Is marijuana safe for pediatric use?

Marijuana Use in Pediatric Populations: Safety Concerns and Recommendations

Marijuana is not safe for pediatric use and should be avoided due to documented adverse effects on brain development, cognitive function, and increased risk of substance use disorders, psychiatric illness, and diminished academic achievement.

Risks of Marijuana Use in Children and Adolescents

Neurological and Developmental Risks

• Cannabis use during adolescence can cause significant changes to the developing brain 1
• Marijuana alters brain development and has detrimental effects on brain structure and function in ways that are not fully understood 2
• Evidence indicates that cannabis use may have a negative effect on brain development in adolescents 1

Psychiatric and Cognitive Risks

• Cannabis use in adolescents is linked to:
  • Substance use disorders
  • Increased rates of psychiatric illnesses
  • Cognitive decline
  • Diminished school performance and lifetime achievement 1, 2
  • Increased risk for psychosis 1
  • Lack of motivation 1

Cardiovascular Risks

• Higher THC concentrations in modern cannabis products increase risk of adverse effects 3
• Cannabis use is associated with:
  • Increased heart rate (tachycardia)
  • Blood pressure changes
  • Increased risk of adverse cardiovascular events including myocardial infarction and stroke 3
  • Increased stroke risk in a dose-dependent manner 3

Acute Intoxication Risks

• Marijuana ingestion can cause dangerous and potentially life-threatening toxicity in children 4
• Primary symptoms include excessive drowsiness, potentially progressing to an unarousable state 5
• May cause seizures in severe cases of intoxication 5

Medical Evidence and Guidelines

Lack of Evidence Supporting Pediatric Use

• There are insufficient data to support either the efficacy or safety of cannabis use for any indications in children 6
• No studies suggest a benefit of marijuana use by children and adolescents 2
• Any recommendations for medical marijuana use by adolescents are based on research with adults and anecdotal evidence, not pediatric data 2

Limited Therapeutic Applications

• While cannabidiol has shown efficacy for certain conditions like epilepsy (with high certainty of evidence) 7, this does not justify recreational use
• The potential for cannabis as a therapeutic agent must be evaluated carefully for both efficacy and safety in treating specific pediatric health conditions 6

Strong Recommendations Against Use

• The Canadian Association of Gastroenterology strongly recommends against cannabis or derivatives to induce or maintain remission in Crohn's disease (87% strongly agree) 1
• The Canadian Paediatric Society recommends that sales of all cannabis products to children and adolescents be prohibited 1
• The American College of Physicians urges caution in policy changes regarding marijuana legalization due to limited knowledge about effects 1

Special Considerations

Accidental Exposure

• With increasing legalization, there is greater risk of accidental ingestion by children 4
• Marijuana products in edible forms (confectioneries) pose particular risk for accidental pediatric consumption 5
• Parents and caregivers may be unaware that marijuana exposure is responsible for clinical presentation of symptoms 5

Prevention and Education

• Revenue from legalized marijuana should be earmarked for public prevention and education efforts 1
• Strong product and commercial regulations should be implemented to ensure product safety and prohibit sales to minors 1
• Healthcare providers should consider screening for cannabis use patterns in adolescents 3

Conclusion

The evidence strongly indicates that marijuana use in pediatric populations poses significant risks to physical and mental health, with particular concerns about brain development and long-term cognitive outcomes. Current medical guidelines and research do not support marijuana use in children or adolescents for any purpose outside of very specific medical conditions under careful supervision. The potential harms clearly outweigh any purported benefits in this vulnerable population.