Medical marijuana: What’s all the buzz?

PHOTO: ADOBE STOCK

Is medical marijuana safe for children and teens? Depending on who you ask, you may get very different answers.

On one side, pro-marijuana websites, marijuana companies and dispensaries are keen to promote the numerous (often unproven) benefits of using marijuana for medical reasons. On the other side, many public health agencies, community organizations and pediatric providers warn about the risks of marijuana use during childhood and adolescence, making it quite challenging to form an unbiased opinion. 

Medical marijuana: The facts

Interestingly, the term “medical marijuana” does not come from the medical profession. Rather, the term was coined by the cannabis industry to describe any marijuana product, coming from the marijuana plant itself or its derivatives, used for medical reasons.

There is an important difference between medical marijuana products and medications that are approved by the Food and Drug Association (FDA). Currently, there are three FDA-approved medications that are made from marijuana substances (Nabilone, Dronabinol and Epidiolex), but those are not sold in medical marijuana dispensaries and are only prescribed in very specific circumstances.

The main difference between marijuana sold in medical dispensaries and that sold in recreational dispensaries lies in the way it is controlled. Medical marijuana must meet certain hygiene and quality measures determined by the state, whereas recreational marijuana is usually less controlled. That said, in both cases there is no limit on the strength or concentration of marijuana products, which can make them very risky, especially for youth.  

The marijuana plant contains more than 100 different substances, often referred to as cannabinoids. The two most common ones are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is known to produce the euphoric effects (“high”) that most people experience when they use marijuana. THC is also associated with several negative effects on the brain, specifically in adolescents and young adults. CBD isn’t known to have a euphoric effect and is thought to have anti-inflammatory properties.

Research about CBD is just getting started, so it is still unclear if the properties of CBD can actually translate into medical benefits, especially in children and adolescents. An important point is that many products labeled as CBD also contain THC and several other cannabinoids that we know very little about.

Minors and medical marijuana

Research shows that children and teens with some rare forms of epilepsy that is resistant to other medications can benefit from the medication Epidiolex, made with CBD. Medical marijuana could also be helpful for some young people with cancer who experience severe side effects from chemotherapy. For other indications, there still isn’t enough research to show whether medical marijuana could be a safe and effective option.

In adults, marijuana has been shown to help with some chronic medical conditions like multiple sclerosis or chronic pain, but this has not been shown in young people.  

It is currently possible for minors to obtain a medical marijuana card allowing them to purchase marijuana from a medical dispensary, but only under certain strict conditions. It is important to note that doctors cannot prescribe “medical marijuana”; they can only make general recommendations around it. Unfortunately, since almost all medical marijuana products haven’t been tested by researchers or approved by the FDA, it is very difficult to verify if they are safe. What we do know, however, is that when teens use marijuana, medical or not, they place themselves at risk of experiencing several harmful consequences.

Take home messages

It is not uncommon for teens to use marijuana obtained from medical dispensaries to get “high.” Teens need to understand that the fact that marijuana comes from a dispensary does not make it safe to use.

Because their brains are still developing, adolescents are more vulnerable to the negative effects of marijuana and at higher risk of developing marijuana addiction than adults.

While certain forms of marijuana, like edibles, marijuana vaporizers (or “dab pens”) may have less of the harmful chemicals found in smoked marijuana, they often contain very high concentrations of THC, (up to 90 percent or more). This can have serious negative effects on how the brain functions and lead to memory, attention and intellectual problems.

Except in a few specific conditions, such severe epilepsy or cancer treatment, the potential risks of using marijuana for medical purposes as a young person usually outweigh potential benefits. In most situations, there are several other treatment options available that are likely to be safer, better researched and, ultimately, more effective.

There are still many things that we do not know about medical marijuana. While it is possible that new or existing medical marijuana products will eventually be considered safe and effective enough to be used by children and adolescents, for the time being, it is best to remain cautious and avoid using these products unless discussed with a medical provider.

Learn about Boston Children’s Adolescent Substance Abuse and Addiction Program (ASAP).

About the author: Dr. Nicholas Chadi is a pediatrician specializing in adolescent and addiction medicine. He is the first pediatric addiction medicine fellow in North America and is currently conducting clinical and research work with the Adolescent Substance Use and Addiction Program (ASAP) at Boston Children’s Hospital. Follow him on Twitter @nicholaschadi or at www.nicholaschadi.com.