Young pa­tients use pot: sur­vey

The Beacon Herald - - NATIONAL NEWS - CAS­SAN­DRA SZK­LARSKI THE CANA­DIAN PRESS

TORONTO — About half of pe­di­atric doc­tors sur­veyed about cannabis say they’ve en­coun­tered a young pa­tient who had used mar­i­juana for a med­i­cal rea­son.

The ques­tion­naire for the Cana­dian Pae­di­atric Sur­veil­lance Pro­gram found 419 of 835 re­spon­dents had a pa­tient who had used ei­ther au­tho­rized or unau­tho­rized cannabis for some sort of med­i­cal re­lief.

The one-time study did not de­tail how many cases in­volved unau­tho­rized use, the na­ture of the con­di­tion be­ing treated nor the ages of the pa­tients. Prin­ci­pal in­ves­ti­ga­tor Richard Be­langer says he’s sur­prised by the num­ber of young cannabis users and says it points to the need for more in­for­ma­tion for doc­tors, par­ents and pa­tients.

The Que­bec City pe­di­a­tri­cian, also a pro­fes­sor at Laval Uni­ver­sity, notes that more than a third of re­spon­dents — or 316 doc­tors — said they had been asked by a par­ent or ado­les­cent pa­tient to pre­scribe cannabis.

Only 34 doc­tors said they had done so, with many ex­press­ing reser­va­tions about ef­fi­cacy, im­pacts to de­vel­op­ing young brains, and con­cerns about abuse and de­pen­dence.

The one-time sur­vey was con­ducted in the spring of 2017 as part of the sur­veil­lance pro­gram’s larger look at a host of hot-but­ton is­sues in­clud­ing Lyme disease, Zika virus and eat­ing dis­or­ders.

Be­langer says re­searchers were sur­prised by how many kids and ado­les­cents ap­peared to be turn­ing to med­i­cal mar­i­juana: “We thought it was less than that.”

“We re­ally want to make clear that cannabis is not only an adult is­sue, ei­ther for recre­ational but (also) med­i­cal pur­poses,” Be­langer said of the find­ings.

“Some­times when we look at

treat­ment we tend to for­get kids and it should not be the case.”

He sus­pected younger kids re­ceived au­tho­rized use for con­di­tions in­clud­ing re­frac­tory seizures, cere­bral palsy, and chronic pain, while ado­les­cents were more likely to be unau­tho­rized users and to treat other con­di­tions “such as sleep prob­lems or anx­i­ety.”

Be­langer says the higher-thanex­pected us­age could also be be­cause the doc­tors sur­veyed gen­er­ally treat kids with chronic and se­vere con­di­tions that may re­quire al­ter­na­tive treat­ments, and be­cause most re­spon­dents came from ur­ban and aca­demic cen­tres more likely to han­dle se­vere cases.

The sur­vey re­sponse rate was also just 31 per cent, which “may un­der or over rep­re­sent the knowl­edge and/or ex­pe­ri­ences of Cana­dian pe­di­a­tri­cians,” said the study, re­leased Thurs­day.

Still, the find­ings raise ques­tions about how im­pend­ing le­gal­iza­tion of recre­ational mar­i­juana could im­pact unau­tho­rized med­i­cal use.

“We’re a bit anx­ious re­gard­ing that,” said Be­langer, point­ing to “mixed per­spec­tives” among doc­tors.

“From a pe­di­atric per­spec­tive there’s sel­dom rea­son to au­tho­rize cannabis and maybe seizure is one of them but still, there’s no clear, no big ev­i­dence re­gard­ing that.”

The sur­vey found a clear ma­jor­ity of re­spon­dents had no knowl­edge or min­i­mal knowl­edge on why cannabis might be pre­scribed for a child or youth and what prod­ucts and dosages may be au­tho­rized.

“Para­dox­i­cally, they have a fairly pos­i­tive view re­gard­ing cannabis use for med­i­cal pur­poses for cer­tain con­di­tions, de­spite the lack of solid sci­en­tific ev­i­dence re­gard­ing its safety and ef­fi­cacy,” said the sur­vey, not­ing that could be due to dif­fi­cult cases with lim­ited ther­a­peu­tic op­tions.

Al­though med­i­cal mar­i­juana has been le­gal since 2001, many ques­tions re­main, says Be­langer. “It’s a burn­ing is­sue.”

“There’s a large space for the (Cana­dian Pae­di­atric So­ci­ety) or any other as­so­ci­a­tion or au­thor­i­ties to give more in­for­ma­tion on what are the clear facts re­gard­ing the pos­si­ble ben­e­fits and the likely ad­verse events that can be re­lated to med­i­cal use of cannabis.”

Be­langer notes the data was gath­ered prior to the pub­li­ca­tion of a piv­otal study eval­u­at­ing the use of cannabid­iol (CBD) to treat epilepsy among chil­dren with Dravet syn­drome re­ported in the New Eng­land Journal of Medicine in the spring of 2017.

Still, he be­moans a dearth of ma­te­rial to of­fer guid­ance. While more stud­ies are un­der­way, he says they mostly look at CBD and its ef­fects on seizures and se­vere con­di­tions.

VERONIQUE COTE/VIA THE CANA­DIAN PRESS

About half of pe­di­atric doc­tors sur­veyed about cannabis say they’ve en­coun­tered a young pa­tient who had used mar­i­juana for a med­i­cal rea­son. Prin­ci­pal in­ves­ti­ga­tor

Richard Be­langer, of the De­part­ment of Pae­di­atrics at Cen­tre mere-en­fant Soleil, says he’s sur­prised by the num­ber of young cannabis users and says it points to the need for more in­for­ma­tion for doc­tors and pa­tients.

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