Last reviewed by Daniel Gana and Abraham Benavides, MD, 11/22/2024

A discussion of cannabis in pediatric health was all but an unspeakable taboo even ten years ago.

It’s still difficult to talk about today, but we owe it to our children to follow facts and science when making decisions about their health.  Research studies show that children have much to gain from non-impairing cannabinoids like CBDA, CBG and CBGA.

The endocannabinoid system is highly active in young children and adolescents, which provides an excellent opportunity for therapeutic and preventive cannabis use.

The human ECS develops from the earliest embryonic and fetal stages. Cannabinoids exhibit a substantial effect on social behavior in early development. Children can benefit from enhanced interpersonal communication and less negative emotions. As always, it’s important to find the right combination of cannabinoids and terpenes.

Children and the Endocannabinoid system

CB1 receptors were detected in human embryos at week 14 of gestation. Endocannabinoids like 2-arachidonoylglycerol and anandamide (AEA) are present in maternal milk and may constitute one of the earliest forms of defense for nursing babies. The ECS is also established to assist prenatal brain development and post-natal suckling, which may be critical to healthy development. Recall that  both endocannabinoids and cannabinoids can trigger the formation of new brain cells (neurogenesis) in children and adults. 

The ECS and its receptors are important for a successful embryonal passage through the oviduct and implantation into the uterus. This is achieved via the enzymatic control of endocannabinoids.

Endocannabinoids and CB1 receptors are important for setting up our nerves in the right way. They regulate neural progenitor differentiation and guide axonal migration and synaptogenesis during the fetal stage. Postnatal activation of CB1 by 2-AG appears to play an important role in initiating milk suckling and may be responsible for activating tongue muscles.

Therapeutic Potentials of Cannabis for Children

Epilepsy

Cannabis medicine has a long history of providing anticonvulsant properties. Its anticonvulsant effect was reported in the ancient Middle East and India for at least 4,000 years. This and many more historical claims led to the possible use of THC-rich cannabinoids for epileptic patients in the 19th century. 

While CBD-based medication (Epidiolex) was endorsed by the FDA to remedy chronic epileptic seizures associated with Dravet and Lennox–Gastaut syndromes in 2018, recent research reports show CBGa may offer a better anticonvulsant property. The research discovered that CBGa may provide better relief from seizures and has a more potent interaction with clobazam for treating epileptic convulsions. CBGa interacts with numerous epilepsy-relevant targets, including GABA, TRPV1, and GPR55 receptors. Other cannabinoids capable of producing a similar interaction in childhood epilepsy include CBDV, CBDVa, and CBGVa.

Autism

About 3% of school-age children are affected by autism spectrum disorder (ASD). As a result, they are prone to behavioral difficulties like tantrums, non-compliance, aggression, and self-injury. These behaviors are often worse in children with neurodevelopmental disorders. 

The possible use of cannabis and cannabinoids in ASD stems from how well children tolerate CBD-dominant therapies.  Cannabinoid therapy may alleviate symptoms and reduce anxiety and irritability. It may also play some important roles in social interaction. Recent research on cannabinoids for ASD shows over 80% improvement after six months of treatment. 

Cannabinoids like CBD may improve core ASD symptoms and associated conditions like ADHD, dystonia, spasticity, seizure disorders, anxiety, mood, and sleep disorders and might help reduce the symptoms of Tourette syndrome.

The sleep-inducing nature of cannabinoids can be traced to their ability to trigger the release of feel-good hormones, promote internal balance, and reduce the activity of free radicals. 

Cannabinoid therapy is very successful in children with ASD because they increase endocannabinoids, helping supplement the endocannabinoid deficiency observed in these patients. CB1 receptors are normally highly expressed in the frontal cortex and subcortical areas linked with social functioning, but CB1 is less expressed in autistic brains. The cannabinoid receptors and their endogenous ligands AEA, 2-AG, OEA, and PEA can regulate social play and anxiety in humans. Other cannabinoid-sensitive receptors like PPAR and GPR55 may also be involved in social play behaviors. 

Activating the endocannabinoid system by administering cannabinoids like CBD and CBGa may restore endocannabinoid levels and therefore perhaps also social deficits and increase prefrontal GABA activity.

Pediatric Crohn’s disease

A study discovered that THC-rich cannabis dosage could be an option for steroid-based medicines for people with Crohn’s disease due to the anti-inflammatory properties of various cannabinoids. Studies also show that pediatric IBD patients usually start cannabis at a younger age, around 15–16 vs 19–20 for the general population.

Further data suggest that CBG, and thus likely CBGa, aid digestive health and reduce gut inflammation for those with IBD.

Cancer

Cumulative studies find  that medicinal cannabis may also help reduce anxiety and improve appetite among people undergoing cancer treatment. The FDA has approved dronabinol, a synthetic cannabinoid, for nausea relief and vomiting associated with cancer in adults. The same compound is also used to stimulate appetite in adults.

However, while it’s not yet approved for children, other countries are proceeding with caution.  Dronabinol is pediatrically used in Canada and Italy to manage spasticity in the setting of neurological complexities and palliative care.

While several researchers have reported the anti-cancer properties of CBGa and other cannabinoids, its possible use in pediatric cancer is still under study. So far, its derivative CBG shows antitumoral activity in glioblastoma, a rare but aggressive pediatric brain cancer. Note that CBGa is  also an excellent antioxidant, which theoretically reduces the spread of cancer cells. 

Is Cannabis Safe for Children?

Concerns on this topic include addiction, decreased motivation, mild cognitive decline, and schizophrenia, all of which are directly linked to the direct consumption of THC. Using cannabis-based products with a high concentration of THC can create more problems than we are trying to solve. 

At the same time, children possess a highly active ECS, which presents an excellent opportunity for therapeutic and preventive use. Although children are vulnerable to a host of challenges due to the nature of their bodies and systems, they may benefit greatly from cannabinoids for the same reason. So far, animal models show that using pure CBD and CBDV during early development is very safe.

Bottom line: when it comes to cannabis & children, consult your informed pediatrician and steer clear of THC.

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