Is the medical use of cannabis a therapeutic option for children?

Question 1

What substances produce the psychoactive properties of cannabis?

Answer 1

1. delta-9-tetrahydrocannibinol (delta-9-THC)

2. cannabidiol (CBD)

Question 2

What is the Health Canada legislation regarding the use of cannabis for medicinal uses?

Answer 2

Require documentation from a HCP which patient provides to licensed producer and supplied 30d to max. weight of 150g of marijauna

Question 3

What medical conditions have stronger support for the limited efficacy of marijauna?

Answer 3

1. Spasticity in adults with MS
2. Bladder complaints in adults with MS
3. tremors in adults with MS
4. chorea in adults with Huntington’s disease
5. Levodopa associated dyskinesia in adults with Parkinson’s disease
6. tics in adults with Tourette’s syndomre

Question 4

What are side effects of medicinal marijauna?

Answer 4

1. Red eyes
2. Dry mouth
3. Delayed motor skills
4. Tachycardia
5. Nausea
6. Weakness
7. Mood changes
8. Anxiety
9. Cognitive impairment esp. in younger children
10. Psychosis?
11. 9-50% risk of dependence
12. Smoking - inconsistent dosing and carcinogens

Question 5

What are withdrawal symptoms of marijuana?

Answer 5

1. Headaches
2. Sleep disruption
3. Irritability
4. Anxiety

Question 6

What are the CPS recommendations regarding medicinal marijuana use?

Answer 6

1. While anecdotal evidence and biological plausibility suggest that cannabis and its derivatives may be an effective treatment for refractory epilepsy in children, its efficacy in this population should be carefully evaluated over the long-term, using appropriately supported and well-designed research into developmental effects, including neuroimaging
2. Medical evidence and biological plausibility suggest that therapeutic use of cannabis may have significant adverse effects in children. Risks should be carefully evaluated over the long-term, using appropriately supported and well-designed research into the safety issues specific to children, including development and neuroimaging studies.
3. Smoking as the customary mode of delivery for marijuana is unacceptable in children for several reasons. Studies investigating cannabis use for medical purposes in children should explore alternative delivery systems to provide safe and consistent drug concentrations.
4. While research is ongoing, the use of cannabis for medical purposes in children should be evaluated on a case-by-case basis, and always with a comprehensive discussion of potential benefits and risks.
5. Treatment plans that include cannabis should be constructed with careful attention to dose-finding, evaluation of efficacy and safety monitoring, and should only be conducted by clinicians or health teams with condition-specific expertise and the ability to assess for, and evaluate, both efficacy and toxicity.
6. Using cannabis to treat neurological conditions in children should be evaluated in accordance with a careful research strategy. The decision to study cannabis use for a specific condition should always be based on the biological plausibility of efficacy and on evidence determined by well-designed clinical trials.
7. Clinicians who treat children with cannabis should have specific expertise and training in the use of potent psychoactive drugs in this population. Treatment should be predicated by robust discussions with the patient (if possible) and family concerning the goals and potential risks of this choice, with a strong monitoring strategy in place to test for efficacy and adverse effects.
8. There is biological plausibility that cannabis may produce harm if used to treat certain conditions in children, especially when started at an early age.
9. The selective use of cannabis for medical purposes in children must not be confused with condoning its recreational use by adolescents. Strategies to discourage its recreational use among adolescents should be developed on models underway to discourage alcohol and tobacco use in this age group