Cannabidiol (CBD) products are wildly popular among older adults for treating chronic pain and anxiety, and a new poll suggests that nearly three-quarters of U.S. parents think CBD might also be a good option for their kids when other meds don't work.
On the other hand, more than that - 83% - think CBD products should be regulated by the U.S. Food and Drug Administration, while 74% said they should require a doctor's prescription.
The poll results suggest that parents have limited knowledge about CBD products, said poll co-director Sarah Clark. It's important that parents talk with their pediatrician or other health care providers if they're considering giving CBD products to their children, she added in a University of Michigan Health news release.
Dr. Renee Shellhaas is a pediatric neurologist at University of Michigan Health C.S. Mott Children's Hospital, who was not involved with the poll. She said, "It is always important to make sure your child's doctor is aware of all of the medicines and supplements you are giving. Open and honest communication is the best way to make sure we work as a team to find the best treatment plan for your child."
Shellhaas distinguished between unregulated CBD products and Epidiolex, the CBD medication approved by the U.S. Food and Drug Administration and available by prescription only for children with specific types of epilepsy.
"As an epilepsy specialist, I view this as one more medicine on my list of treatments for difficult-to-control epilepsies. We see some children with treatment-resistant epilepsy whose seizures improve with this medication, but others see no benefit or have important side effects," Shellhaas said.
Shellhaas said she does not endorse or prescribe unregulated CBD for several reasons, including that the products do not have predictable or consistent ingredients. It's not possible to know how much CBD a person receives when taking an unregulated product or what else they're ingesting. It is also expensive and not covered by health insurance.
The FDA-approved form of the drug as a treatment in combination with the anti-seizure medication valproic acid can cause seriously low platelets, so doctors monitor blood counts regularly for children on this regimen. It is also important to periodically check for liver dysfunction.
CBD can have side effects in kids
Shellhaas said that use of unregulated CBD in children was concerning to her because it was not possible to know exactly what the children would be taking, what the long-term effects would be and whether a medical professional would be monitoring for liver function and blood counts. If the CBD product contained THC, the psychoactive ingredient in cannabis, it might also have negative impacts on the developing brain, she added.
"Families try alternative therapies because they want their children to feel better. As a doctor, I want children to feel better, too," Shellhaas said. "We want to use medicines safely and carefully, to make sure that what we give to a child does more good than harm."
The nationally representative poll surveyed 1,992 U.S. parents of children aged 3 to 18 in October 2021.
Most parents (71%) said they had never used a CBD product themselves, and only 5% used CBD products regularly. Only 3% said they knew a lot about CBD use in children, and a combined 80% either didn't know much about it or had never heard about it before the poll.
Important factors that parents would consider when deciding whether to give their children a CBD product included, in descending order of importance, side effects, safety testing, how well it works in children, recommendation of their child's doctor, FDA approval and product reviews.
About one-third of parents said they thought that taking CBD was the same as using marijuana.
While studies have researched CBD for use in attention-deficit/hyperactivity disorder, anxiety, insomnia and depression, research on these uses is limited. CBD also must have less than 0.3% of THC, the component in marijuana that delivers the high, and lack of regulation raises questions about quality control, the poll noted.
Dr. Karen Keough, a pediatric neurologist in Texas who works mostly with patients who have epilepsy, does prescribe CBD for some, including products from a medical cannabis dispensary in Texas, where she also serves as the chief medical officer.
For some parents, CBD a good treatment option
The parents in the poll offer a different perspective than those Keough typically sees in her practice, many of whom come to her having done their own research into possible treatments, including CBD.
Keough thinks CBD and other forms of medical cannabis should be prescribed by a physician and with the treatment guided by a physician, rather than purchased on their own when it's not clear if the ingredients are what they claim to be. It's a medicine, she said, and should be treated like one.
She does prescribe the products for her pediatric patients.
"To me that's what my job is, as a doctor, to know how to use this medicinal product appropriately," Keough said, "but it's controversial in the medical world because it lacks the rigor of scientifically based studies that get you to FDA approval, so that's why many physicians won't touch it."
Some large academic medical centers have policies disallowing prescribing the drugs, while others do not, so the treatment options are inconsistent, depending on where you live, she added.
Most of Keough's patients have epilepsy. Other conditions she has seen it prescribed for include spastic cerebral palsy, autism and as palliative care for young, terminally ill patients.
"I can't pretend it isn't there, because my patients are using it whether I help them or not. And I would rather that I help them," Keough explained.
The U.S. Food and Drug Administration has more on Epidiolex, the approved CBD medication for epilepsy.
SOURCES: Renee Shellhaas, MD, pediatric neurologist and clinical professor, C.S. Mott Children's Hospital, Ann Arbor, Michigan; Karen Keough, MD, assistant professor of pediatrics and neurology, Dell Medical School, University of Texas, Austin, and clinical associate professor, pediatrics, Texas A&M College of Medicine, Bryan, Texas, and chief medical officer, Compassionate Cultivation, Austin, Texas; C.S. Mott Children's Hospital National Poll on Children's Health, Feb. 21, 2022