The pediatric use of medical marijuana is on the rise for conditions ranging from epilepsy, Autism Spectrum Disorder (ASD) to cancer and inflammatory bowel symptoms. The public’s perceived belief may be parents merely go to a dispensary, then begin dosing their child on the advice of a salesperson. This is erroneous. Many pediatricians and integrated cannabis physicians are coming together in patient treatment with medical marijuana.
One such person is Bonnie Goldstein, MD, Medical Director of Canna-Centers and the author of Cannabis Revealed. While working as a pediatric emergency medicine physician Goldstein was asked about medical cannabis by an ill friend. Digging into research, Goldstein was surprised to learn about the endocannabinoid system (ECS), something discovered in the early 1990s after she’d already graduated from medical school.
Goldstein explains ECS is “a physiologic system humans have that’s meant to help regulate many of the chemical messages sent from cell to cell in our brains and bodies.” ECS, she says, “…is crucial to our basic physiologic functions including our emotion responses, pain perception, sleep, appetite, response to illness, immunity and inflammation.”
Fascinated, Goldstein learned everything she could about medical cannabis. Eventually, she began working in a medical cannabis doctor’s office, where she witnessed an improved quality of life for adult patients suffering from cancer, pain and chronic illnesses. Today, Goldstein is the medical director of Canna-Centers and author of Cannabis Revealed.
Like Goldstein, Dr. Junella Chin, an Integrative Cannabis Physician and author of Cannabis and CBD for Health and Wellness (being released next month), has been treating pediatric illnesses with legalized medical cannabis products for over a decade.
“I’ve seen firsthand just how much medical cannabis can benefit patients, improve their quality of life and alleviate suffering, all with fewer side effects compared to other prescription medication,” she says.
Epilepsy and Autism
Of late, there’s been much reported in the media about the use of Cannabidiol, also known as CBD for treating ASD. One of marijuana’s two active ingredients, CBD, unlike Tetrahydrocannabinol, known as THC, doesn’t create a sense of euphoria. “It [CBD] may prove to be a useful treatment used in conjunction with behavioral therapies and prescription medication,” Chin says. “Its excellent safety profile in humans, as well as its efficacy in clinical studies, suggest it could be a safe and effective drug for managing the symptoms associated with ASD.”
Goldstein explains why so much anecdotal evidence of CBD’s surfacing in the treatment of these disorders. “We now know many serious conditions, such as epilepsy and autism, stem from a deficiency in endocannabinoids, meaning there’s an imbalanced message being sent by the brain that endocannabinoid compounds aren’t being made as they should.”
The solution: boosting deficient endocannabinoid compounds with phytocannabinoids, such as CBD and THC. Based on recent research being done, Goldstein believes testing endocannabinoid levels will be commercially available in the near future.
According to Chin cannabis has been used in treating seizures as far back as Sumerian times. So why is its use just amping up now? According to the Centers for Disease Control and Prevention (CDC), the number of people in the U.S. living with epilepsy — over 3.4 million — is at an all-time high. Advancements continue to be made in therapies, devices, medication and dietary treatments. Despite this, Chin says, “We still have approximately 30% of people — both children, and adults — with epilepsy, whose seizures can’t be adequately controlled despite available therapies.”
What Chin has seen through working with a team that includes neurologists, “Over 50% of my patients have a reduction in seizures after a trial of various CBD extracts. Many patients report decreased frequency, severity and duration of the seizures.”
As for how CBD and THC impacts their daily activities, Chin says patients report whereas they would have an entire day of feeling groggy or hung over after having seizures in the past. And interestingly, they report back that where the patient had a seizure before, through the use of CBD they recover and feel like themselves again faster.
How doctors use cannabis products depends on the illness they’re targeting and the patient. Also at issue is where the doctor and patient are located, and how different conditions are classified based on state law. For example, Chin’s practice is in New York, where laws are stricter than Goldstein’s California-based practice. Based on her legal limitations, Chin says, “I always try CBD first, since it has no psychoactive affects, but CBD and THC can be used safely together.”
Conversely, Goldstein never uses CBD-only products, choosing instead to garner benefits from whole plant products. “There’s a huge misconception that THC is ‘bad’ and ‘CBD’ is good,” she says. “It’s important people understand these pediatric patients aren’t intoxicated despite the THC in the products they use. We’re using medical dosing, not recreational dosing.” Goldstein is also very clear about advising healthy teens against using marijuana, as it can negatively impact a health brain that’s in the process of developing.
An upside to cannabis use in pediatric patients is being able to step them down from, if not completely off, pharmaceutical protocols. Side effects of prescription medications can be significant, yet, Goldstein says, “All physicians know this, but we’re taught to accept these side effects.” A natural medicine, cannabis, when medically supervised, can have minimal side effects. Before parents ditch conventional medications, Goldstein says it’s imperative to discuss with specialists involved in their child’s care.”
CBD can have side effects of its own. Chin says, “It’s important to note CBD can interact with prescription medications, especially anti-psychotic and anti-epilepsy medications. It can also increase liver enzymes.” She emphasizes the importance of patients being monitored on a care plan tailored to their needs.
Dosing is still a question mark when it comes to CBD use. “It can take months to find which product will work best,” Goldstein says, “and there’s an element of trial and error (not unlike pharmaceuticals), but if there’s an unwanted side effect, changing the product, dose or timing of the dosing will resolve the issue.”
Chin sums up CBD use succinctly. “Medical cannabis is not a silver bullet. We still have to follow standard of care for medicine. However, medical cannabis can be an alternative when other treatment options aren’t working.”
Bonnie Goldstein, MD, Medical Director, Canna-Centers
Cannabis Revealed by Bonnie Goldstein, MD
Dr. Junella Chin
Cannabis and CBD for Health and Wellness by Dr. Junella Chin
Centers for Disease Control and Prevention article
Endocannabinoid Testing article a and article b