Cannabidiol (CBD), the primary non-intoxicating compound present in the cannabis plant, is known to have a wide range of potential therapeutic uses for adults. But can kids also take CBD?
While CBD may be relatively safe for kids compared to the intoxicating compound tetrahydrocannabinol (THC), parents and physicians must weigh the benefits and potential risks of giving CBD to children for symptoms like general anxiety or stress, coping with social situations, or a variety of medical conditions.
In this article, we’ll provide a summary of the current research on whether CBD is safe for children before exploring three specific, emerging use cases for CBD in a pediatric wellness context.
Generally speaking, adolescent cannabis use is associated with negative effects such as decreased motivation, but the number of studies specifically studying cannabis use in children is limited.
The good news, however, is that THC seems to be the main culprit when it comes to those negative effects.
According to a literature review published in 2020, “the current knowledge on the long-term side-effects of cannabinoids is based mainly on longitudinal follow-up of recreational cannabis users. Several large studies have demonstrated that the main risks of decreased motivation, addiction, mild cognitive decline, and schizophrenia are directly related to the THC and CBD concentrations in the strain used, i.e. the higher the ratio of THC to CBD, the greater the risk.”
The review also found that, based on the results of several animal studies, CBD is “relatively safe” during early development, despite some risk of side effects like drowsiness, weight loss, and decreased liver function.
“As recreational cannabis use during youth is associated with serious adverse events and medical cannabis use is believed to have a relatively high placebo effect, decisions to use medical cannabis during childhood and adolescence should be made with caution and based on evidence,” the review’s authors conclude.
One medical use case for CBD that has made appearances in headlines is treating refractory epilepsy, Lennox-Gastaut syndrome, and other types of treatment-resistant epilepsy.
For families with children who experience seizures as a result of hard-to-treat epilepsy, CBD may initially have seemed like something of a miracle cure. Despite the media attention, however, studies from the last several years indicate that CBD’s efficacy for reducing seizures in children may not be as great as early studies showed.
The most important takeaway from the current literature is that, despite effectively reducing how often the children under treatment experience seizures, the effects of regular CBD consumption begin to wear off after a couple of years.
One study, published in 2022, credits the development of a tolerance to CBD for this change in efficacy.
“The ‘honeymoon’ period might be very short, and subsequent deterioration might be very severe,” the authors state. In this particular study, about one third of the participants developed some tolerance by around 11 months after starting treatment. At the end of the 12 month study, 38 out of 86 patients reported that CBD was still effective for them.
The solution to this tolerance, the study’s authors suggest, is to consider CBD just one part of a broader therapeutic strategy. They call for additional research regarding how to deal with CBD tolerance and whether the tolerance is dose-dependent.
An earlier study, published in 2018, found a similar rate of tolerance development at 2 years after beginning CBD treatment when examining another group of child patients over a longer period of time.
Still, the study also reports that “clinically meaningful improvement in seizure frequency (>50% reduction) was sustained over 2–4 years in 7/26 (26.9%) of children with otherwise medically refractory epilepsy of various types, including three (11.5%) who became seizure free.”
Both studies reported a variety of side effects similar to those included in the first literature review covered above, including drowsiness, fatigue, increased body temperature, decreased appetite, diarrhea, and decreased liver function.
“Autism spectrum disorder (ASD) is defined as a group of neurodevelopmental disorders whose symptoms include impaired communication and social interaction, restricted and repetitive patterns of behavior, and varying levels of intellectual disability,” explains one literature review, published in 2022 and covering the efficacy of CBD for treating symptoms of ASD.
Unfortunately, there are few clinical trials specifically examining CBD as a treatment for ASD. In fact, the authors of another brief literature review published just a few years earlier in 2018 state that they weren't able to find any clinical trials at all.
According to the 2022 review, however, the lack of treatments available for the wide range of symptom presentations for ASD, as well as the possibility of a connection between ASD and the endocannabinoid system, make CBD worth exploring as a treatment option.
Based on evidence gathered from animal studies, researchers have confirmed that the CB1 receptors of the endocannabinoid system “are located in areas associated with motor control, learning and memory, emotional response and cognitive functions, and structures related to ASD neurobiology,” the study’s authors state.
While the authors do note that “to date, clinical studies suggest that CBD-enriched cannabis may benefit epilepsy, aggression, improved mood, anxiety, and social interaction in ASD patients,” they also acknowledge that a significant amount of the hype around CBD and ASD is based on anecdotal evidence.
One additional medical use case being explored for CBD is juvenile idiopathic arthritis (JIA), a type of chronic arthritis affecting 1 in 1000 children.
A survey, published in 2021 by two pediatric rheumatologists in response to having been “frequently asked about using CBD products to treat JIA symptoms,” found that, while “while CBD use is currently infrequent for JIA, many parents/guardians are interested in using CBD to help with JIA symptoms.”
“As such, it is important that pediatric rheumatologists and other pediatric providers educate themselves about CBD to increase their comfort in discussing CBD and its potential safety issues with their patients and/or parents,” the authors add.
There isn’t any clinical evidence supporting the use of CBD for treating JIA symptoms, but the authors do point to two clinical trials that came up in the course of conducting background research for their survey, both of which examine arthritis symptoms in rodents.
The first study concluded that “topical CBD application has therapeutic potential for relief of arthritis pain-related behaviours and inflammation without evident side-effects.” The second study found “that CBD, through its combined immunosuppressive and anti-inflammatory actions, has a potent anti-arthritic effect in” treating collagen-induced arthritis.
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