Medical Cannabis for Paediatric Care

Medical Cannabis for Paediatric Care

In November 2018, the UK law was changed to make prescribing medical cannabis legal, but parents still struggle to obtain prescriptions. Parents whose children have a condition that can be helped by medical cannabis are very upset and frustrated that they can’t get the medicine. Prescriptions for medicinal cannabis are far from straightforward at the moment.

Sativex is not recommended for use in children or adolescents below 18 years of age.

Does your child, or a patient under the age of 16, require paediatric care?

As parents and caregivers, our number one goal is to give our kids the best care possible. When traditional treatments aren’t enough to help a child, medical cannabis can be a safe and effective option.

In the most common case studies, medical cannabis has been shown to help people with severe epilepsy. A variety of childhood syndromes, including Dravet syndrome and Lennox-Gastaut syndrome (LGS), can be treated with medicinal cannabis, which typically does not respond to anti-seizure medications.

The study ‘Medical Marijuana in the Pediatric Population with Epilepsy-What You Should Know’ by Michelle Markle and Donna G. Nativio from 2019 gives anecdotal evidence of the positive effects of on children with seizures.

Types of Cannabis-Based Medicines Available in the UK

In the UK, cannabis-based medicinal products are generally classified into three main types: licensed, unlicensed (‘specials’), and non-pharmaceutical grade.

  1. Licensed Cannabis-Based Medicinal Products:
    • CBD-Only Products: One of the key products is Epidyolex®, a cannabidiol (CBD) oral solution that has undergone extensive clinical trials and is pharmaceutical-grade. It was approved in 2019 for treating certain types of epilepsy, such as Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS), in combination with clobazam .
    • CBD Plus THC Products: Sativex, an oromucosal spray, is another licensed medication used to treat symptoms of spasticity in adults with multiple sclerosis (MS). However, its use is not generally recommended for children due to a lack of comprehensive studies on this age group .
    • Synthetic Cannabinoids: Nabilone is a synthetic cannabinoid used in adult patients to manage chemotherapy-induced nausea that does not respond to traditional treatments, though its usage is relatively rare .
  2. Unlicensed Cannabis-Based Medicinal Products (‘Specials’): These are specially manufactured or imported for specific cases when no suitable licensed medication is available. They often contain a mixture of CBD and THC, posing potential risks such as dependency and cognitive effects if not carefully monitored .
  3. Non-Pharmaceutical Grade Cannabis Products: Products in this category are often found in health stores and online but lack the stringent quality controls of licensed products. Their ingredient consistency is questionable, and they may contain impurities, making their effectiveness uncertain and potentially posing risks .

Prescribing Practices in the UK

Currently, Epidyolex® is the only widely prescribed licensed cannabis-based medication in the UK, with other unlicensed options considered only under strict conditions and guidelines provided by the Home Office .

Global Differences in Cannabis-Based Medicine Availability

While cannabis-based medicines are more readily available in some other countries, this disparity largely stems from the varying levels of research and acceptance regarding their efficacy and safety. The UK’s approach remains conservative, awaiting more substantial scientific evidence before these products become broadly accessible .

The RCPCH’s Position

The Royal College of Paediatrics and Child Health (RCPCH) continues to advocate for accelerated, high-quality research into the use of cannabinoid-based treatments for complex childhood epilepsies and other applicable conditions. They stress that any prescribed treatment must be grounded in solid scientific data to ensure its safety and efficacy .

Additional Considerations

RCPCH highlights the importance of reporting any adverse reactions associated with cannabis-based medicinal products, whether they are licensed or unlicensed, to the Medicines and Healthcare products Regulatory Agency (MHRA). This vigilance is essential to safeguard patients and to help refine the guidelines for these treatments in clinical practice .

For further details, you can access the full reports and guidelines:

FAQ

What is the goal of paediatric care?

The goal of paediatric care is to treat and manage the symptoms of severely unwell children and young people suffering from a variety of complex diseases. It is classified into four major categories:

  • General paediatrics: a hospital role covering children from birth to the age of 16
  • Paediatric cardiology: a small area specialising in the diagnosis and treatment of children with heart conditions
  • Neonatology: specialising in looking after newborn babies, usually based in an intensive care unit looking after premature babies or those with problems at birth
  • Community paediatrics: based in the community to look after children with developmental, social, or behavioural problems and those with a physical disability

When it comes to our children, getting the greatest possible care is the number one priority of any parent and caregiver. When standard methods of support or improvement are insufficient, medical cannabis can be a safe and beneficial alternative, even for youngsters.

What are some of the most common conditions that necessitate paediatric care?

There are certain illnesses that affect children in unique ways and must thus be addressed with these specific problems in mind. They are as follows:

  • Rare and chronic epileptic disorders
  • Lennox-Gastaut Syndrome
  • Gastroenterological conditions
  • Chronic pain
  • Behavioural issues
  • Anxiety and depression disorders

Of course, children can develop many of the same illnesses and conditions that adults do, but it’s vital to note the distinction for these conditions, where they can either just affect children or affect children differently than adults. This is especially crucial in the case of epilepsy, because certain epileptic disorders only affect children.

What are some common symptoms of illnesses requiring paediatric care?

The specific symptoms experienced by the youngster will, of course, depend on the disease for which they have been diagnosed. They may suffer from the following conditions, depending on their condition:

  • Seizures
  • Stress and anxiety
  • Speech or memory loss
  • Developmental issues
  • Chronic pain

What types of treatments are commonly employed in paediatric care?

Treatment for children must always be carefully evaluated, as some treatments used on adults cannot be utilised on children. Treatment is usually determined by the illness and the intensity of the symptoms.

Treatment for paediatric neurology, for example, will frequently differ from treatment for epilepsy or other children diseases. They may, however, include:

  • Prescription medications, such as pain relief
  • Psychological therapy
  • Certain surgeries
  • Behavioural therapy

At CPGUK, we offer information and support about the possible treatment options and patients who are looking for specialist doctors. We can guide you through the medical cannabis treatment evidence in the UK, and the research by academics and advocates.

Read about how to get a prescription for cannabis medicines.