Medical Cannabinoid Products in Children and Adolescents.

Abstract

1. Kathleen K. Miller, MD* 2. Jonathan D. Klein, MD, MPH† 1. *Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN 2. †University of Illinois at Chicago, Chicago, IL Cannabinoid-containing products have become increasingly ubiquitous worldwide, both through legalization of recreational marijuana and widespread use of cannabinoid derivatives in medical products. In the United States, the Centers for Disease Control and Prevention (CDC) reported that more than 1 in 3 adolescents said they have tried recreational marijuana in 2017. Pediatricians should be aware of the limitations of cannabinoids as medical treatments, and should knowledgeably counsel patients about their potential risks and benefits. Cannabinoids are derived from the cannabis plant, which contains a variety of metabolically active compounds, of which the most well-known are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is derived primarily from marijuana plants, and CBD primarily from hemp plants. THC is the primary psychoactive ingredient in marijuana and is responsible for the “high” associated with marijuana use. CBD, conversely, does not have psychoactive effects. In recent years, CBD has experienced a surge in popularity as an alternative treatment for a variety of ailments. Manufacturers have claimed that it has anxiolytic and anticonvulsant properties and that it can treat chronic pain, insomnia, and posttraumatic stress disorder. Recreational marijuana and plant derivatives of cannabis that can be smoked or ingested in edible forms contain THC in addition to other, less psychoactive cannabis-derived compounds. Only one cannabinoid derivative is Food and Drug Administration (FDA)–approved for use in children: dronabinol is approved for the treatment of nausea and vomiting induced by chemotherapy. Synthetic cannabinoids, also known as spice or K2, have neither therapeutic properties nor medical …