Cannabidiol (CBD) has gained attention for its potential wellness applications, leading many parents to consider its use for children. This article provides an overview of CBD’s suitability for pediatric use, addressing current scientific and regulatory information.
Understanding Cannabidiol
Cannabidiol (CBD) is a naturally occurring chemical found in the Cannabis sativa plant. Unlike tetrahydrocannabinol (THC), the primary psychoactive compound in cannabis, CBD does not produce intoxicating effects or a “high.” CBD primarily interacts with the body’s endocannabinoid system (ECS), a complex network involved in regulating various physiological processes.
The ECS includes cannabinoid receptors, endocannabinoids produced by the body, and enzymes that break them down. While THC directly binds to cannabinoid receptors, CBD works more indirectly. It influences the ECS by affecting the production and breakdown of the body’s own endocannabinoids, such as anandamide, thereby modulating receptor activity without direct binding. This indirect interaction contributes to CBD’s non-psychoactive nature and its potential therapeutic properties.
Regulatory Landscape and Current Research
The regulatory status of CBD, particularly in the United States, presents a complex picture. The 2018 Farm Bill federally legalized hemp-derived CBD products containing less than 0.3% THC. However, this legislation does not mean all CBD products are regulated for safety or effectiveness. The U.S. Food and Drug Administration (FDA) has maintained that, with one exception, CBD products cannot be marketed as dietary supplements or therapeutic agents.
The singular FDA-approved CBD-based medication is Epidiolex, a purified form of cannabidiol. This prescription drug is approved for treating seizures associated with specific severe forms of epilepsy, including Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex, in patients aged one year and older. Beyond Epidiolex, comprehensive clinical trials on CBD use in children are largely lacking, with most research still in early stages or observational.
Potential Therapeutic Applications in Children
Parents may explore CBD for their children, often driven by preliminary findings or anecdotal accounts. The most robust evidence for CBD’s therapeutic use in children is for severe forms of epilepsy. Epidiolex, the FDA-approved CBD medication, has demonstrated effectiveness in reducing seizure frequency in children with Lennox-Gastaut syndrome and Dravet syndrome.
Beyond epilepsy, CBD is being investigated for other pediatric conditions, though scientific backing remains limited. Some preliminary research and ongoing studies explore its potential role in managing symptoms associated with autism spectrum disorder, such as anxiety, irritability, and sleep disturbances. Additionally, its use for general anxiety and sleep disorders in children is an area of active research. However, these remain areas of ongoing investigation, and CBD is not an established treatment for these conditions in children.
Safety Considerations and Adverse Effects
The safety of CBD in children is a primary concern due to limited research on long-term effects. Known side effects can include drowsiness, fatigue, changes in appetite, and diarrhea. More serious concerns involve potential liver issues, with studies on Epidiolex noting increased liver enzymes in some patients.
CBD can also interact with other medications, particularly those metabolized by liver enzymes like the cytochrome P450 system. This can lead to altered drug levels in the body, potentially increasing side effects or reducing the effectiveness of other medications. Concerns also arise from product quality due to the lack of stringent FDA regulation for most CBD products. This can result in products containing inaccurate CBD or THC levels, or being contaminated with heavy metals, pesticides, or other harmful substances. The long-term effects of CBD on a developing child’s brain and body are not yet fully understood due to insufficient research.
Informed Decision-Making for Parents
For parents considering CBD for their child, consulting with a pediatrician or a specialist is paramount before initiating any CBD product. A healthcare provider can offer personalized guidance based on the child’s specific health needs, existing medical conditions, and current medications. It is important to discuss all concurrent treatments to identify potential drug interactions and ensure overall safety.
When selecting a CBD product, parents should prioritize reputable brands that provide third-party lab testing results, often called Certificates of Analysis (COAs). These reports verify the product’s purity, potency, and confirm the absence of contaminants like heavy metals, pesticides, and excessive THC. Starting with a very low dose and carefully monitoring for any adverse reactions or changes in the child’s condition is a prudent approach.