Is CBD Oil Safe For Children With Anxiety And ADHD?
Dr. Mubina Agboatwalla is a well-known pediatrician, practicing paediatrics since the last 20 years in Karachi Pakistan. She is the head of the department of Pediatrics in Karachi Liaquat Hospital, as well as her private practice in three s. more
Swati Patwal is a clinical nutritionist and toddler mom with over eight years of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and. more
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If you are unaware of using Cannabidiol or CBD oil for kids, you should be reading this post. CBD oil is a component found in the Cannabis Sativa family’s hemp and marijuana plants, making individuals feel high. (1). The oil has gained popularity in recent years for treating various conditions, including chronic pain, stress, insomnia, nausea, and vomiting.
Different procedures are used to extract the oil, including carbon dioxide extraction, ethanol extraction, and hydrocarbon extraction (2). After extraction, the oil is refined and marketed as tinctures, capsules, topicals, chewable gummies, beverages, and other products.
This post discusses the safety of CBD oil for children, including its advantages, age-appropriate dosage, and potential side effects and hazards associated with its use.
Is CBD Oil Safe For Children?
There’s no scientific evidence to prove the safety and efficacy of CBD oil for children. However, one CBD product, namely Greenwich Biosciences’ Epidiolex, has been approved for use as a part of a regulated medication to treat epilepsy in children by the US FDA (3). This prescription drug contains a purified form of CBD that helps treat seizures in children that occur in rare and severe epilepsy forms, such as Lennox-Gastaut syndrome and Dravet syndrome (4).
Since these epilepsy forms do not respond to anti-seizure medications, CBD use becomes crucial. However, remember that using CBD oil as a standalone medication to treat epilepsy in children isn’t well-researched. Thus, if you want to use CBD oil for treating epilepsy or any other ailment in your child, consult a pediatrician.
Note: CBD is often confused with THC (tetrahydrocannabinol), another cannabinoid found in hemp and marijuana. THC is a psychoactive compound that makes a person feel “high” and causes addiction and psychosis. However, CBD doesn’t have these effects and affects separate brain regions than THC (5).
Uses Of CBD Oil For Children
Apart from treating epilepsy, the FDA doesn’t approve CBD oil’s use to treat any ailment in children. However, studies suggest that CBD oil may be an effective treatment for the treatment of several ailments.
- Anxiety: Some recent studies show that CBD oil use may help reduce anxiety (6) (7). Preclinical evidence from animal studies demonstrates that CBD oil use can reduce anxiety associated with multiple disorders, such as post-traumatic stress disorder (PTSD), generalized stress disorder, and social anxiety disorder (8 ). It helps in relaxing the brain and musculoskeletal system. However, there’s a need for further study to make any recommendations for children.
- Autism: A 2019 study on 188 autism spectrum disorder (ASD) patients showed that the use of cannabis oil containing 30 percent CBD and 1.5 percent THC appears to be a “well-tolerated, safe, and effective option to relieve symptoms associated with ASD” (9). Another study involving 60 children also showed some promising results (8 ). However, these results aren’t sufficient for clinical validation as the research samples are quite small.
- Attention deficit hyperactivity disorder(ADHD): A systematic review conducted in 2020 highlighted that CBD could help alleviate symptoms of ADHD (10). It helps in calming the child and lowers the hyperactivity. However, currently, no targeted research studies are available to support the use of CBD oil for treating or managing ADHD in children.
- Multiple sclerosis (MS): A 2019 study by Thorsten Rudroff and Jacob Sosnoff suggests that CBD use may be associated with less pain and spasticity, ultimately leading to improved mobility and proper sleep (11). The release of musculoskeletal spasms is the mainstay of treatment. Yet, more research is warranted to derive any conclusions about CBD oil use for MS treatment in children.
Side Effects Associated With CBD Oil Use
CBD oil use for children isn’t well-researched, and its unguided use may cause certain side effects, such as
- Gastrointestinal disturbances: Upset stomach and abdominal pain are common side effects of CBD oil use in sensitive individuals. So, always consult a doctor or alternative medicine expert before using CBD oil for children.
- Toxicity: If CBD oil isn’t used under guidance, there’s a potential risk of overdose and toxicity. Therefore, it’s essential to use CBD oil only after consulting an expert. Some of the symptoms you may see in CBD toxicity are severe nausea or vomiting, high blood pressure, anxiety, paranoia, rapid heart rate, and hallucinations (12).
- Possible drug interaction: CBD is a bioactive compound that can interact with other chemicals and compounds in the medications. Since CBD affects the brain and the central nervous system, antidepressants and antipsychotics are the most obvious drugs that can interact with CBD.
Some other drugs that can interact with CBD are blood thinners and thyroid and heart medications (13). Therefore, if your child is on any medication, consult your doctor before using CBD for any purpose.
Besides these, CBD oil can also cause headaches, drowsiness, dry mouth, and low blood pressure (14).
Note: Milk and foods containing high amounts of fats can increase the absorption of CBD in the body, thus increasing the effects and side effects of CBD on an individual (12).
Possible Risks Associated With CBD Oil Use In Children
Baring Epidiolex, which contains CBD, CBD oil isn’t regulated by the US FDA, making its use in children and teens risky as (5) (8 )
- The ingredients of CBD oil can’t be determined accurately, meaning the products can have ingredients that aren’t mentioned on the label. For instance, several products that claim to contain only CBD may also contain high doses of THC, a psychoactive compound.
- CBD oil’s quality can’t be ascertained, as there are chances that the oil may be contaminated with microorganisms, pesticides, and heavy metals. Consuming contaminated CBD oil can cause severe effects in sensitive individuals.
- The efficacy and safety of CBD oil in children and teens are unclear, and research on this subject is still in its early stages. Also, existing studies have been either done on animals or human adults and not on pediatric patients. Further, the studies that involve children have small sample sizes.
- The dosage guidelines aren’t clear, except for CBD used in the drug Epidiolex to treat Epilepsy. Thus, using CBD oil at home is tricky, especially when you aren’t aware of how much CBD oil you can administer to a child to get the desired effect. Also, there is no way to know which mode of use is best and how much CBD would be absorbed in the body based on the method of administration.
Besides these, the legality of the use of CBD oil varies from one country to another and state to state. For instance, according to the US FDA, THC or CBD can’t be sold legally as a dietary supplement, food, or therapeutic product (4). Instead, it can only be included in cosmetics when its THC content is less than 0.3 percent (14). So, check your state’s legal requirements for CBD oil purchase and use before you make any purchases.
How To Choose CBD Oil?
Proper selection of a CBD oil brand can be tricky as it’s manufactured by several companies globally. So, here are some tips that could help (15).
- Buy the product from a trusted manufacturer and seller. It will ensure the product you’re buying is of good quality and is not contaminated. Some manufacturers may dilute CBD isolate with hemp seed oil, which can make the product comparatively ineffective as they lack the balance of beneficial components found in broad-spectrum CBD oil (2).
- Read the product label carefully and determine the
- Oil source: The oil should be extracted from hemp or marijuana. Typically, hemp has a significantly less amount of THC when compared to marijuana. THC is a psychoactive chemical that can create dependence over long-term use. So, ensure you buy CBD oil extracted from hemp plants cultivated by domestic farmers. Domestic hemp is typically free of toxins and pesticides.
- Extraction method: The extraction method indicates how the oil has been extracted from the hemp plant. Typically, CBD oil is extracted using carbon dioxide (CO2) extraction or by using solvents such as ethanol, propane, and butane. Out of these, propane and butane extraction isn’t considered safe as these solvents are toxic and hazardous for children. On the other hand, ethanol and CO2 extraction techniques are safe and potent as they leave no harmful chemicals in the oil.
- Chemical composition: It signifies whether the oil is full-spectrum or isolate. Full-spectrum CBD oil will contain several phytonutrients, such as flavonoids, terpenes, and trace amounts of THC. If THC’s presence concerns you, look for CBD isolates, which are the pure form of CBD oil.
But, while you make that choice, consult an expert as concentrated CBD has high amounts of CBD per serving, increasing the chances of overdose.
- Product certification: Ensure the product has been certified by a reputable third-party testing lab or organization. The lab will test the oil quality and certify that the oil is true to its claim about its chemical composition. It’s best to buy oil that has testing information attached.
CBD oil for children and adults is the same. However, since children weigh less and are comparatively sensitive, using CBD oil with lower potency is advisable.
CBD Oil Dosage For Children
The appropriate dosage of CBD oil for children depends on their body weight, metabolism, medical condition, overall health, and intent of use. For instance, the US FDA has approved the daily oral use of 25mg per kg of body weight for Epidiolex, the prescription drug that contains CBD (14). Its use is approved for children aged one and above.
However, this dosage may or may not be suitable for every child. So, consult a doctor or alternative medicine expert to determine the appropriate CBD oil dosage and suitable mode of use for a child.
While CBD oil has gained popularity over the past few years as a remedy for various ailments, it is important to remember that the FDA does not approve CBD oil for kids. More research is needed to support and establish the safety of CBD oils in the treatment of ailments such as anxiety, autism, and ADHD. In addition, it is advisable to refrain from using these oils if your children are on any other medications. Further, consult your pediatrician before using this oil on your child.
- CBD oil or Cannabidiol, a derivative of the cannabis plant, is reportedly used to treat certain neurological ailments, such as epilepsy, in children.
- It is essential to use this oil only when prescribed by an expert since it poses the risk of side effects such as CBD toxicity, gastric problems, and drug interactions.
- The oil is not approved for use in children in some countries. Therefore, seek professional advice before using it.
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CBD: What Parents Need to Know
Parents are giving it to kids to combat anxiety and other problems. But there are risks, and little research to support it.
What You’ll Learn
- Is CBD safe for kids?
- What are the risks of giving kids CBD?
- Can CBD help kids who have mental health disorders?
- Quick Read
- Full Article
- What do we know about CBD?
- Concerns about CBD
- Is CBD safe?
- CBD oil for anxiety
- CBD and autism
- Research boom
These days, you can find CBD everywhere. Some people believe that it can treat everything from chronic pain and cancer to anxiety and ADHD. But is it safe for kids?
CBD is still pretty new, so there’s very little research about its safety or how well it works, especially for children. So far, there’s only one marijuana-derived medication that has been approved by the Food and Drug Administration. It’s called Epidiolex, and it’s used to treat a rare form of epilepsy in patients who are at least two years old.
Because CBD is so new, there also aren’t a lot of rules about what can and cannot be included in CBD products. So, there’s a huge variety in the quality of products. You may even find different amounts of CBD in different packages of the same product.
Since there isn’t a lot of research about CBD, doctors say there are some risks with using CBD for kids. For example, CBD products may contain things other than CBD, and those things could be harmful. Plus, we don’t yet know if CBD works well with other medications or how much you should give your child.
Although a few studies have found that CBD oil might work for anxiety, they only looked at healthy people who were put in situations that made them anxious. There are no studies yet on people with chronic anxiety. Researchers are also exploring CBD for kids with autism spectrum disorder. The results are good so far, but more research needs to be done before we can know if it’s safe and effective.
CBD is everywhere. From corner stores and bars to medical marijuana dispensaries, it’s being offered for its reputed ability to relieve pain and make people feel better.
Though CBD — full name cannabidiol — is extracted from marijuana or hemp, it doesn’t contain THC, the chemical in marijuana that has psychoactive effects, so it doesn’t make you feel high.
Available in the form of vaping, oils, lotions, cocktails, coffee, gummies — you name it — CBD has been touted as a treatment for complaints as far-reaching as chronic pain, cancer, migraines, anxiety and ADHD. You know it’s gone mainstream when even Consumer Reports has issued guides on how to shop for CBD and tips for safe CBD use.
Not only are adults experimenting with CBD for whatever is bothering them, increasingly parents are turning to CBD to help their kids focus, sleep, calm down and more.
But popular use of CBD is blowing up with very little research into its safety or its efficacy, especially in children. The first and only marijuana-derived drug approved by the Food and Drug Administration, Epidiolex, is used to treat a rare, severe form of epilepsy in patients two years of age and older. And since cannabis is in the early stages of legalization and regulation, there is a huge variety in the quality and dosage of products — risks associated with using products that have not been vetted by the FDA.
What do we know about CBD?
For millennia, hemp plants have been used for medicinal purposes around the world. In 1851 marijuana was classified by the United States Pharmocopeia as a viable medical compound used to treat conditions like epilepsy, migraines and pain. But since marijuana and cannabis-related products were made illegal in the US in 1970, there has been a dearth of research about either marijuana or CBD. Its classification as a Schedule 1 drug made it nearly impossible to get federal funding to study cannabis.
“The biggest problem is there’s a lot that we still need to know, especially in kids,” says Paul Mitrani, MD, a clinical psychiatrist at the Child Mind Institute. “In regards to treating mental health disorders in children and adolescents, there’s a lack of evidence to support its use.”
Dr. Mitrani, who is a pediatrician and child and adolescent psychiatrist, says it’s an area worthy of investigation but recommends that parents wait until further research is done before giving a child CBD.
Concerns about CBD
While anecdotal evidence of the benefits of CBD is common, there are risks associated with using these products, especially in children. Some of the concerns:
- Products are unreliable in delivering a consistent amount of CBD. They could have less, or more, than advertised, and most do not offer independent verification of active contents. Analysis of products for sale show that many do not have the amount of CBD that they advertise. “So you can’t depend on the quality of what you’re getting,” notes Dr. Mitrani.
- How much is absorbed? Very little is known about how much CBD is actually delivered to the brain in a given product. Various delivery systems — vaping, taking it orally, eating it in baked goods, etc. — have different rates of delivery. Even the oils that the CBD is dissolved in can result in varying effects. “Effects can vary a lot based on the delivery system used and the amount people are exposed to can be inconsistent,” Dr. Mitrani says.
- Products may contain things other than CBD, and they could be harmful. Lab testing — which provides information about CBD levels, THC levels (if any), and contaminants in the product — isn’t mandatory for CBD products in every state. Without a CoA (Certificate of Analysis) it’s that much harder to verify the safety of the product. Bootleg CBD may be connected to recent lung illnesses and deaths that have been attributed to vaping. The CDC and the American Medical Association recommend avoiding vaping entirely while the cause of these illnesses is determined.
- CBD may be safe itself, but it may interact with other medications a child is taking, that are also metabolized in the liver.
- If it’s used for sleep, Dr. Mitrani worries that while it may potentially help with sleep, “your child may become tolerant to it and possibly experience worsening sleep problems if stopped.”
- Since CBD use — especially for kids — is a still so new, few people are familiar with dosing for children, so determining how much to give your child would be tricky. Clinical doses versus what you might find at a coffeehouse could vary dramatically.
- The legality of cannabis products and CBD is still murky. CBD derived from hemp is federally legal, while CBD derived from marijuana plants is subject to the legal status in each state — and remains federally illegal. Meanwhile, the FDA issued a statement making clear that products that contain CBD — even if they are derived from legal, commercial hemp — cannot claim to have therapeutic benefits or be sold as dietary supplements unless they have been approved by the FDA for that use.
Is CBD safe?
Last year the World Health Organization, acknowledging the explosion in “unsanctioned” medical uses of CBD, reviewed the evidence for its safety and effectiveness. The WHO report concluded that “CBD is generally well tolerated with a good safety profile.” Any adverse effects could be a result of interactions between CBD and a patient’s existing medications, the WHO noted.
The report found no indication of potential abuse or dependence. “To date there is no evidence of recreational use of CBD or any public health-related problems associated with the use of pure CBD.”
As for effectiveness, the WHO noted that several clinical trials had shown effectiveness for epilepsy, adding: “There is also preliminary evidence that CBD may be a useful treatment for a number of other medical conditions.”
CBD oil for anxiety
In 2015 a group of researchers led by Esther Blessing, PhD, of New York University, investigated the potential of CBD for treating anxiety. In a review of 49 studies, they found promising results and the need for more study.
The “preclinical” evidence (ie from animal studies) “conclusively demonstrates CBD’s efficacy in reducing anxiety behaviors relevant to multiple disorders,” Dr. Blessing wrote. Those include generalized anxiety disorder, PTSD, panic disorder, social anxiety disorder and OCD.
The review notes that the promising preclinical results are also supported by human experimental findings, which also suggest “minimal sedative effects, and an excellent safety profile.” But these findings are based on putting healthy subjects in anxiety-producing situations and measuring the impact of CBD on the anxiety response. Further studies are required to establish treatment with CBD would have similar effects for those who struggle with chronic anxiety, as well as what the impact of extended CBD use may be.
“Overall, current evidence indicates CBD has considerable potential as a treatment for multiple anxiety disorders,” Dr. Blessing concludes, “with need for further study of chronic and therapeutic effects in relevant clinical populations.”
CBD and autism
A group of Israeli researchers have been exploring the use of CBD to reduce problem behaviors in children on the autism spectrum. A feasibility study involving 60 children found substantial improvement in behavioral outbreaks, anxiety and communication problems, as well as stress levels reported by parents.
The researchers, led by Adi Aran, MD, director of the pediatric neurology unit at Shaare Tzedek Medical Center, went on to do a double-blind, randomized, placebo-controlled trial with 150 participants with autism. In this trial, just completed but not yet analyzed, patients were treated CBD for three months.
In the US, research has been given a boost by changing guidelines and laws. In 2015 the DEA eased some of the regulatory requirements that have made CBD, as a Schedule 1 substance, difficult to study. “Because CBD contains less than 1 percent THC and has shown some potential medicinal value, there is great interest in studying it for medical applications,” the DEA said in announcing the change.
And in approving the first CBD-based drug, Epidiolex, last year the FDA expressed enthusiasm for the research boom that is sure to come, paired with stern words for the flood of marketers of products claiming unsubstantiated health benefits.
“We’ll continue to support rigorous scientific research on the potential medical uses of marijuana-derived products and work with product developers who are interested in bringing patients safe and effective, high quality products,” the FDA pledged. “But, at the same time, we are prepared to take action when we see the illegal marketing of CBD-containing products with serious, unproven medical claims.”