Cbd oil for children with odd

Oppositional Defiant Disorder (ODD) – Can CBD Oil Help?

It is a known fact that no pharmacological treatment exists to manage ODD. Cannabidiol (CBD), is a natural compound found in the cannabis plant, with little to no side-effects, both short- and long-term, and the results that parents have reposted in treating ADHD, ODD, ADD and ASD, has been encouraging and could pave the way for future clinical studies.

Oppositional Defiant Disorder Overview

As its name indicates, Oppositional Defiant Disorder (also referred to as Oppositional Defiance Disorder or ODD) is a disorder characterized by anger, defiance, and negativity. Adolescents and teenagers who have Oppositional Defiant Disorder are prone to be destructive, belligerent, and physically violent.

Oppositional Defiant Disorder may begin to manifest in children as young as 7, and commonly surfaces by age 13; however, reaching the ages of 14 does not mean that a young person is now immune from developing Oppositional Defiant Disorder.

Though Oppositional Defiant Disorder is more commonly diagnosed in boys, girls can develop this disorder.

It is important to understand that Oppositional Defiant Disorder is not a “phase” or a temporary period of adolescent moodiness. Young people who have Oppositional Defiant Disorder are unlikely to grow out of the disorder.

Left untreated, adolescents and teens who struggle with Oppositional Defiant Disorder may develop additional conduct disorders, may be at increased risk for developing an antisocial personality disorder, and are also at risk for depression, substance abuse, and a host of additional unhealthy behaviours.

Causes of Oppositional Defiant Disorder

As is the case with depression, learning disabilities, and many other emotional and behavioural problems that affect adolescents and teenagers, Oppositional Defiant Disorder does not lend itself to quick diagnosis and one clear cause.

Mental health professionals and other experts attribute the development of Oppositional Defiant Disorder to a host of possible causes, including factors in the genetic, psychological, and social realms.

When considering if a child may have Oppositional Defiant Disorder, it is important to also assess the child for disorders such as depression, panic/anxiety disorder, learning disabilities, ADHD, and similar conditions. Students who have been struggling with these issues without the benefit of diagnosis or treatment may be much more likely to behave in a manner that resembles Oppositional Defiant Disorder.

Symptoms of Oppositional Defiant Disorder

Students with Oppositional Defiant Disorder will exhibit many (or even all) of the following:

  • Hostility toward peers, teachers, parents, and other family members
  • Persistent negative or pessimistic attitude
  • Refusal to obey orders or follow directions
  • Aggression toward others (both verbal and physical aggression)
  • Anger that can quickly boil over into a rage
  • The propensity to be easily frustrated and to quickly blame others for personal failures
  • Loss of most or all friendships
  • Continuous problems in school and, eventually, with law enforcement officers

To meet the criteria for being categorized as Oppositional Defiant Disorder, adolescents and teenagers who exhibit these symptoms must do so for a period of at least six months — and the severity of these behaviours must be greater than “normal” adolescent angst or teen anger.

Conventional Treatments for ODD

While diet and lifestyle are incredibly important for children who suffer from ODD, the two main treatment regimes are psychotherapeutic and pharmacological. A popular evidence-based treatment is a type of behaviour therapy called parent-child interaction therapy. The parent and child work together through a set of exercises while a therapist coaches parents through an earbud. Parents learn to increase positive interactions with the child and to set consistent consequences for undesirable behaviour. Children learn to rein in behaviour and enjoy a more supportive relationship with parents.

While medicines are not specifically indicated for ODD, many children with ODD have co-occurring conditions such as ADHD. They may already be on medications for those other disorders. In addition, some children are so troubled by their own aggression, and their difficulties managing their painfully low frustration tolerance, that a clinician may recommend medication – like psychostimulants used to treat ADHD, to help them control those responses and benefit more from behaviour therapy.

What Role Can Medical Cannabis Play?

While no clinical studies exist for the treatment of ODD with medical cannabis, anecdotal evidence exists, none more so than the story of Debbie Jeffries and her journey to legally administer medical cannabis to her son, Jeffrey, who suffered from a myriad of behavioural conditions, including ODD. Debbie has documented their struggle in her book Jeffrey’s Journey, in which the most profound extract is the one sentence uttered by Jeffrey after receiving medical cannabis treatment: “Mommy, I feel happy, not angry, and my head doesn’t feel like a traffic jam”! The abridged version of Jeffrey’s Journey can be found on RX Marijuana.

Though Jeffrey is the most notable case where medical cannabis has assisted in the treatment of ODD and other behavioural conditions, Miranda, mother of Axle, shares her story with the world:

Miranda, the mother of Axle, shares that the conditions mentioned above are only some of the diagnoses her son has. The ones mentioned are the most difficult to handle. He has been in therapy since he was 2 years old (5 years). Part of the therapy, he sees a psychiatrist on a regular basis. He attends school and has an IEP.

Part of the process many parents go through, they try many different medications. She has tried this with him but didn’t see the results she hoped for.

It breaks her heart to see people look at her son differently and treat him different. He feels it and it hits him hard.

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Even their family members treat him differently and get annoyed with him easily and quickly. This is the most painful scenario given it is family doing this too since they should be more understanding. She has tried so many things to help him fit in, calm down, and to cope with his condition.

She kept hitting a dead end.

Started Using CBD Oil

She started him on CBD Oil a month and a half ago. She noticed he doesn’t have as many meltdowns and he is starting to calm down and it is easier to calm him down. He also sleeps better with fewer nightmares. His behaviour with other children his age is improving while playing.

There are so much more that could be said that is improving and she is so happy with the results.

While there is no guarantee that all children will respond the same as the children mentioned in this article, it is a known fact that no pharmacological treatment exists to manage ODD. Cannabidiol (CBD), is a natural compound found in the cannabis plant, with little to no side-effects, both short- and long-term, and the results that parents have reposted in treating ADHD, ODD, ADD and ASD, has been encouraging and could pave the way for future clinical studies.

CBD is a non-psychoactive component found in the cannabis plant and is used by many parents worldwide to treat a myriad of conditions, including epilepsy, ADHD, ODD and other conditions in the ASD range.

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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

Quick Read

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.

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“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.

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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.

Research boom

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.”

Pharmacokinetics and Perceptions of Children and Young Adults Using Cannabis for Attention-Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder: Protocol for a Mixed Methods Proof-of-Concept Study

Background: Despite the lack of evidence on the use of cannabis for the treatment of attention-deficit/hyperactivity disorder (ADHD), the growing perception that cannabis is safe has led more patients and caregivers to self-medicate. Some psychiatrists now authorize medicinal cannabis for patients with ADHD with features of oppositional defiant disorder (ODD) to curtail the unregulated (ie, self-medicated) use of recreational cannabis or to offer a therapeutic option to those who continue to experience symptoms after exhausting all other treatment options.

Objective: This protocol aims to explore the perceived effectiveness and pharmacokinetics of cannabis in youth and young adults, who are currently taking it as part of their treatment plan for ADHD with features of ODD, under the supervision of a psychiatrist.

Methods: Patients between the ages of 12 and 25 years with a diagnosis of ADHD and features of ODD, who are currently taking cannabis herbal extract (at a Δ 9 -tetrahydrocannabinol [THC]:cannabidiol [CBD] ratio of 1:20) as a treatment adjunct to stimulant pharmacotherapy will be recruited. A sample size of 10-20 individuals is estimated. The study interview will consist of (1) validated symptom rating scales (Swanson, Nolan, and Pelham-IV Questionnaire [SNAP-IV], 90-item; Patient Health Questionnaire, 9-item [PHQ-9]; and Screen for Child Anxiety Related Emotional Disorders [SCARED] tool to measure symptoms of ADHD and ODD, depression, and anxiety, respectively); (2) a semistructured interview to probe the experiences of using cannabis; and (3) a cannabis side effects survey. A cannabis product sample as well as 2 blood samples (a trough level and 2-hour postdose level) will be collected to measure plasma concentrations of cannabinoids and relevant metabolites (THC, CBD, 11-hydroxy-THC, 7-hydroxy-CBD, cannabichromene, and 11-nor-9-carboxy-THB) using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Self-report rating scales (SNAP-IV, SCARED, and PHQ-9) will be scored in accordance with standard protocols and compared to retrospective scores obtained from the participant’s chart. Demographic variables (age, weight, and race), symptom scores, and blood levels (peaks and troughs) of THC, CBD, cannabichromene (CBC), and metabolites will be summarized using descriptive statistics. Relationships between plasma concentrations and symptom scores will be determined using analysis of variance, and multiple regression analysis will be performed to determine associations between plasma concentrations and demographic variables (age, weight, and ethnicity). The qualitative data will be audio-recorded and transcribed and organized into themes.

Results: The protocol was approved by the Biomedical Research Ethics Board at the University of Saskatchewan (protocol #1726), and recruitment began in May 2021.

Conclusions: This proof-of-concept study will explore the potential treatment effectiveness of medical cannabis in participants with ADHD and ODD through a mixed methods approach to inform future research in this area.

International registered report identifier (irrid): DERR1-10.2196/31281.

Keywords: ADHD; attention-deficit/hyperactivity disorder; cannabidiol; cannabis; marijuana; oppositional defiant disorder; pharmacokinetics; young adults; youths.

©Holly Mansell, Declan Quinn, Lauren E Kelly, Michael Szafron, Jane Alcorn. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 18.10.2021.

Conflict of interest statement

Conflicts of Interest: None declared.

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