On June 26, 2018, the US Food and Drug Administration announced its approval of Epidiolexin for the treatment of seizures associated with Lennox-Gastaut and Dravet syndromes, two rare and severe forms of epilepsy. Who Epidiolexin is available to: patients starting as young as two years old.
What might seem surprising? “This is the first FDA-approved drug that contains a purified drug substance derived from marijuana,” the FDA stated in a press release. That’s right, Epidiolexin is a liquid cannabidiol, more commonly referred to as CBD.
So, what’s happened since? “The CBD market has exploded over the past year, and this trend definitely applies to awareness around the use of it for children,” Dr. Stuart Titus, CEO of Medical Marijuana, Inc. and subsidiary HempMeds tells Parentology.
Issues Surrounding CBD Treatment for Children
CBD is being targeted to treat various pediatric issues — even those encountered by newborns. These include cancer, anxiety, ADHD, OCD/ODD, inflammatory bowel symptoms, PTSD, Parkinson’s, and neurological disorders. It’s also being used as an immune booster for those grappling with colds and flu. The biggest buzz being generated around children benefitting from CBD has been in reference to epilepsy and autism/spectrum disorder.
With a multitude of benefits being recognized, Titus hopes CBD use of will become more universal. A first stop for treating children dealing with seizures versus a last resort.
The Marijuana Stigma vs Reality
So if CBD is so great, why isn’t everyone using it?
What first must be tackled – dispelling the myths behind the hemp-based product. For many years the public has been bombarded with stories about marijuana abuse. Much of the confusion is over the two main ingredients in medical cannabis: THC and CBD.
“THC causes a euphoric ‘high’ at recreational doses, but when dosed in small amounts for medical purposes, patients can achieve symptom relief without the high,” Dr. Stacia Woodcock, a pharmacist with Curaleaf NY dispensaries, explains to Parentology. “CBD is the non-euphoric component of cannabis that’s a very powerful anti-inflammatory, anti-anxiety, anti-seizure medication.”
There’s also the difference when medical marijuana is used by children suffering from medical cannabis versus healthy kids. Adolescents who are medically well should avoid cannabis, which can interfere with their body’s developing endocannabinoid system, which maintains the body’s homeostasis and helps produce a healthy adult brain.
For kids dealing with specific wellness issues, Woodcock says, “The use of CBD poses little to no risk to a developing brain, but offers a dramatic life-changing opportunity for pediatric patients to have a better quality of life.”
The benefits of CBD, Woodcock says, often outweigh other treatment protocols. “It’s important to understand that in many cases, the seizures or self-harming behavior a child is exhibiting, along with the many medications often prescribed for these conditions, can be far more damaging to their brain and quality of life than CBD, with or without THC, could possibly be.”
According to Woodcock, several studies, including one from the National Center for Biotechnology Information, state that parents of pediatric patients using CBD report their children are more alert and verbal, sleep better, are in a better mood, and in the hospital less, when CBD is added to their medication regimen.
Buoying the trend of CBD becoming mainstream are success stories from parents. Even doctors currently using CBD are eager for research to join anecdotal evidence.
Happily, research findings are starting to surface. Titus says, “…we also look at the science, particularly of the endogenous cannabinoid system, and know these non-psychoactive cannabinoids can help to supplement regulatory functions.”
The government is even beginning to acknowledge CBD’s benefits. Titus points to US Government Patent #6,630,507, aka 507 Patent. “Cannabinoids as Antioxidants and Neuroprotectants” describes CBD as being a potent antioxidant — stronger than vitamin C and vitamin E — as well as having neuro-protective properties.
Is CBD Safe?
Safety of use is discussed in Patent 507, too, which describes CBD as being extremely non-toxic with no possibility of a fatal overdose or damage. However, a concern is the lack of research regarding potential liver damage.
Titus has seen that, “The synthetic version of CBD does seem to create a type of liver toxicity in some children, but we don’t see this with the all-natural botanical version.” Additionally, he says, “Some children are on six to 12 medications, but seem to tolerate CBD quite well and without interference with their other medications.”
Forms of CBD for Pediatric Use
Pediatric patients tend to use products with a high CBD-to-THC ratio, containing very little THC. The second form used for children is hemp-derived CBD with no THC.
Hemp CBD comes in various forms, from liquid tinctures (where CBD is mixed with an MCT oil like coconut oil) to capsules, edible candies, and topical products. Not advised for young developing lungs are products that require being smoked or vaped. Woodcock warns against using food-based products, which children can mistake for treats versus medicine.
“Typically, the tinctures or oil-based drops are the easiest to administer to children as the dose is easily adjusted and they are simple to administer. They can even be hidden in food if necessary for a picky child,” Woodcock says.
Precautions Woodcock puts forth, “If your child has any underlying liver or kidney disease, CBD may not be a good option for them. There are also some drug interactions, particularly with anti-epileptic medications, that can occur when adding CBD to a child’s medication regimen.”
Sourcing and Dosing
From chain pharmacies to Bed, Bath & Beyond, CBD products line store shelves. Knowing the source of a CBD product is imperative.
“As of now, over-the-counter hemp CBD products are not regulated by the FDA,” Woodcock notes. “This means companies that sell hemp-derived CBD products don’t have to test or prove their products are free from contaminants like heavy metals or pesticides, don’t contain ingredients not listed on the packaging — like melatonin or dextromethorphan, both of which have been found in mislabeled CBD products – and actually contain the amount of CBD listed on the packaging.”
Her advice: only purchase a CBD product from a trusted company that performs third party testing and manufactures them with the highest standards.
Finding the right dosage can also be an issue for parents. Finding the right dose often comes down to trial and error or word-of-mouth.
Woodcock offers the following guidelines regarding dosing, “In lower doses under 50mg/day, CBD can be over-stimulating and make symptoms worse, so getting the right dosing can be a challenge.” Typically, she says, when dosing CBD without THC, higher doses are needed to see an effect – something that can be cost prohibitive. “Thus, it’s important that parents not only purchase CBD from a trusted source, but that they consult a doctor or pharmacist trained in cannabis medicine to help them properly dose their child.”
The hopes of research joining anecdotal evidence echo yet again when considering CBD leaping hurdles joining pharmaceutical protocols. Another hope held by Titus: the 2018 Farm Bill’s passage will reap just such research opportunities for the US.
Dr. Stuart Titus, CEO of Medical Marijuana, Inc. and subsidiary HempMeds
Dr. Stacia Woodcock
National Center for Biotechnology Information: Cannabinoids in Pediatrics
Hemp Mexico press release