Israel’s association of pediatricians has issued a position paper warning against the dangers – known and unknown – of the use of medical marijuana for children.
Medical marijuana is prescribed very rarely for children in Israel – out of 18,000 permits only a few hundred were issued for pediatric treatment, mainly for children with cancer or cerebral palsy. In March 2014 the Health Ministry announced that children with severe epilepsy, where other drugs did not help, would be allowed to apply for permits; 90 such permits have so far been issued to children with severe epilepsy.
The public has shown great interest in the use of medical marijuana, including for children, leading the Israel Ambulatory Pediatric Association to issue its position paper expressing reservations over the use of the drug for children.
“Few reports exist in the medical literature, as opposed to many unfounded reports of the efficacy of cannabis for various illnesses. In addition, elements with a vested interest stress the advantages (proven and unproven) through all the media. As a result, the demand has gone up among patients and their families for the use of medical cannabis for children as well,” the report states.
The report quotes various studies regarding the use of cannabis for children under the age of 18. Studies that included large numbers of participants who began using cannabis before the age of 16 were shown to have significantly lower IQs at age 30 than people with similar socioeconomic characteristics due to lowered motivation. A decline in cognitive function was also observed beginning a few hours after exposure and in the long term, the report states.
The pediatric association also notes that MRI, PET and CT scans show changes in the central nervous system, and other tests showed changes in the central nervous system relating to emotions and some cases of psychosis and anxiety attacks.
Some users develop dependency on the drug, although this finding varies among the different studies.
Because there is no information on dosage, it is difficult to determine the concentration of the materials administered, thus giving rise to concerns over possible toxicity given the lower weight of children, according to the position paper.
The pediatric association advises the Health Ministry to transfer any request for medical marijuana for children to a pediatrician with experience prescribing the drug, and to create a system of communication among pediatricians seeking recommendations on the matter, so they can determine indications, use and follow-up.
The association also recommends that family physicians exhaust all other treatment options before turning to cannabis, except in terminal patients, and to make the risks clear to children and their parents.
“Cannabis should not be recommended for children with a known tendency to psychosis or a family history of mental illness,” the paper states.
A study underway in Israel at the Wolfson Medical Center, Sheba Medical Center at Tel Hashomer, Ichilov Hospital and Assaf Harofeh Hospital seems to show positive results of treatment with cannabis. The study is following 72 children with severe epilepsy who have been treated for three months with cannabis oil containing a very small concentration of the drug’s psychoactive substance. The final results are not yet in, but the interim results showed a 75-percent decline in epileptic attacks and an improvement in quality of life.
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