In February of this year, the American Academy of Pediatrics, the official professional organization for more than 60,000 pediatricians representing the United States and Canada, published a position paper, entitled “The Impact of Marijuana Policies on Youth: Clinical, Research and Legal Update,” outlining the Academy’s recommendations regarding marijuana policies for children and youth.
That position statement and the comprehensive technical report that accompanied it, relied on the most current research and epidemiologic data available about the negative effects of marijuana on the developing pediatric brain; the physical, cognitive, and mental health side effects of both short-term and long-term recreational use; and what is known about the efficacy and safety of “medical marijuana.”
These two publications from the AAP were very timely given the recent laws across a number of states in the U.S. legalizing marijuana for both recreational use and medicinal purposes.
In short, The AAP has come out strongly against the legalization of marijuana for recreational use for all ages, as well as the legalization of medical marijuana for youth under the age of 18 outside of the FDA regulatory process. It was also recommended that the federal government change the scheduling of marijuana from a Schedule 1 to a Schedule 2 substance.
This would allow easier access for scientists to study the effectiveness of medical marijuana and the purified substances from the marijuana plant known to have pharmacological properties, such as tetrahydrocannabinol, or THC.
This change would promote needed scientific studies on the effectiveness of medical marijuana for certain specific conditions, as well as the risk to young people in terms of short-term and long-term side effects.
There are a number of reasons why the AAP has specifically come out against the expansion of medical marijuana laws to include adolescents and children under the age of 18 years.
First, “medical marijuana” refers to the use of the actual marijuana leaf or plant, in its various combustible and ingestible forms, for the alleviation of a number of specific conditions, such as intractable pain, nausea associated with chemotherapy as well as vague symptoms such as “pain.”
With smoked or ingested products (as in baked goods, for example), standardization of the amount of the active component in the marijuana plant, THC, is not possible, and the actual amount of THC delivered is at best only an estimate.
The FDA, whose purpose is to approve the indications and safety of drugs for children and adults, currently has no authority over the standardization of any “medical marijuana” products. Without this FDA approval process, the THC content in medical marijuana cannot be consistently verified and physicians cannot possibly provide accurate and safe dosing of these products to children. In addition, there is no impetus for this industry to standardize the products it is so successfully selling and marketing to millions of Americans.
Second, while there are a small number of research studies that have been done in adults assessing the effects of marijuana- based products and treatments on specific conditions such as chemotherapy-related nausea, poor appetite from chronic conditions, and intractable neuropathic pain, there are no studies that have been done on the beneficial effects or side effects of medical marijuana in children.
There are scattered anecdotal reports of its benefit, for example, with rare forms of seizures, but these are few and have not been systematically studied. This will undoubtedly continue to be the case unless, as mentioned above, marijuana is re-categorized as a Schedule 2 substance and research studies are done.
And while the AAP recognizes that there may be rare and specific cases where such an unusual clinical or an end-of-life situation may exist for a child, granting carte-blanche access to medical marijuana for any child requesting medical marijuana sets a dangerous precedent, and one that is expected to have repercussions in terms of overall increased access and greater recreational use by our youth.
Given the negative effects of marijuana on brain development, and cognitive performance and mental health disorders, we should not be recommending and supporting such laws.
We must remember that marijuana is not a benign substance. We owe it to our children and youth to be careful not to jump on the “marijuana band wagon.” The recommendations of respected professional scientific organizations provide guidance to our state of Connecticut, and future direction as data emerge regarding the effects of these laws in other states.
I urge the legislators of this state to exercise caution and prudence in moving forward with laws increasing our youth’s access to medical marijuana.
Dr. Sheryl Ryan is a professor of pediatrics at the Yale University School of Medicine and Chair of the AAP National Committee on Substance Abuse.