Cannabidiol (CBD) is a compound found in both medical marijuana and industrial hemp plants that is gaining popularity for its therapeutic potential without any of the psychoactive effects related to marijuana.
As any parent knows, even if a medicine or supplement is great for adults, that does not necessarily apply to children.
In this article, we will use scientific studies and their findings to try and help you answer the following questions. Is CBD safe for children? How effective is CBD for kids? What uses have scientific studies found evidence for when it comes to the therapeutic potential of hemp oil products for the pediatric population?
What is CBD?
Cannabidiol, also known as CBD oil or hemp oil, is a compound that is found in the Cannabis sativa plant.
This plant contains both medical marijuana plants and industrial hemp plants, with these two varieties being bred for different purposes, leading to differing chemical compositions.
Medical marijuana plants are much higher in THC (tetrahydrocannabinol), the compound in weed that is responsible for the “high” feeling that comes from it. Industrial hemp plants tend to have much lower concentrations of THC and higher concentrations of CBD.
CBD and THC belong to a group of compounds known as cannabinoids, with over 85 found in the Cannabis sativa plant. These compounds have been found to interact with the endocannabinoid system (ECS), a lipid signaling system found in the body of humans and many other animals.
It is important to understand the difference between CBD products and high-CBD strains of medical marijuana. CBD products are not medical marijuana and thus do not have the psychoactive effects.
Both CBD products and high-CBD strains of medical marijuana have been found to help those suffering from a variety of conditions, however for those seeking the therapeutic benefits without the “high” feeling, CBD products are the way to go.
How Does CBD Work?
There are multiple mechanisms of action of cannabidiol.
The first has to do with the way that CBD interacts with the ECS.
The ECS is made up of endocannabinoids (cannabinoids produced by the body), cannabinoid receptors, and enzymes responsible for the synthesis and breakdown of cannabinoids.
There are two cannabinoid receptors: CB1 and CB2 receptors. CB1 receptors are located mostly in the brain and have been found to be involved in the reduction of inflammation and pain, and are also involved in memory, cognitive ability, sensory perception, movement, and neurotransmitter release. (1)
While THC has an affinity for CB1 receptors, which is why it is believed THC produces psychoactive effects, CBD does not have a high affinity for these receptors.
While cannabidiol does not have a strong binding affinity for CB1 receptors, it has been found that CBD slows the enzymatic breakdown of the endocannabinoid anandamide. This allows anandamide to stay in the system longer, possibly providing medicinal benefit as it does bind to CB1 receptors.
Cannabidiol effects have been tied to the way that they impact the immune system. CBD has been found to mediate the release of cytokines from immune cells, which appears to help reduce pain and inflammation. (1)
These are only two of numerous ways that CBD hemp oil works in the body, with others involved in mood, anxiety, sleep, metabolic syndrome, headaches, nausea, pain, inflammation, and possibly osteoporosis. (1)
Researchers are continuously learning more about how cannabinoids work in the body, with hope for future medicinal roles of the cannabinoids found in Cannabis sativa, such as CBD, and even synthetic cannabinoids created by humans.
What Evidence Exists for Treating Kids with CBD or Cannabis Products?
Currently there are countless preclinical studies demonstrating the benefits of cannabidiol, but fewer human studies. Here we will review the evidence that comes from studies on humans and those that evaluate the role of CBDs in children.
Case Study: Cannabidiol Oil Reduces Pediatric Insomnia and Anxiety in a Young Girl with Posttraumatic Stress Disorder (PTSD)
In a 2016 study published in The Permanente Journal, a 10-year-old girl who was suffering from anxiety and sleep trouble attributed to PTSD was treated with CBD oil after little relief and major side effects from pharmaceutical medications. (1)
For 5 months the patient was given 25 mg of an oral CBD oil supplement every night at bedtime, and 6 mg to 12 mg of a sublingual CBD spray during the day when needed for anxiety relief.
Over the 5 month period, the patient demonstrated a gradual decrease in anxiety symptoms and a gradual increase in sleep quantity and quality as measured by the Screen for Anxiety Related Disorders and Sleep Disturbance Scale for Children, respectively.
The legal guardian of the patient reported overall improvements in her ability to sleep alone and her handing the school year with less anxiety and more appropriate behavior.
There were no observed side effects from taking the CBD oil supplement or sublingual spray.
The researchers concluded that CBD oil was safe and effective at reducing the anxiety and insomnia secondary to PTSD in this young girl, supporting the sleep-inducing and anxiolytic effects of CBD oil.
Studies Demonstrate Effectiveness of CBD for Treatment of Pediatric Epilepsy
In a 2017 review published in the Journal of Epilepsy Research, studies conducted to determine the effectiveness and safety of cannabidiol as a treatment for intractable childhood and adolescent epilepsy were examined. (2)
While there exist many antiepileptic drugs, many children continue to have uncontrolled seizures. In fact, roughly 1 out of every 3 patients with epilepsy have treatment-resistant epilepsy. (3) The impact of cannabidiol and other Cannabis sativa compounds have been investigated in these cases of intractable epilepsy.
In most of the studies that were examined, the initial treatment doses of CBD were 2-5 mg/kg of body weight/day, divided into two doses. (2) These doses were slowly increased by 2-5 mg/kg/day weekly until a maximum dose of 25 mg/kg/day or an intolerance was reached. Some studies did increased to the maximum of 50 mg/kg/day set by the US Food and Drug Administration, with the average dose of CBD at 200-300 mg/day.
Many of these studies did show CBD to be effective for the treatment of epilepsy in children.
One of these studies was published in 2016 in The Lancet Neurology. (3) This study was an open-label trial at 11 epilepsy centres in the US with 162 patients aged 1-30 years old who had intractable, severe, childhood-onset, treatment-resistant epilepsy.
Patients were given oral cannabidiol at 2-5 mg/kg/day with a slow increase to a maximum dose of either 25 mg/kg/day or 50 mg/kg/day depending on the site. Following 12 weeks of treatment, the percentage change in motor seizure frequency was measured.
Following 12 weeks of treatment, the average reduction in monthly motor seizures was 36.5%, leading researchers to conclude that cannabidiol may reduce the frequency of seizures in both children and young adults, and the safety profile in the study was adequate.
In this study and the others examined in the 2017 review published in the Journal of Epilepsy Research, the majority of side effects from the CBD treatment were mild, including decreased appetite diarrhea, and drowsiness.
More severe reactions were reported, such as epilepticus, however it is not clear if this was related to the CBD.
It is important to note that many of these trials were limited by design, such as a survey or open-label design, leaving the need for future double-blind, controlled trial studies relating to CBD and pediatric epilepsy.
How Safe is Cannabidiol for Kids?
As outlined in the above studies, CBD appears to be well-tolerated in children. That said, more studies need to be done to confirm these results.
Side effects are possible, so it is best to start small and slowly work up if you do decide to try CBD oil as a treatment for any condition for children.
Concluding Remarks on Cannabidiol for Children
As the legal status of Cannabis sativa and its constituents, such as CBD oil, expand, so does the funding and breadth of research done to understand how CBD may help with a variety of conditions along with safety and dosage.
Currently there has been very little research done on CBD and children outside of intractable epilepsy, however these findings have been so promising that many states allow CBD and medical marijuana solely for those with pediatric epilepsy.
It is likely that CBD will have similar effects in children as it does in adults, so it is possible that CBD products may help children with pain disorders, nausea, neurological conditions, anxiety, depression, and many other conditions.
- Shannon, S, Opila-Lehman, J. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. The Permanente Journal. 2016; 20(4):108-111. doi 10.7812/TPP/16-005
- Chung Mo Koo, Hoon-Chul Kang. Could Cannabidiol be a Treatment Option for Intractable Childhood and Adolescent Epilepsy? Journal of Epilepsy Research. 2017; 7(1):16-20. doi 10.14581/jer.17003
- Devinsky O, Marsh E, Friedman D. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. The Lancet Neurology. 2016; 15(3):270-8. doi 10.1016/S1474-4422(15)00379-8