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.”
CBD Oil for Kids: 13 Things All Parents Should Know
The use of CBD oil (cannabidiol, extracted from marijuana) for kids is growing in popularity. We chatted with experts and real parents to get the scoop.
*Please consult your doctor before making any decisions about trying new products for your child’s health.
Could CBD (cannabidiol) oil be the new go-to for calming kids down? With states green-lighting the green stuff one after another, there’s a new wave of marijuana-using millennials and open-minded parents in general who are more curious than ever before about giving marijuana- and hemp-derived oils to their kids and babies.
In one of the private mom groups I belong to on Facebook, there have been more than 100 threads since October of 2017 around incorporating CBD into families, and there was an honest conversation unfolding between parents about an article that featured a CBD-infused hot chocolate recipe. Moms wanted to know if it was safe or not to serve it to their kids before bedtime, and shared their opinions that it’s okay to use in smaller doses or for children with autism and anxiety who medically need it. There was a lot of curiosity around the topic — was it safe for all children or not?
The attitude around pot and CBD oil is constantly evolving, too. Federal advisers to the Food and Drug Administration (FDA) unanimously voted on April 19, 2018 to approve of the drug Epidiolex, and on June 25, 2018 the medicine was officially approved. This is the first prescription cannabidiol medicine to be recommended by the FDA committee for its effective treatment of certain forms of epilepsy.
While previous generations may have just accepted the first line of treatment recommended by a family physician, there is truly a new wave of parents who recognize there might be life-changing benefits from using CBD to treat a child. More than ever before, parents are initiating these conversations. And don’t forget that parents (yes, even those who don’t personally use marijuana!) legally advocate for and use CBD oil as medicine for their children who truly need it.
To find out the real deal on CBD oil for kids, we chatted with cannabis expert Frank Lucido, M.D., of Berkeley, California, who has been consulting individuals and families regarding alternative cannabis therapies since 1996. We also turned to canna-parent Melissa Hilt of Albany, New York, whose daughter Hailey suffers with multiple seizures daily and Lelah Jerger of Huntingburg, Indiana, who is facing issues with Child Protective Services after treating her daughter Jaelah with CBD for her daughter’s epilepsy.
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1. THC and CBD are different.
They’re the two main compounds in the marijuana plant, but THC is psychoactive, and CBD is not. In other words, THC can get you high (and maybe even make you feel paranoid), but CBD can not. The oil used to medically treat a child will often be legally sold through a dispensary and contain a CBD-to-THC ratio, such as 19-to-1. Since the oil sold over the internet doesn’t contain THC, you should keep in mind that plenty of medical professionals argue that CBD loses its efficacy when it’s not used in conjunction with THC.
2. CBD oil can change lives.
There are incredible testimonials from families who have found relief after incorporating CBD oil into their daily lifestyle. Melissa Hilt’s 11-year-old daughter, Haley, was having more than 100 seizures a day. Surgery, alternative diets, more than 15 medications — nothing could effectively limit the amount of her seizures.
A prescription dose of 19-to-1 (CBD-to-THC) oil is given to her at breakfast and dinnertime, and Melissa told us she finally feels like she’s “met” her real daughter as her daughter began to experience seizures only twice a month at the start of treatment. Her kiddo is no longer in a constant “haze” from all of the different medications she was trying. Now, Haley smiles and plays with her sister. Melissa told us, “It’s been the greatest gift to our family to be able to finally ‘meet’ her.” Now, that’s powerful .
3. It’s not cheap to use CBD oil on a regular basis.
For parents like Hilt who’ve found CBD oil to be the only remedy for their children, they’ll pay up to $500 a month out of pocket (since CBD oil is not covered by insurance). The price will vary depending on what you’re getting, where it’s from, and what the state tax is.
4. Families move across state borders to legally access it.
Of course not all states have legalized the use of CBD oils. And for parents whose children have a medical diagnosis (like a form of epilepsy or autism) for which CBD oil is one of the only things that seems to help, it’s worth it for them to move their lives to a state where they can access it legally. Hilt told us she would “absolutely” move if she no longer had access to the oil in Albany, New York.
5. Families are dealing with CPS issues where it’s not legal.
When Lelah Jerger’s 3-year-old daughter, Jaelah, was diagnosed with epilepsy in Huntingburg, Indiana, they had no idea that a nightmare was about to unfold. Jerger was offered CBD oil during an appointment with a chiropractic neurologist to treat her daughter. She purchased the oil from him, though she was simultaneously getting other opinions from doctors and surgeons at traditional treatment centers. But the CBD oil was the only thing to bring her daughter’s visible seizing down from 30 times each day to twice each day.
She purchased more CBD oil from a company online to continue treating her child. When one of the hospitals she was seeking treatment from alerted Child Protective Services about the alternative treatment, an invasive investigation was conducted, including blood tests.
Jerger said: “We were terrified to have any allegation of abuse or neglect. I’ve got four other kids (the oldest is 15), and we’ve never been questioned. The fear is indescribable — it’s an agency that has the power to take your children away.” The family is currently suing CPS and awaiting their court date.
6. There’s still research that needs to happen.
Back to the Hilts: Haley’s seizures did start to pick up again after slowing down tremendously for the first month of treatment, but she’s still making wonderful progress developmentally and seizing less intensely overall. Normally, seizures can prevent Haley from reaching new, important milestones, but Hilt says it seems like there’s almost something protective about the CBD oil (which she said her daughter’s doctors in New York and Boston agree with).
“[CBD] oil shouldn’t be used unless it’s to treat a medical disorder in a state where it’s legal.”
Even so, Hilt still thinks the science is still out for CBD’s efficacy in kids without any medical issues. She thinks there needs to be more long-term research to safely use CBD oil on young children regularly, and she suggests that parents use it with caution. Dr. Lucido says that the oil shouldn’t be used unless it’s to treat a medical disorder in a state where it’s legal.
7. You shouldn’t buy the stuff online to treat your kid
For parents, it’s tempting to read about the effects of non-psychoactive CBD oil and mix some into their kid’s hot chocolate at night before bed. But it’s better to stay away from the online options, especially when the intentions are for a small child to ingest it regularly. CBD oils sold online contain even more obscure ingredients than vitamins (which aren’t regulated by the FDA), since companies often won’t disclose ingredient lists, according to Dr. Lucido.
Without accurate dosing and ingredient information, it’s just not the safest thing to use, he warns. He also reminds us that, up until recently, certain companies were receiving warning letters from the FDA regarding their CBD products.
8. CBD oil can be used to treat a variety of children’s ailments.
Dr. Lucido cautions against giving children CBD oil without the recommendation from a doctor. But, he says, if it’s legally purchased from a dispensary with a doctor’s recommendation, CBD oil can be highly effective in treating seizures, autism, ADHD, depression, and anxiety in children. The CBD-to-THC ratio may differ based on the child and what’s being treated.
9. You can serve it mixed into food.
Dr. Lucido says the best way to give the oil to your child is in a tincture placed right under the tongue or on the side of the cheek. If the child is fussy, he recommends mixing it into food. Because it’s fat-soluble, Dr. Lucido warns that dropping a dose into a glass of water will be less effective, as the oil can stick to the side of the glass. The oil mixes better with milk, for example.
10. Shaming is preventing sick children from getting help.
There are so many children with medical diagnoses who suffer daily, rotating different treatment plans, medications, and even surgeries, like Hilt’s daughter. Hilt insists that parents need to not be afraid to talk. She says: “Parents are afraid. There are benefits out there for epilepsy, autism, ADHD, and cancer pains. Parents are simply afraid to ask their doctor, and the best thing I ever could have done was ask my daughter’s neurologist about it.”
“The best thing I ever could have done was ask my daughter’s neurologist about it.”
11. Parents are trying to figure this out on their own.
Check your judgement at the door. There are parents who are desperately looking for healthy answers for their children, and other parents who are just curious. The internet has been a source of experience-sharing for parents. From Facebook groups to Reddit threads, parents are trying to figure this out together. Here’s a Reddit thread on the topic of finding relief for children with autism using CBD oil.
12. Conservative medical doctors acknowledge the benefits and need for studies.
13. Hemp-derived CBD products are now legal, but may contain contaminants . or no CBD at all.
Since CBD derived from hemp is of much lower quality than CBD derived from the flower of a marijuana plant, the risk of toxins released into the product skyrockets during production. The presence of contaminants in CBD products is a real concern. Plus, recent testing shows that plenty of brands advertise a CBD ingredient percentage on the label that is inaccurate, almost always portraying that there is more CBD in a product than there actually is. In fact, certain hemp-derived CBD products were found to contain zero CBD. If you have no idea what dose is included in a product, it likely isn’t the best idea to start giving it to a child regularly. Plus, the fact that the ingredient lists are still obscure is unsettling when it comes to dosing a tot or child.
Kids with different diagnoses can genuinely benefit from CBD oil to relieve their negative symptoms. The problem is, there aren’t enough solid long-term studies to know what kind of effect daily use will have later on in life in someone whose use started at a young age. The other problem? Kids who get serious relief from the CBD oil, like Hilt’s daughter Haley, need to live in a state where it’s legal. Plus, parents need to be able to afford it.
There’s still so much more to be found out about the long-term effects of the oil.
Meanwhile, buzz is floating around the internet that might lead other parents to start giving their kids daily doses of CBD oil before bed when there’s still so much more to be found out about the long-term effects of the oil. It’s also apparent that some of the CBD oil online contains obscure ingredient lists and doesn’t always inform the consumer of accurate dosing measurements. If you’re still tempted to bring home some CBD products for your tot or child, go with organic products from Wash With Water. The brand promises a transparent ingredient list and they were the first to release a legal skincare CBD line for little ones.
So, let’s support the research and the parents whose lives have changed for the better once they had safe, legal access to CBD oil for their kids. If you’re a parent who’s not sold on using CBD oil for your little ones but still need natural relaxation alternatives, use some lavender essential oil, a white-noise machine, and consult your pediatrician if that’s not cutting it.
Here are some alternatives to CBD to help safely calm your kiddo down before bedtime: