Efficacy and safety of paediatric medicinal cannabis use: A scoping review

Pawliuk, Colleen; Chau, Briana; Rassekh, Shahrad R.; McKellar, Terri; Siden, Harold

doi:10.1093/pch/pxaa031

Cited by 21 publications

(17 citation statements)

References 43 publications

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“…and H.S.). 7 A librarian working with the team conducted the MEDLINE search for experiences, attitudes and opinions of caregivers for pediatric patients using medical cannabis. The search found very limited data.…”

Section: Data Collectionmentioning

confidence: 99%

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Family attitudes about and experiences with medical cannabis in children with cancer or epilepsy: an exploratory qualitative study

Gibbard

Mount

Rassekh

et al. 2021

cmajo

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P ediatric use of medical cannabis entered widespread public consciousness in 2013, when the CNN television network aired Weed, a documentary highlighting its therapeutic benefits in children with severe epilepsy. 1 Since then, pediatric medical cannabis has continued to gain societal and scientific attention. [2][3][4][5] Cannabis contains 2 main cannabinoids with proposed medicinal effects: cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC). 6 Cannabidiol reduces seizure frequency and duration in children with treatmentresistant epilepsy, 7 specifically Dravet syndrome; 8-10 THC is known to have antiemetic, appetite-stimulant and analgesic effects useful in cancer treatment. [11][12][13][14][15] We use the term medical cannabis for any combination of CBD and THC.In 2018, Canada became the second nation to legalize cannabis for both recreational and medical use. Products under pharmaceutical regulations (Controlled Drugs and Substances Act [S.C 1996, c. 19]) are available via prescription as semisynthetic drugs 16 or highly purified plant-derived drugs. 17 Nonpharmaceutical, standardized cannabis extracts are available with medical authorization from more than 150 licensed producers, (Cannabis Act [S.C. 2018, c. 16]). Additionally, adults may obtain cannabis intended for recreational use, without medical authorization, from retail stores, called dispensaries, or black market sources. 18,19 Provenance of cannabis from dispensaries is often unknown. Cannabis can also be grown at home.There is a lack of robust evidence to guide cannabis practices across pediatric medical disciplines. 2,20,21 The Canadian Paediatric Society does not support its use, except on a carefully considered, case-by-case basis, citing limited evidence and potential harms. 2 Thus, in Canada, use of medical cannabis is most known in children with severe conditions. Few

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Section: Data Collectionmentioning

confidence: 99%

“…*Categorization based on Pawliuk et al7 † Refers to homemade or store-bought products that have not been licensed for medical use, often intended for recreational use.…”

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Family attitudes about and experiences with medical cannabis in children with cancer or epilepsy: an exploratory qualitative study

Gibbard

Mount

Rassekh

et al. 2021

cmajo

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“…Previous reviews have examined the evidence for medicinal cannabis in treating medical conditions in paediatric populations (Pawliuk et al, 2020; Wong & Wilens, 2017). A 2020 systematic review of cannabinoids in ASD highlighted significant knowledge gaps but did not focus on a paediatric population (Fusar‐Poli et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Medicinal cannabis in children and adolescents with autism spectrum disorder: A scoping review

Fletcher

Pawliuk

et al. 2021

Child

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Background Autism spectrum disorder (ASD) is a neurodevelopmental condition estimated to affect 1 in 66 children in Canada and 1 in 270 individuals worldwide. As effective therapies for the management of ASD core and associated symptoms are limited, parents are increasingly turning to clinicians for advice regarding the use of medicinal cannabis to manage behavioural disturbances. Objective The objective of this scoping review was to identify and map symptoms, outcomes and adverse events related to medicinal cannabis treatment for ASD‐related behaviours. Methods Ovid MEDLINE, Embase, CINAHL, PsycInfo, Web of Science Core Collection, Google Scholar and grey literature sources were searched up to 5 January 2020 for studies. Included studies met the following criteria: (1) investigate the use of medicinal cannabis, (2) at least 50% participants had ASD, (3) at least 50% of the study population was 0–18 years old and (4) any study design (published or unpublished). Results We identified eight completed and five ongoing studies meeting the inclusion criteria. All studies reported substantial behaviour and symptom improvement on medicinal cannabis, with 61% to 93% of subjects showing benefit. In the three studies reporting on concomitant psychotropic medication usage and with cannabis use, up to 80% of participants observed a reduction in concurrent medication use. Adverse events related to cannabis use were reported in up to 27% of participants related, and two participants had psychotic events. Conclusions Early reports regarding medicinal cannabis in paediatric ASD symptom management are presented as positive; the evidence, however, is limited to very few retrospective cohort and observational studies. Evidence of safety and efficacy from prospective clinical trials is needed.

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“…Caregivers are becom ing aware of evidence that suggests medical cannabis provides benefit for children with conditions that include drugresistant epilepsy, cancer pain and autism. 1,2 At present, children and youth aged 18 years and younger (henceforth referred to as chil dren) access medical cannabis through a framework regulated by Health Canada. In 2018, the Cannabis Act (Bill C45) created separate medical and recreational streams for purchasing canna bis.…”

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Improving the regulation of medical cannabis in Canada to better serve pediatric patients

Huntsman

Kelly²,

Alcorn

et al. 2021

CMAJ

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Efficacy and safety of paediatric medicinal cannabis use: A scoping review

Cited by 21 publications

References 43 publications

Family attitudes about and experiences with medical cannabis in children with cancer or epilepsy: an exploratory qualitative study

Family attitudes about and experiences with medical cannabis in children with cancer or epilepsy: an exploratory qualitative study

Medicinal cannabis in children and adolescents with autism spectrum disorder: A scoping review

Improving the regulation of medical cannabis in Canada to better serve pediatric patients

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