulated just like any other FDA-approved medication.
CBD products are increasingly available over the counter. You might have seen everything from CBD oils that promise medical benefits to CBD-infused soda water at the local grocer. Medical marijuana legalization increases concerns that more CBD products will be available with dubious quality and consistency. Medical providers share these concerns.
If someone buys CBD that is not approved by the Food and Drug Administration (FDA), there is no guarantee that it is purified. In states where marijuana is legal, month-to-month changes have been observed in CBD preparations. While the Ohio Medical Marijuana Control Program does require laboratory testing of products, these products are still not FDA-approved. The testing performed may not be done by a laboratory that can accurately determine the content of the products being sold. It may be dangerous to give a child or patient a product unless it has been properly studied and is consistent every time.
What About THC?
THC is the chemical found in marijuana that causes people to get “high” and experience euphoria and an increased appetite. In children and young adults ages 12 to 23, major developmental changes in the brain make marijuana use during this time particularly risky. Our body already makes a natural cannabinoid, which helps build connections in the brain. During adolescence, the brain is essentially maturing from a basic to a high-functioning computer. Adding external THC into the system causes dysfunction, as nerve connections form erratically and imperfectly, leading to a decrease in IQ that may not improve, affected memory, and a higher risk of lifelong substance use. Particularly for younger adolescents, allowing the brain to mature under the influence of extra external THC can lead to the brain being hardwired to function under that influence, making it difficult to stop using.
What About Synthetic Marijuana?
Synthetic cannabinoids are dangerous. Because synthetic marijuana has a higher potency than its original counterpart, it can be as much as 100 times stronger than cannabis. Products with names like JWH-018, Spice, K-2, King Kong, Relief, and others can cause coma, delirium, seizure, paranoia, hallucinations, muscle destruction, kidney failure, high blood pressure and heart attacks. There have been cases of life-threatening bleeding caused by contaminants in synthetic marijuana.
So What Should Families at Nationwide Children’s Hospital Know?
Given what is known about the risks associated with medical marijuana that is not regulated or approved by the FDA, the American Academy of Pediatrics opposes the use of marijuana in children and adolescents from birth to 21 years.
The AAP recognizes that marijuana may currently be an option for cannabinoid administration for children with life-limiting or severely debilitating conditions and for whom current therapies are inadequate. Currently, no physicians at Nationwide Children’s Hospital have obtained certificates to recommend medical marijuana. Nationwide Children’s worked in a multidisciplinary fashion to create a medical marijuana policy when Ohio legalized it. Per hospital policy, if your child is admitted to Nationwide Children’s and is taking medical marijuana, please speak with your attending physician about continued use while hospitalized.
Click here for more information and answers to questions patients and families may have about medical marijuana. If there are concerns about an ingestion or questions parents might have, call the poison center at 1-800-222-1222 to speak with an expert immediately, 24/7.