Rarely do questions of medical efficacy show up on the radar of public awareness. In most cases, the majority of us are quite happy to put trust in the hands of the experts. But every now and then, a trend is bucked, and a new phenomenon emerges. One such buck has been the use of cannabis, and its many mediums, as legitimate medical treatment. In recent years CBD has become a hotly debated topic – the cannabis industry is gaining traction across the world, grabbing headlines and sparking public discussion. There isn’t a single self-respecting trendy café in London that doesn’t offer a CBD shot in your beverage of choice. Even Holland & Barrett, Boots and other high street chains are flexing their CBD muscles.
The history of cannabis as a recreational drug has left it with a stigma that lingers to this day, even as it becomes legal and increasingly recognized for its medicinal benefits around the globe. As a result the idea of using it as a treatment for children has been met with scepticism. But is this scepticism outdated stereotyping or is there a valid reason to hesitate?
Cannabis has been in use for centuries – in some civilisations, for millennia. But the history of its refined by-product CBD is far shorter. First isolated by Roger Adams in the 1940s, research into cannabidiol has been mounting, slowly but significantly. Recent liberalisation of attitudes towards cannabis, from individuals and governments alike, belie the exponential increase in research in recent years. Many businesses see obtaining a licence to sell CBD and CBD products as laying the groundwork for the eventual legalisation of cannabis products more generally.
Why do some parents give children CBD?
Online forums abound with thousands of parents propounding the administration of CBD for their children, the effectiveness of which is particularly pronounced in those with autism. Those with children suffering from ADHD also report CBD to be effective at containing episodes and improving focus. The April 2020 issue of Remedy review, a cannabis-focused magazine, published the results of a survey of more than 500 parents, 40% of whom had used CBD to treat behaviours associated with autism.
CBD is unique in its ability to reduce the instance of seizures related to a wide variety of conditions. As well as autism, it is popularly used to treat seizures related to epilepsy, in sufferers of which it reduces both the frequency and intensity of seizures. There are currently dozens of studies and trials in progress, geared towards pinpointing exactly how, and to what degree, CBD can treat seizures.
CBD for children – what do studies say?
CBD is now legal in most countries around the world, being taken and prescribed for such things as anxiety, sleeplessness and chronic pain. Despite all this however, research into CBD is still relatively sparse. To date Epidiolex, the only prescription drug actually derived from cannabis, is only used to treat two very rare forms of epilepsy in children. There are currently no legal restrictions in place limiting the use of CBD strictly to adults in the UK. although several cannabis trade bodies do advise against parents providing it to their children or encourage parents to consult a doctor before administering CBD.
Research is being done to investigate the efficacy of CBD for treating other varieties of epilepsy. Results indicate that it has a significant effect on reducing the number of seizures even for cases of epilepsy outside of the two described above. Along with being a treatment for epilepsy, commercial CBD has seen use for numerous children’s ailments, and varying degrees of research have been undertaken into several potential uses. For example, studies have shown persuasive results indicating that CBD can have a positive outcome when treating symptoms of autism. A 2018 Israeli study looking into oral cannabidiol use in children with autism spectrum disorder as a treatment for related symptoms and comorbidities found that in a group of 53 children, hyperactivity symptoms improved in 68.4% of the study group and sleep problems improved in 71.4%.
CBD and anxiety in children
There are widespread reports of CBD being treated to alleviate childhood anxiety, with the majority of parents surveyed reporting largely positive effects on their children’s mental wellbeing. However, much of the evidence is anecdotal rather than scientifically proven. Although valid, parents’ perceptions are not proof enough for the efficacy of CBD as a treatment for various issues, we still need to examine effects through the study of measured changes compared with placebo groups before making any definitive declarations.
Some studies do indicate that CBD oil may help reduce anxiety, although this claim hasn’t been tested sufficiently in children. There has been a recent hopeful and positive pilot study by Orygen, Australia’s centre of excellence in youth mental health. The Cannabidiol Youth Anxiety Pilot Study ascertained that young people with treatment-resistant anxiety had an average 42.6% reduction in anxiety severity and impairment following 12 weeks’ treatment with cannabidiol. The 31 participants were aged between 12–25. Orygen’s Professor Paul Amminger, who led the study, remarked on the profound impact the trial had on some of the participants: “The young people had fewer panic attacks and could do things which they were previously unable to do like leave the house, go to school, participate in social situations, eat at restaurants, take public transport or attend appointments by themselves.”
Another reason some parents are looking at CBD for their children is due to the public interest and anecdotal reports on the effects of CBD as a treatment for some of the more negative symptoms of ADHD. A 2022 case study of three males with ADHD (ages 18, 22, and 23) who integrated cannabis into their treatment regimen – interviews with the patients detailed subjective improvements in symptoms and on quality of life. Still, clinical trials are needed to confirm the efficacy of cannabis in the treatment of ADHD and since CBD hasn’t been studied specifically to treat ADHD in children, it’s best to talk to your child’s paediatrician before giving your child CBD to treat ADHD symptoms.
Is it safe to give CBD to children?
Bodies as prolific as the World Health Organisation have concluded that CBD has a good safety profile, stating that, in its pure state, cannabidiol does not appear to have abuse potential or cause harm. Due to its chemical make-up, CBD does not cause the “high” associated with cannabis, and thus far no addictive quality has been identified and connected to its use. Though predictably, there will always be concerns around the introduction of children to what has, for almost 80 years, been considered an illicit substance. The considerable anecdotal evidence from parents, and the wealth of research available on the effect positive effects CBD has on adults in no way guarantees suitability for children. But it certainly lays optimistic ground for further research. As with any and all medications, regardless of provenance, one must be wary of the temptation to see it as a “cure-all”.
In that light it must be recognized that for all its potential uses, CBD is still in the relatively early stages of its life as a medicine. It has been seeing more and more use, but the rate of medical research cannot, by its nature, keep up. Therefore there are still numerous unknowns when it comes to its applications. This lack of knowledge is the greatest downside to using CBD, especially on the developing mind of a child. Like any medicine, CBD may also interact with other medications the child is taking. There are also side effects from the use of CBD to be aware of. Effects can range from things as mundane as dry mouth and lethargy to less likely but far more serious impacts when taken incorrectly such as low blood pressure and liver injury.
There are numerous factors at play when it comes to the notion of giving CBD to children. As things currently stand, doing so appears to be broadly safe, but there are a number of uncertainties, with the final outcome likely to vary from child to child. Research is still very much underway and while it is unlikely that anything will be discovered that would get CBD declared unsafe for children in its entirety, there are questions of dosage, biology and side effects which are still in the process of being answered. Those answers will shape the landscape for CBD use in the years to come. This has not stopped parents from administering CBD however, and given that the WHO has declared CBD as safe and well tolerated in humans, it ultimately should not if administered after research and professional advice.
Parents are free to use it as they see fit, however, there are ways to maximise the effectiveness of CBD while minimising any danger to the child. Before anything else, it must be reiterated that a parent should consult their child’s doctor before administering CBD and if a doctor signs off, any advice they give should be strictly followed. Continued watchfulness to ensure that any symptoms can be addressed at the earliest possibility is also important to maintain. But beyond that, there are things a parent can do of their own initiative as well. First of these would be to start small, giving children minimal dosages of CBD to test reactions, slowly increasing the dosage to the advised and optimal amount. Parents must also be mindful of which product and brand they choose. Different brands and sources can create similar products at different strengths, so careful inspection of any product is required. This inspection is also necessary to ensure that the product was not made in such a way that it contains contaminants such as pesticides or soil-borne toxins. Buying CBD products, particularly oil, sourced from organically grown hemp is the best way to avoid these sorts of tainted products.
A vital factor to be aware of is whether or not the product contains THC. While CBD does not cause any sort of high, THC does, so it is important for parents to check and make sure the product they buy does not contain it. CBD is legal in the UK as long as it contains less than 1mg of THC per container, meaning it’s highly unlikely a consumer sold product would have a higher amount, but it’s still important to be mindful when purchasing CBD and go for an established and reputable brand. Documented testing has shown that what it says on the bottle is not always true as there may be no quality assurance testing. A 2022 review conducted by Leafreport, an online resource dedicated to CBD, found that out of the 188 cannabidiol (CBD) brands they tested, 20% of brands carried out no purity testing on their products at all. With this in mind, when acquiring CBD, make sure you choose a transparent brand that publishes third-party laboratory tests to see the exact CBD and THC content in the oil.
It’s essential to educate yourself on CBD before administering it to someone else in order to tailor the method of use to one’s specific need. CBD comes in three forms: CBD isolate, broad spectrum and full spectrum CBD. Full-spectrum CBD includes many of the cannabinoids and compounds of the cannabis plant, including a small amount of THC. Broad-spectrum CBD contains all the same compounds as full-spectrum CBD, minus THC. CBD isolates contain CBD only — none of the other cannabinoids and compounds from the plant are included. Most parents turn to a CBD isolate for their children as it’s the purest form of CBD and a way to avoid any THC or other cannabinoids of the plant. If you are nervous about giving any small trace of THC to your children, always select isolate CBD.
Is it legal to give CBD to children?
Currently, there are no legal regulations restricting CBD use to adults, meaning the decision of whether children should take CBD is ultimately down to parents. Great Ormond Street Hospital for Children (GOSH) has stated that they cannot legally provide CBD for children and ultimately don’t recommend parents to do so due to the lack of information on the side-effect profile of cannabinoid oils, especially in young children. The American based Child Mind Institute, an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders, has voiced a similar viewpoint, declaring that there’s “very little research about its safety or how well it works, especially for children.”
Ultimately, when it comes to giving CBD to children, there are not yet any concrete answers or solid, unanimous advice from medical professionals. Simply, not enough controlled research has yet been conducted on CBD and kids. For parents who think that CBD could be beneficial to their child, there is surprisingly little guidance and information. The decision appears to remain a judgment call. Although it is agreed that CBD is generally very safe, it is unlikely to work in a similar way for everyone. One child may see benefits whilst another may experience some side effects – it is up to a parent to weigh up the potential benefits against any worries they may have and assess any results.