Cannabis and Kids: What Cannabinoids Do to a Child's Developing Brain

Cannabinoids, the active compounds in cannabis, act on the endocannabinoid system, a network that helps regulate many body and brain functions, and in children and teens that system is still developing. That makes kids more sensitive to THC's effects and raises concerns about long-term impacts on brain development and behavior; the one use with strong evidence is pure CBD for two rare forms of childhood epilepsy.

Because a young brain is still wiring itself, the influence of cannabinoids there is especially significant and potentially risky.

On top of that, there are concerns about possible long-term effects on neurological development and behavior. Here's a look at how cannabinoids affect young brains, and what that means for using them in such a vulnerable group.

Medical cannabis in pediatrics

Using medical cannabis to treat children is a topic of growing interest and plenty of controversy. Cannabinoids can cross the placenta during pregnancy, which can affect the developing brain of the fetus.

Studies have linked prenatal cannabis exposure to hyperactivity, impulsivity and attention problems in childhood. The toxic effects of cannabinoids can also be stronger in children than in adults, because their nervous systems are still developing.

In children, even small doses of marijuana can cause a range of symptoms, including ataxia (loss of coordination), drowsiness, lethargy, altered mental status and clouded consciousness. In rare cases, pediatric patients can have serious adverse effects like apnea (pauses in breathing), cyanosis, bradycardia (a slow heart rate), low muscle tone and opisthotonos (severe arching spasms).

Medical cannabis for kids: what does the evidence say today?

Right now, the strongest evidence for medical cannabis in children is for treatment-resistant epilepsy, specifically Dravet syndrome and Lennox-Gastaut syndrome, using pure cannabidiol (CBD) with no traces of other cannabinoids.

For other developmental conditions in children, such as autism and attention deficit hyperactivity disorder (ADHD), the evidence is limited and comes mostly from case series or single case reports.

These treatments have gained traction on social media, and with so many forms of cannabinoids now easy to get, the risk of kids being accidentally exposed has gone up.

In short, while medical cannabis may offer benefits for certain pediatric conditions, its use needs to be carefully evaluated and monitored because of the potential risks and the limited scientific evidence available.

What medical cannabis is approved for

Medical cannabis and its cannabinoids have been the subject of tons of research and debate, especially around their medical uses and how they're regulated. Here are the approved medical uses and the precautions that come with them.

FDA-approved THC medications

A few medications containing tetrahydrocannabinol (THC) or related compounds have been approved by the US Food and Drug Administration (FDA) for specific uses. They're mainly used to treat chemotherapy-related nausea and vomiting, and appetite loss in patients with AIDS.

Keep in mind that these drugs have to be prescribed by a doctor and aren't approved for patients under 18. And because THC is so tightly restricted for minors, research on its use in kids is very limited.

Epidiolex and CBD

A major milestone for medical marijuana was the development of Epidiolex, a prescription drug made with purified cannabidiol (CBD). Epidiolex has been shown to reduce seizures linked to two rare conditions: Lennox-Gastaut syndrome and Dravet syndrome. It's currently the only CBD product approved and regulated by the FDA.

Outside of Epidiolex, no other form of CBD is FDA-approved. Even so, CBD is sold over the counter in all sorts of forms, like oils, gummies and patches. The purity and amount of CBD in these products can vary a lot, and some may contain small amounts of THC, which isn't recommended for kids.

CBD can also have side effects, including interfering with how the body processes several prescription drugs. Epidiolex clinical trials showed that CBD can be hard on the liver in some patients.

Is medical cannabis safe for children?

Even with CBD products easy to find, giving them to kids is still controversial and lacks solid scientific backing. Some parents use CBD for a range of conditions in their children, but there are no conclusive studies supporting its effectiveness and safety.

There's some evidence that CBD may help with anxiety in adults, but it hasn't been studied much in children. One study suggested CBD might help reduce symptoms in kids with severe autism, but it had no control group, which limits how much weight its results can carry.

A lot more research is needed before CBD can be recommended for children.

What the American Academy of Pediatrics recommends

The American Academy of Pediatrics (AAP) doesn't support using medical marijuana products outside the FDA approval process. The AAP has backed the Drug Enforcement Administration (DEA) moving marijuana to Schedule II, which would make it easier to do more research. The AAP also advises against giving any drug by smoking it, because of the risks involved.

The bottom line on cannabinoids and kids

Medical cannabis, especially CBD, shows promise for treatment-resistant epilepsy and chemotherapy-induced vomiting. But any treatment needs to be supervised by medical professionals because of possible drug interactions and side effects. Ongoing research is key to fully understanding what medical cannabis can and can't do for children.