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Medical Cannabis for Children: A Controversial Yet Hopeful Approach
In This Article
- Introduction
- Understanding Medical Cannabis
- Medical Cannabis in Pediatrics - The Controversial Debate
- Potential Benefits of Medical Cannabis in Children
- Risks and Challenges
- Navigating the Canadian Cannabis Culture and Medical System
- The Future of Pediatric Cannabis Treatment in Canada
- Current State and Trends
- Neurologist Attitudes and Practices
- Legal and Regulatory Landscape
- Estimating Treatment Prevalence
- Looking Ahead
- Conclusion
Introduction
The use of medical cannabis in pediatric care, a topic deeply embedded in Canadian cannabis culture, is both controversial and promising. Recent data shows a slight decrease in the number of medical client registrations with federally licensed cannabis sellers in Canada, dropping from 224,474 in December 2022 to 212,700 in March 2023. This trend is echoed in the reduction of individuals registered for personal and designated cannabis cultivation for medical purposes, which declined by 6% in the same period. Despite these fluctuations, a considerable number of Canadians continue to explore medical cannabis as a therapeutic option, highlighting its persistent relevance in the national healthcare conversation.
In Canada, the majority of medical cannabis users, including children and adolescents, access their medication through federally licensed sellers. This ensures a regulated supply of quality-controlled cannabis, with the average daily authorized amount for medical use remaining consistent at about 2 grams per day since the implementation of the Cannabis Act in October 2018. Scientific evidence suggests that most patients use up to 3 grams per day of dried cannabis, though smaller amounts can also be effective with reduced risk of side effects.
In the realm of pediatric care, children suffering from chronic, debilitating illnesses and pain are increasingly turning to medical cannabis, especially when traditional treatments fall short or have significant adverse effects. Conditions like drug-resistant epilepsy, cancer pain, and autism are among those where medical cannabis shows potential benefits. In Canada, the process of accessing medical cannabis for children is regulated under the Cannabis Act, necessitating authorization by a physician or nurse practitioner. While this regulatory framework provides a degree of safety and consistency, it also faces criticism for being outdated and not fully reflecting the unique needs of pediatric patients.
However, research into medical cannabis use among children in Canada faces significant challenges due to inadequate national data. Health Canada's statistics on medical cannabis usage are not currently age-stratified, which obscures a clear understanding of its use in pediatric populations. Moreover, the reporting of adverse events associated with cannabis products, although mandated for licensed producers, is not compulsory for healthcare providers. This gap in reporting and data collection hinders a comprehensive understanding of both the benefits and risks associated with medical cannabis use in children.
At High Flyer Media, we recognize the complex and nuanced nature of this topic within the Canadian cannabis landscape. Our stance is to support informed decision-making by providing up-to-date information and advocating for continued research and refinement in the regulations governing medical cannabis, especially concerning its use in pediatric care. This commitment aligns with our goal of promoting a responsible and informed approach to cannabis culture in Canada, emphasizing both safety and potential therapeutic benefits.
Understanding Medical Cannabis
Medical cannabis, a critical aspect of Canadian cannabis culture, refers to the use of the Cannabis sativa plant for therapeutic purposes. Originating from Asia, this plant is now cultivated worldwide, including in Canada. It contains hundreds of chemical substances, over 100 of which are cannabinoids that affect cell receptors in the brain and body, altering cellular behaviour and communication.
The most researched cannabinoid is delta-9-tetrahydrocannabinol (THC), known for its psychoactive effects. THC's potency in cannabis has significantly increased over the years, from an average of 3% in the 1980s to around 15% today, with some strains reaching as high as 30%. While THC has therapeutic effects, its higher concentrations can also lead to more pronounced harmful effects.
Cannabidiol (CBD) is another crucial cannabinoid, which unlike THC, does not produce intoxication or a high. CBD is noted for its potential to mitigate some of THC's effects on the mind, especially when its concentration equals or exceeds that of THC. The therapeutic uses of CBD are currently a subject of extensive study, adding to its importance in the medical cannabis discussion.
At High Flyer Media, we emphasize the importance of understanding these key components of medical cannabis. Recognizing the differences between THC and CBD, as well as their individual and combined effects, is vital for informed usage, particularly in a medical context. This knowledge forms the foundation for understanding medical cannabis's role in therapy and its evolving place in the broader Canadian cannabis culture. Our stance is to encourage education and informed discussion about these compounds, highlighting both their potential benefits and the need for cautious usage, especially in medical settings.
Medical Cannabis in Pediatrics - The Controversial Debate
The use of medical cannabis in pediatric care is a topic of considerable debate in Canadian cannabis culture. The Canadian Paediatric Society has expressed concerns over the use of medical marijuana in children, citing a lack of sufficient evidence to assert its safety and efficacy. While cannabis is being used increasingly to treat children's illnesses, such as epilepsy, attention-deficit hyperactivity disorder, chronic pain management, and autism, the overall effects on children remain uncertain.
Despite the concerns raised by paediatricians, some parents have reported significant benefits from using cannabis oil for their children with severe medical conditions. For example, Alex Repetski spoke of the transformative impact of cannabis oil on his three-year-old daughter's severe epilepsy, noting an end to her seizures and improvement in her ability to crawl, walk, and feed herself. However, these anecdotal successes are contrasted by warnings from experts about the potential risks associated with cannabis use in children. Dr. Michael Rieder, a key figure in the Canadian Paediatric Society, highlighted the need for more research to substantiate the safety and efficacy of cannabis use in pediatric care. He also pointed to an increasing body of data suggesting potential harm from marijuana use, including research indicating that cannabis use during adolescence may impact brain development and increase the risk of psychosis.
The Canadian Paediatric Society recommends that any treatment involving cannabis should be administered by doctors with specific expertise in its use for pediatric conditions, emphasizing thorough discussions with families about the goals and risks associated with this treatment. The society also stresses the importance of differentiating medical use from recreational use, especially in adolescents.
At High Flyer Media, we recognize the complexity of this issue. While we understand the potential benefits that medical cannabis might offer to some pediatric patients, we also acknowledge the need for more comprehensive research and informed medical guidance. Our position is to advocate for safe, responsible, and well-informed use of medical cannabis in pediatric care, aligning with our commitment to fostering a knowledgeable and cautious approach within the Canadian cannabis community.
Potential Benefits of Medical Cannabis in Children
The exploration of medical cannabis use among children, particularly in Canada, reveals a growing interest, especially for conditions where conventional treatments have limited effectiveness or severe side effects. Children with chronic debilitating illnesses, such as drug-resistant epilepsy, cancer-related pain, and autism, are increasingly turning to medical cannabis. This shift is driven by caregivers who are becoming more aware of the potential benefits of medical cannabis in these challenging medical scenarios.
A significant aspect of medical cannabis use in children pertains to cannabis extracts. By the latter half of 2018, these extracts accounted for 67% of the cannabis authorized for medical purposes in Canada. Although there's no specific pediatric data, clinical experience indicates that extracts, rather than dried cannabis products, are predominantly used in pediatric care. The use of extracts introduces complexities in dosage calculations due to varying cannabinoid content and the diverse extraction methods that affect the cannabinoid, terpenoid, and solvent profiles of the resulting product.
However, research on the effectiveness and safety of medical cannabis use among children in Canada is limited by inadequate national data and the absence of age-stratified statistics on medical cannabis use. This data gap hampers the development of a comprehensive understanding of both the benefits and risks associated with medical cannabis in pediatric populations. Current regulations have led to the use of medical cannabis products for children rapidly outpacing the knowledge base informed from clinical trials, pointing to a need for more robust research infrastructure and funding.
Additionally, there's a lack of high-quality research, specifically concerning the potential long-term neurodevelopmental effects of cannabis exposure in children. Insufficient education for health professionals on the indications, efficacy, dosage, and safety of medical cannabis products contributes to their reluctance to authorize its use in pediatric cases. Moreover, regulatory discrepancies between provinces and territories further complicate the scenario, adding to healthcare provider uncertainty regarding the appropriateness of authorizing medical cannabis to children.
In the context of Canadian cannabis culture and at High Flyer Media, we recognize the importance of advancing research and education in this field. While anecdotal evidence and early studies suggest potential benefits of medical cannabis for certain pediatric conditions, we advocate for a cautious approach that prioritizes patient safety, informed decision-making, and the development of a robust evidence base. Enhancing the understanding and regulation of medical cannabis in pediatric care is crucial for its safe and effective use, aligning with our commitment to responsible and informed cannabis use in Canada.
Risks and Challenges
The conversation around medical cannabis in pediatric care must also address the risks and challenges involved, particularly in the context of Canadian cannabis culture.
- Accidental Poisonings and Adverse Effects: One of the most significant risks associated with medical cannabis, especially in children, is accidental poisoning. Hospitals in Canada have reported an increase in emergency room visits due to accidental cannabis poisonings, predominantly involving children under 12 years old, with most cases being under the age of 5. Serious cases can lead to coma, the need for a ventilator, and in rare instances, death. These risks are heightened with illegal cannabis edibles, which may contain higher levels of THC and come in non-child-resistant packaging that could appeal to children.
- Challenges in Prescribing Medical Cannabis: Healthcare practitioners (HCPs) in Canada face significant challenges when prescribing medical cannabis. A study found that many HCPs feel uncomfortable or ambivalent about their knowledge of medical cannabis. This discomfort is compounded by the lack of training in medical cannabis during professional schooling. Only 6% of the respondents received training in medical cannabis in professional school, while 60% received some form of training through workshops or conferences. Despite this, over half of the respondents reported an increase in questions regarding medical cannabis since the legalization of recreational cannabis, with 82% having patients who use medical cannabis. The most common symptoms and conditions for recommending medical cannabis were pain, nausea, cancer, and intractable pain. However, the primary barriers to prescribing or authorizing medical cannabis were uncertainty in safe and effective dosage and routes of administration, and the lack of research evidence demonstrating its safety and efficacy. The study concluded that increasing research, training, and knowledge could help HCPs feel more equipped to make informed treatment and prescribing decisions, thereby improving access to medical cannabis.
- Lack of Research and Data: The lack of high-quality research specifically on the long-term neurodevelopmental effects of cannabis exposure in children is a significant challenge. Furthermore, the reluctance of healthcare professionals to authorize its use in children is compounded by insufficient education on the indications, efficacy, dosage, and safety of medical cannabis products. Regulatory discrepancies between provinces and territories also add to the complexity and uncertainty surrounding medical cannabis use in pediatric patients.
At High Flyer Media, we understand these risks and challenges inherent in the use of medical cannabis for children. We advocate for increased awareness, education, and research to address these challenges. Ensuring the safety and well-being of pediatric patients is paramount, and this can only be achieved through a cautious and informed approach, backed by robust research and education in the field of medical cannabis.
Navigating the Canadian Cannabis Culture and Medical System
Navigating the medical cannabis system in Canada, especially for pediatric use, involves understanding the regulatory framework and challenges in accessing appropriate treatment.
Regulatory Framework: In Canada, children with chronic illnesses access medical cannabis through a framework regulated by Health Canada. The Cannabis Act of 2018 created separate streams for medical and recreational cannabis. Treatment must be authorized by a physician or nurse practitioner, and strict production and labeling requirements have been instituted. However, there is a need for refinement in authorization processes and adverse effect reporting to enhance patient safety.
Dosage and Prescription Challenges: Health care providers must specify the quantity of cannabis in grams per day. Cannabis extracts, which are predominantly used for children, add complexity to dosage calculations. The variance in cannabinoid content and extraction methods complicates dosage determination and raises concerns about safety and efficacy.
Inadequate Research and Data: The lack of pediatric-specific data and stratification by age in national cannabis use reports hinders understanding the impact of medical cannabis on children. Research is further hampered by the current regulatory environment, which does not sufficiently differentiate between medical and recreational cannabis, leading to a gap in knowledge about clinical efficacy and safety.
Improving Current Regulations: To better support safe cannabinoid use in children, there are proposals for several improvements. These include revising physician authorization forms to specify daily doses in milligrams and the ratios of cannabinoids, and requiring licensed producers to clearly label the concentrations of cannabinoids on products. This consistency in labeling will address safety concerns and the psychoactive effects of THC on children.
Role of Community Pharmacies: Community pharmacies could play a significant role in dispensing and compounding medical cannabis products, given their infrastructure and expertise in drug interactions and adverse effects. This aligns with the Canadian Pharmacist Association's position that pharmacists are well-suited to advise patients and oversee the safe storage and dispensing of medical cannabis.
Reporting and Data Collection: Health Canada should mandate the reporting of all serious adverse effects associated with medical cannabis, including by pharmacists. This reporting could be integrated with existing surveillance programs and made accessible through digital platforms for ease of use.
Funding for Research: Adequate research funding, independent of industry influence, is crucial. Established organizations like the Canadian Childhood Cannabinoid Clinical Trials Consortium and others are positioned to conduct high-quality research. Partnerships between hospital foundations, health research foundations, and licensed producers are being developed to provide funding for pediatric cannabis research. Intergovernmental coordination to earmark a percentage of taxation revenues from recreational cannabis sales for research would also support a better evidence base.
At High Flyer Media, we emphasize the importance of navigating the Canadian cannabis culture and medical system with an informed and cautious approach. Advocating for improved regulations, enhanced research, and better education for healthcare providers and patients is crucial. This approach aligns with our commitment to ensuring safe and effective use of medical cannabis, particularly in pediatric care, within the broader context of Canadian cannabis culture.
The Future of Pediatric Cannabis Treatment in Canada
The future of pediatric cannabis treatment in Canada is evolving, shaped by emerging research, clinical practices, and regulatory changes.
Current State and Trends
Medical cannabis has recently been recognized as a treatment option for children with drug-resistant epilepsy in Canada. A survey distributed to 148 pediatric neurologists across the country revealed that while some neurologists prescribe cannabis (34%) or refer to another authorizing physician (38%), there remains a significant portion (29%) who do not support cannabis treatment in pediatric epilepsy patients. This reflects the complexity and hesitancy within the medical community regarding the use of cannabis in pediatric care.
Neurologist Attitudes and Practices
The majority of neurologists consider cannabis for patients with specific syndromes like Dravet syndrome and Lennox–Gastaut syndrome, often after other treatments have failed. Despite this, there are concerns about the lack of robust evidence, quality control, and cost. These hesitations highlight the need for more comprehensive research and clearer guidelines for the use of medical cannabis in children.
Legal and Regulatory Landscape
Canadian healthcare practitioners are legally authorized to prescribe medical cannabis for epilepsy in patients of all ages. However, there are no specific guidelines regarding its use in children, indicating a gap in the regulatory framework that needs to be addressed to provide clearer direction for healthcare providers.
Estimating Treatment Prevalence
As of 2018, it's estimated that approximately 5% of Canadian children with epilepsy were being treated with cannabis. This number, while seemingly low, suggests a growing acceptance and use of cannabis for treatment-resistant epilepsy. However, the actual prevalence might be higher, considering the high patient-driven demand for cannabis therapy and the number of patients not receiving cannabis due to hesitations among neurologists.
Looking Ahead
Moving forward, the trajectory of pediatric cannabis treatment in Canada will likely be influenced by several factors. These include the development of more comprehensive clinical guidelines, increased research funding for pediatric-specific studies, broader educational initiatives for healthcare providers, and potential regulatory reforms to facilitate safer and more effective use of medical cannabis in pediatric care.
At High Flyer Media, we anticipate these developments and advocate for a future where medical cannabis is an accessible, well-researched, and safely regulated treatment option for children in need. The integration of medical cannabis into pediatric care represents a significant step forward in Canadian cannabis culture, promising new avenues of relief and hope for many families.
Conclusion
The exploration of medical cannabis for pediatric care in Canada presents a landscape filled with potential, controversy, and evolving understanding. While recent data suggests an uptick in its use for conditions like drug-resistant epilepsy, the medical community remains divided due to concerns over evidence, quality control, and cost. With approximately 5% of Canadian children with epilepsy estimated to be treated with cannabis, the demand for this therapy is evident, yet it's met with caution due to the lack of comprehensive research and clear regulatory guidelines.
As we look to the future, it's crucial to bridge these gaps with rigorous research, improved regulatory frameworks, and enhanced healthcare provider education. The goal is to ensure safe, effective, and accessible cannabis treatment for pediatric patients, aligning with the evolving Canadian cannabis culture. At High Flyer Media, we support this journey towards a more informed, cautious, and research-backed approach to medical cannabis in pediatric care, aiming to offer hope and relief to families navigating these complex health challenges.