CBD has taken the health and wellness market by storm. Cannabidiol (CBD) is a compound naturally found in the cannabis plant. Although cannabis has been around for thousands of years, not much was known about cannabidiol (CBD) until recent years. Thanks to new research, CBD has shown a lot of promise in helping manage a wide variety of medical conditions – even disorders that often affect children such as epilepsy, ADD/ADHD, autism, anxiety, insomnia, and much more.
Due to the Substance 1 legal status of cannabis, research on the safety of (CBD) cannabidiol for children has been lacking. This is why many parents are hesitant to join the bandwagon despite the amount of hype and anecdotal evidence. In this article we shall look at whether CBD is safe and effective for kids.
What is CBD?
Cannabidiol or CBD is one of two prominent cannabinoids found in the cannabis plant – the other one being tetrahydrocannabinol or THC.
The main difference between CBD and THC is that CBD is a non-psychoactive compound. This means that CBD does not produce the iconic “high” or euphoria often associated with cannabis. The psychoactive effects of cannabis are produced by THC.
CBD can be extracted from two different cannabis strains: marijuana or hemp. CBD oil that is derived from marijuana contains significant amounts of THC. CBD oil that is derived from hemp contains less than 0.3% of THC.
CBD was first discovered in the 1960s by Israeli organic chemist Raphael Mechoulam. His research led to the discovery of other cannabinoids, including THC. Today, you will find many cannabis strains containing low to medium concentrations of CBD.
Back in the 1980s, people used to take cannabis to get high. Because of the popularity of recreational cannabis, breeders then focused on creating strains with high levels of THC. That trend has changed with the explosion of the CBD market in the last few years.
Groundbreaking research on the CBD molecule has revealed a whole new world of possible medicinal benefits. Studies are starting to show how CBD acts as a powerful anti-inflammatory in managing symptoms such as pain, seizures, and might even help shrink tumors.
Last June 2018, the FDA approved the CBD-rich oral solution Epidiolex for the treatment of seizures associated with two rare and severe forms of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome. Doctors can now prescribe Epidiolex for patients two years of age and older. This is the first FDA-approved drug that contains a purified extract from marijuana plants. [R]
While it is not approved to treat other medical conditions, CBD is now the subject of many studies as scientists try to unearth its therapeutic properties for treating ADHD, autism, anxiety, schizophrenia, chronic pain, multiple sclerosis, and other disorders.
Findings have been positive so far, and many governments around the world are starting to change their stance on cannabis and CBD. The legalization of medical cannabis – and even recreational cannabis – has led to a sudden spike in demand for CBD products. Now breeders are realigning their focus to create strains that contain a high percentage of CBD instead of THC.
CBD and the human endocannabinoid system
Endocannabinoids occur naturally in the body, and children are often exposed to cannabinoids at an early age. Human breast milk is a rich source of endocannabinoids. [R]
The human endocannabinoid system is a network of neurotransmitters that regulate many bodily functions to achieve homeostasis (balance). Receptors are located in many parts of the body, especially the brain. When CBD interacts with CB1 and CB2 receptors, it encourages the body to produce more endocannabinoids, promote cellular re-growth, and trigger responses to infection.
Charlotte's Web and Dravet syndrome
In 2013, the story of young Charlotte Figi shocked the medical world. Charlotte hails from Colorado and has been suffering from Dravet syndrome. This rare form of infant epilepsy causes intense, hour-long seizures and paralysis in the body. Charlotte had been experiencing more than 300 epileptic episodes per week – preventing her from moving, talking, or eating on her own.
By the time she turned six, her seizures had become so bad and the mix of drugs she was taking was no longer working. Worse, these medications were beginning to cause developmental damage. Thankfully, the family lives in Colorado where high-CBD strains of cannabis are readily available. As a last resort, Charlotte's mother purchased CBD oil at a local marijuana dispensary.
Charlotte began taking CBD with food. The effects were immediate – her seizures went from 300 intense and painful grand mal episodes per month to just two to three that occurred in her sleep. She stayed that way throughout the first week of treatment. Today Charlotte is virtually seizure-free with zero to one seizure per week. She has demonstrated no long-term side effects or negative consequences from taking CBD.
The CBD-rich cannabis extract that changed the life of Charlotte Figi is now known as Charlotte's Web – often taken by children and adults suffering from chronic pain, anxiety, stress, seizures, and arthritis.
More anecdotal evidence
Apart from Charlotte, there are other incredible testimonials from families with sick kids who have found relief from CBD.
Ten-year-old Haley Hilt was experiencing more than 100 seizures daily. According to her mother Melissa, Haley had undergone surgery, tried alternative diets, and was taking a cocktail of over 15 medications to try to slow down her seizures with not much success. When she turned 11, Haley started a medical cannabis treatment through the New York State Medical Marijuana program. She took a dose of CBD and THC with a ratio of 19-to-1 at breakfast and dinnertime. Melissa said the CBD-THC medication "has been the greatest gift to our family to be able to finally 'meet' her." Haley was no longer in a constant "haze" from the pharmaceutical medications. She has fewer seizures and has been able to stop taking two of her anti-epileptic drugs. She can now smile, hold her head up, communicate with her parents through a computer, play with her sister, and is even learning how to ride a bike.
Two-year-old Jaelah Jerger of Huntingburg, Indiana was diagnosed with epilepsy. Jaelah's mom Lelah first heard about CBD oil during an appointment with a chiropractic neurologist. She sought the opinion of doctors and surgeons at traditional treatment centers before finally deciding to purchase the oil. CBD treatment was able to reduce Jaelah's visible seizing from 30 times each day to just twice per day.
In December 2017, the World Health Organization released a statement confirming that their own study found no adverse health risks or any public health-related problems associated with taking CBD. [R]
Potential benefits of CBD for children
The story of Charlotte Figi gave hope to millions of parents who were desperate in finding an effective solution to managing symptoms of debilitating pediatric diseases. Let us look at how CBD can help children for therapy as well as dietary supplement.
CBD for anxiety and sleep disorders
A case report published in October 2016 showed how CBD was able to effectively treat anxiety and insomnia in a 10-year-old girl who was suffering from post-traumatic stress disorder due to sexual abuse and parental neglect. [R]
CBD for epilepsy
Studies have shown that CBD can be an extremely potent anticonvulsant in managing severe forms of childhood epilepsy, including Dravet syndrome. [R]
An open-label trial in 2016 studied patients aged 1-30 who had severe, intractable, childhood-onset, and drug-resistant epilepsy. Before the study, this group was already receiving stable doses of anti-epileptic drugs and was enrolled in an expanded-access program at 11 epilepsy centers across the United States. During the study, the patients were given oral CBD at 2-5 mg/kg per day and up-titrated until intolerance or to a maximum dose of 25 mg/kg or 50 mg/kg per day. The primary objective of the study was to establish the safety and tolerability of CBD in treating motor seizures during a 12-week period. Findings suggest that CBD might be able to reduce seizure frequency in children and young adults with treatment-resistant epilepsy. [R]
That same year, Israeli scientists looked into CBD-rich cannabis for treating intractable pediatric epilepsy. The cohort included 74 patients aged 1-18 with epilepsy that was resistant to over 7 types of anti-epileptic drugs. The patients were given a formula of CBD and THC with a ratio of 20:1 dissolved in olive oil. The CBD dose ranged from 1 to 20mg/kg administered during a period of 3-6 months. Most of the children (89%) reported a reduction in seizure frequency. The researchers also observed improvement in behavior and alertness, communication, motor skills, and sleep quality. [R]
In a 2018 study published in the New England Journal of Medicine, a group of researchers investigated the efficacy and safety of CBD when added to a regimen of conventional anti-epileptic medication. A total of 225 patients with Lennox–Gastaut syndrome were enrolled in the trial. The patients were placed in three groups: 76 patients took 20mg of CBD, 73 patients took 10mg of CBD, and 76 patients took a placebo. The study concluded that the addition of CBD to a conventional anti-epileptic regimen resulted in greater reductions in the frequency of drop seizures than placebo. [R]
CBD for Dravet syndrome
Dravet syndrome is a severe form of epilepsy that is associated with drug-resistant seizures and a high mortality rate. This rare genetic dysfunction of the brain can cause more than 300 grand mal seizures every month.
In a double-blind, placebo-controlled trial conducted in 2017, researchers randomly assigned 120 children and young adults with Dravet syndrome to two groups. One group received a CBD oral solution at a dose of 20mg per kilogram of body weight per day plus standard anti-epileptic treatment. The other group received a placebo plus standard anti-epileptic treatment. The study looked at changes in seizure frequency over a 14-week treatment period with a 4-week baseline. The median frequency of convulsive seizures decreased from 12.4 to 5.9 per month among those who took CBD. The median frequency of convulsive seizures decreased from 14.9 to 14.1 among those who took the placebo. The percentage of patients who had at least a 50% reduction in convulsive-seizure frequency was 43% in the CBD group and only 27% in the placebo group. Overall patient condition improved by at least one category on the seven-category Caregiver Global Impression of Change scale in 62% of the CBD group and only 34% in the placebo group. [R]
CBD for attention deficit disorders
Many studies have suggested that cannabinoids may help calm children who are suffering from hyperactivity or attention deficit disorders such as ADD or ADHD. [R]
CBD for autism spectrum disorder
There is an ongoing clinical trial on shifting brain excitation-inhibition balance in autism spectrum disorder (ASD) sponsored by King's College London. Estimated study completion date is April 27, 2019.
Another clinical trial run by Shaare Zedek Medical Center in Israel is trying to assess the safety, tolerability and efficacy of a cannabinoid mix (CBD and THC in a 20:1 ratio) for behavioral problems in children and youth with autism. Estimated study completion date is July 2019.
Researchers at University of California San Diego School of Medicine are now investigating whether CBD can safely and effectively provide therapeutic benefits for ASD. The clinical trial involves 30 children aged 8 to 12 who have been diagnosed with autism and severe symptoms. All patients enrolled in the clinical trial will undergo MRI scans, behavioral testing, and electroencephalograms. During the first phase, half of the children will receive CBD and half will take a placebo. The groups will then be switched in the second phase with investigators not knowing which children are receiving which treatment. The study is based at the School of Medicine’s Center for Medicinal Cannabis Research (CMCR) and involves a multidisciplinary team of physicians and scientists. Basic research, computational technologies, stem cells, imaging and clinical assessments are expected to help understand how CBD interacts with brain wave activity. The study aims to assess how CBD can mitigate problematic symptoms of ASD such as hyperactivity, social and communicative deficits, and aggressive, repetitive or self-injurious behavior. [R]
Dr. Igor Grant, CMCR director and chair of the Department of Psychiatry at UC San Diego School of Medicine, said there is a need for more treatment options for children with moderate to severe autism as they suffer the greatest impact and need the most help.
"It is becoming more apparent that CBD has a number of effects on the central nervous system that may be relevant to autism and there are anecdotal reports suggesting CBD treatments may improve functioning in an ASD child. Investigating the effects of CBD on autism has been a long-term goal for CMCR. We are excited to unlock additional, evidence-based knowledge of how cannabinoids can be used as medicines, not only for autism, but for other neurodevelopmental and neuropsychiatric disorders," the doctor added.
CBD for PTSD
Back in 2016, Dr. Scott Shannon of the University of Colorado School of Medicine presented an actual case of a 10-year-old girl who was suffering from post-traumatic stress disorder (PTSD). His young patient was sexually abused and had minimal parental supervision while under the age of five. She had difficulty sleeping, experienced anxiety attacks, and exhibited emotional outbursts at school. Traditional pharmaceutical therapies provided partial relief, but the results were short-lived and had adverse side effects. Before Dr. Shannon administered CBD, the child had to go through two tests – the Sleep Disturbance Scale for Children and the Screen for Child Anxiety Related Disorders – to provide a baseline of measurement.
During the trial period, the young girl took CBD oil sublingually before bed for five months. Dr. Shannon observed a decrease in anxiety and continuous improvement in the quantity and quality of sleep. She was finally able to sleep in her own room and slept comfortably throughout the night. Her emotional outbursts at school had also disappeared.
In examining the potential of CBD in helping children deal with pediatric anxiety and insomnia as a result of PTSD, Dr. Shannon noted a complete lack of measurable side effects. [R]
This is the first study that provides concrete clinical data supporting the use of CBD as a safe and stable treatment option for anxiety and PTSD symptoms in children.
It is not uncommon for children dealing with psychological disorders to take multiple medications at a time. Some drugs are prescribed just to manage the side effects of another drug. Anti-seizure medications can cause drowsiness, fatigue, and behavioral changes while medicines for treating ADD/ADHD can cause agitation, anxiety, nervousness, insomnia, nausea, and vomiting. CBD is a plant-based natural alternative that presents no side effects.
CBD dosage for children
General pediatric dosing of CBD often starts at 0.5 mg per pound of body weight split into three doses throughout the day. You can increase this dosage by 0.5 mg every week under medical supervision until you achieve maximum benefits. Although CBD has a stellar safety profile, cannabis products are known to produce significant side effects when taken at very low or very high doses. Start in small doses and move up slowly until the optimum dose for your child is achieved.
In extreme cases of pediatric epilepsy, the dosage could be 5 to 10 times higher. Children with catastrophic seizure disorders are often given up to 50mg of Epidiolex per kilo of body weight. If a child is already taking anticonvulsant medication, administering high doses of CBD could interact with the drug and cause a toxic overdose. Each child should have an individual prescription to achieve exact dose titration.
Adults and children metabolize drugs differently. Surprisingly, young children can tolerate high doses of cannabis concentrates which might be overwhelming for an adult. This is why you should never calculate dosage for a child based on what works for an adult.
CBD side effects on children
Side effects of taking CBD range from dry mouth to dizziness and nausea.
In a study conducted by Kerstin Iffland and Franjo Grotenhermen for the International Cannabinoid Research Society, thousands of individual medical CBD cases were analyzed to explore data on the side effects of CBD. According to the findings, most patients reported fatigue, diarrhea, and slight changes in appetite and weight. When compared to conventional invasive medication for treating epileptic seizures, CBD was far more preferable than prescription drugs. [R]
In a 2011 review entitled Safety and Side Effects of Cannabidiol, researchers found that controlled administration of CBD was safe and non-toxic for humans and animals. CBD does not affect physiological parameters such as heart rate, blood pressure, or body temperature. [R]
In June 2017, Korean scientists published the results of their one-year study involving over 200 children with treatment-resistant epilepsy. These kids located across the United States required numerous medications for repeated seizures. During the trial, they were given very large doses of CBD. After 12 months, the researchers observed a reduction in seizures by 30 percent with minor side effects such as drowsiness, decreased appetite, and diarrhea. [R]
One thing to note is that these side effects can turn serious if CBD interacts with certain medications. When CBD interacts with pharmaceuticals, it inhibits the activity of cytochrome P450 – a group of liver enzymes – and prevents the drug from metabolizing as expected. CBD could potentially cause an adverse reaction when taken with steroids, antibiotics, antihistamines, calcium blockers, immune modulators, antipsychotics, benzodiazepines, anesthetics, anti-epileptics, antidepressants, and beta blockers.
Based on Charlotte's story and other clinical evidence, we now know that CBD is safe for children. But not all CBD products are created equal. Here are a few things you must understand before administering CBD to your children.
THC vs. CBD
THC and CBD are the two most dominant compounds in the cannabis plant.
THC is the active ingredient in marijuana that binds to the CB1 receptor in the brain to create a high. Formulas that contain a more THC than CBD can produce stronger psychoactive effects.
CBD does not bind with CB1 receptors in the brain so it is impossible to get high. If you want a clean therapeutic solution, make sure that the CBD product you are purchasing does not contain THC.
Medical cannabis for treating pediatric disorders often comes in a CBD-to-THC ratio of 19-to-1. Some medical professionals argue that CBD is not as effective when administered alone compared to working in conjunction with THC.
CBD oil that is extracted from hemp does not contain any THC. If you do not want to give your child any THC, then hemp-derived CBD is the best option for you.
Not all CBD products are created equal
In most states, it is illegal for dispensaries to sell over-the-counter CBD oil that contains any amount of THC. The Internet, on the other hand, is an unregulated market. The FDA has been cracking down on online vendors that sell CBD oil with THC.
Choosing CBD oil for your child requires prudence. Screen every manufacturer carefully before you place an order. CBD products may vary greatly in potency and quality. Read product reviews, talk to other parents, and do your own research to learn more about CBD for kids.
Research on CBD for kids is insufficient
The CBD industry is quite young so there is little documented research to support the possible therapeutic benefits of this cannabinoid. However, there is ample anecdotal evidence and surface research to support the role of CBD in treating autism, anxiety, ADHD, sensory processing, depression, and other pediatric disorders. Some medical doctors even acknowledge the benefits of taking CBD as natural therapy.
Because CBD research has been lacking, it is imperative that you consult your doctor before giving your child CBD. Your physician might prescribe a specific CBD product instead of generic over-the-counter oils. Doctors can also warn you of possible CBD reactions to other medications.
CBD oil is not cheap
Parents who rely on CBD to maintain a medication regimen for their children may have to pay upwards of $500 per month out of pocket. Most insurance companies do not cover CBD treatment so it could cost you a fortune to purchase CBD regularly.
The cost of taking CBD depends on the type of CBD product, where it was grown and processed, and specific tax laws in the state you live in. If you want to continue administering CBD to your child and are struggling with expenses, ask your local representative to push insurance firms to cover the cost.
CBD route of administration for children
CBD can be a game changer for children who are in dire need of relief if it is legally purchased and prescribed by a doctor. There is an abundance of anecdotal reports where CBD oil has been highly effective in treating seizures, autism, ADHD, and anxiety in children. But Dr. Frank Lucido, a cannabis expert from Berkley, California, cautions against giving children CBD without a doctor recommendation. Always speak with your pediatrician before administering CBD. Each formula contains a different CBD-to-THC ratio and only a doctor can determine the best treatment option for your child's symptoms.
According to Dr. Lucido, the best way to administer cannabidiol to a child is by placing a few drops of CBD tincture under the tongue or on the side of the cheek. If the child resists, another alternative is to mix the CBD with food. Because cannabidiol is fat-soluble, it is not advisable to mix it with a glass of water. If you administer CBD this way, the compound might just stick to the side of the glass. CBD mixes better with milk and oils.
CBD also comes in edible form – CBD gummies in particular can be an enjoyable treat for children but might contain too low a dose if you are treating a serious illness like epilepsy.
CBD has become an increasingly popular plant-based option for mitigating the symptoms of childhood illnesses. For children who continue to suffer from poor quality of life with no effective pharmaceutical remedy in sight, parents have turned to cannabis as a last option. Countless families have witnessed how CBD seemingly brought their child back to life, now living like a regular kid without the daily seizures, weekly trips to the doctor, emergency room visits, or the dangerous side effects of medications.
There are so many children who live with debilitating diseases like Charlotte Figi, Haley Hilt, and Jaelah Jerger. These kids go through different treatment plans, medications, and even surgeries at a very young age. If you are a parent with a sick child, do not be afraid to ask your doctor about the possible benefits of CBD.
Although many studies have demonstrated the anti-tumor, anti-epileptic, anti-inflammatory, anti-anxiety and anti-depressant properties of CBD, there is very little data on its safety profile on children. Restrictive laws and social stigma have also contributed to the difficulty of conducting clinical trials. [R]
Administering CBD to kids poses three problems:
- There is no solid evidence on what long-term effects will appear later in life if a child starts taking CBD at a young age
- CBD treatment can be expensive
- Some CBD oil vendors do not disclose their entire ingredients list, do not follow accurate dosing measurements, or fail to have their products tested at a reputable laboratory
Available research on CBD for kids is mostly focused on seizure disorders such as epilepsy. The evidence is largely anecdotal for other medical conditions.
Another problem with CBD is that clinical trials are focused on the action and benefits of a purified CBD compound – not the CBD extract that is sold commercially.
Because the CBD market is not regulated, consumers have to rely on the quality assurances of the manufacturer. While CBD by itself does not appear to be dangerous, many CBD products contain toxic chemicals or synthetic CBD oil. In Utah, there were 52 cases of serious adverse effects related to CBD ingestion, including seizures, loss of consciousness, vomiting, nausea and altered mental state. After a thorough investigation, it was revealed that there was no CBD at all in the blood samples but 4-cyano CUMYL-BUTINACA (4-CCB) or fake CBD oil.
Whether you are a parent desperate for solutions or simply curious about CBD, we should all support the call for more research on cannabinoids.
If you are wondering whether CBD could help your child, talk to your child's doctor and do extensive research. Choose a CBD product that is doctor prescribed and have been independently tested.