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By Amy Norton<\/b>
HealthDay Reporter<\/i><\/p>\n
MONDAY, July 13, 2020 (HealthDay News)<\/p>\n
Parents are increasingly interested in whether medical marijuana<\/a> can help their children with problems like cancer<\/a>-related pain<\/a> and nausea<\/a> — but there’s concern about interactions with their medications and a general lack of research.<\/p>\n That’s one of the main takeaways from a new report in Pediatrics<\/a><\/i> detailing one hospital’s approach to medical marijuana<\/a>.<\/p>\n Doctors at Children’s Hospital Colorado do not prescribe medical marijuana<\/a>. But when kids are admitted, some are already using some form of it. In other cases, parents want to know if it might help with persistent problems like nausea<\/a> or pain<\/a>.<\/p>\n Several years ago, the hospital decided it needed a formal policy on the matter. It wasn’t just about deciding whether kids could use the products in the hospital, according to Dr. David Brumbaugh, associate chief medical officer.<\/p>\n It was also about giving parents accurate information and “having an open conversation,” he said.<\/p>\n “We don’t want to just say, ‘No, you can’t do this in the hospital,’ because that’s not right,” Brumbaugh said. “But also, families might continue to use it without telling us.”<\/p>\n And, he said, it’s important for doctors to be aware of all medications or supplements<\/a> a child takes. A major reason is the potential for those substances to interact — possibly creating side effects or lowering the effectiveness of a vital medication.<\/p>\n As part of its policy, the hospital created a consultation service to give families information. It was also needed to support hospital staff, who could not be expected to have all the answers on medical marijuana<\/a>.<\/p>\n In the August issue of Pediatrics<\/a><\/i>, Brumbaugh’s team describes the hospital’s experience with the first 50 children seen by the service.<\/p>\n A full 80% had cancer<\/a>, and their parents had either already started them on medical marijuana or wanted information about it. (In Colorado, kids under 18 can use it if two separate physicians certify to a medical need, and parents give consent.)<\/p>\n Most often, parents were seeking help for their child’s nausea<\/a> and vomiting<\/a>, appetite loss<\/a> or pain<\/a>.<\/p>\n “That speaks to a real need out there,” Brumbaugh said. “We still don’t have enough treatments for improving quality of life.”<\/p>\n But whether medical marijuana fits the bill is unknown.<\/p>\n “There really is an absence of data in kids and adults, too,” Brumbaugh said. It’s hard to study, because federal law deems marijuana a schedule 1 drug — meaning it has no accepted medical use and a high potential for abuse.<\/p>\n Complicating matters, the cannabis plant is not one thing; marijuana is a variety, as is hemp. And they contain many compounds, of which THC — famous for the marijuana “high” — is only one.<\/p>\n Another compound, cannabidiol (CBD), has become wildly popular — showing up in commercially available oils, capsules and edibles. It does not produce a high.<\/p>\n A majority of the 50 children in this report were taking CBD-only products. Brumbaugh said there’s some reassurance in that, but it doesn’t mean the products are safe, either.<\/p>\n In fact, of the 50 kids, consultations deemed medical marijuana potentially unsafe for 64%. It was almost always because of possible interactions with their medications, Brumbaugh said.<\/p>\n Often, parents were advised to change the timing of the medical marijuana, to make interactions less likely. In one-quarter of cases, the advice was to avoid the products altogether.<\/p>\n The scenario sounded familiar to Dr. Anup Patel, a pediatric neurologist<\/a> at Nationwide Children’s Hospital in Columbus, Ohio.<\/p>\n “Drug interactions<\/a> are one of my major concerns,” Patel said.<\/p>\n Like many medications, cannabis chemicals — including THC and CBD — are metabolized by the liver<\/a>, he explained. When cannabis and other medications are metabolized by the same liver enzymes<\/a>, they are essentially competing: So medication levels in the blood could either be too high (causing side effects) or too low (compromising effectiveness).<\/p>\n Aside from safety, there is the question of effectiveness. There are approved medications containing human-made THC used for nausea<\/a> related to cancer<\/a> therapy. And one drug — a purified form of CBD called Epidiolex — is approved for treating certain forms of epilepsy<\/a>.<\/p>\n
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