The American Academy of Pediatrics (AAP) are putting their support behind medical marijuana use for children with severe childhood diseases on a "case-by-case, compassionate use" basis, and is urging the Drug Enforcement Agency (DEA) to allow more research on marijuana's medical benefits, the group said in a new policy paper released this week.
The new policy statement updates the AAP's official views on marijuana policy 10 years after it last addressed the issue. Although the group remains opposed to recreational marijuana legalization, and says that young adults should not use, and should definitely not smoke marijuana, it now "strongly supports" research on the pharmaceutical uses of the drug.
The AAP's decision is critical because it lends significant weight to the debate happening in many state legislatures about whether to legalize medical marijuana and how quickly it should be made available, advocates say. It could also impact a bill, introduced to Congress last July by Rep. Scott Perry (R-Pa.), that would allow certain low-THC strains of marijuana to be used for medical purposes, despite the federal marijuana ban.
Seth Ammerman, lead author of the policy paper, told VICE News today that it was time for the AAP to join the national conversation on medical marijuana as advocates for children's health.
"The previous AAP policy statement and technical report on marijuana came out in 2004," Ammerman said. "Obviously a lot has changed in the landscape of marijuana in the US since then, both in terms of medical marijuana as well as legalizing recreational use of marijuana in adults 21 and over.
"The Academy felt it was important to update the policy statement to have its voice out there as these marijuana issues are moving forward," he added.
Families of young children who have chronic diseases including epilepsy have been pushing for access to medical marijuana that could help lessen or alleviate symptoms of their illnesses and treatments, Janice M. Buelow, vice president of programs and research at the Epilepsy Foundation, told VICE News.
While more research needs to be done on its possible effects, there should be ways for severely ill children to access the drugs now, she said.
"[Marijuana] is a potential treatment and those decisions need to be made between the physician and the patient," Buelow said. "Because of the way that medical marijuana is scheduled, it's hard to do research with it, and that's what needs to change.
We need much more work to be done to answer questions about doses, how can we make sure we're getting the same substance every time — the efficacy of it as a drug," she added.
Buelow and Ammerman pointed out that young patients with epilepsy aren't looking to smoke marijuana or ingest it in ways that make them vulnerable to psychoactive results like getting high. They are interested in Cannabidiol (CBD), one of 85 active ingredients in cannabis, which is not psychoactive, and may actually help reduce the number of seizures.
"Children who have really, really bad epilepsy — hundreds of seizures a day — kind of stop worrying about the risk of marijuana hurting the brain and are worrying about the seizures killing them," Buelow said. "If nothing else is working and it sounds like marijuana might be it, then it might be worth a shot for them."
The AAP is urging the DEA to change marijuana's classification to a Schedule 2 drug, which would mean it is accepted as having the potential for medical use in the US. The US Food and Drug Administration most recently reviewed marijuana's classification in 2006 and recommended it remain in the Schedule 1 drugs category, which have no accepted medical use, but is currently reanalyzing the classification.
The AAP also recommended that in addition to further research on the potential medical benefits of medical marijuana, kids who need the drugs now should be evaluated for potential treatment with CBD.
'It's good to see the recognition that there are kids facing epilepsy and other serious conditions who could benefit from marijuana.'
"If a family feels that standard therapy has failed their kid, then the pediatrician can have a discussion about whether CBD might be useful," Ammerman said. "From our point of view, it's a case by case basis."
Medical marijuana laws have passed in 23 states, though in some, children still don't have access to medications that might help their conditions, Julie Netherland, New York state deputy director of the Drug Policy Alliance, a reform group aimed at changing the nation's drug policy laws, told VICE News today.
Netherland gave the example of a 14-year-old Long Island boy with a serious brain injury who has not responded to treatment for the dozens and dozens seizures he has a day. Although medical marijuana was legalized in New York last year, it will not be available until 2016, she said.
"Each [seizure] is life threatening and he's being told he can't access this medication that could potentially save his life," Netherland said. "To be denied access is really unconscionable."
The group is now urging New York Governor Andrew Cuomo to grant access to patients earlier.
"CBD has had, for some children, a really dramatic impact on the number and severity of the seizures they've been having," Netherland added. "That's why there's so much interest from families in New York and elsewhere."
The AAP policy statement also included positions on the broader marijuana debate, including on decriminalizing possession and the possibility of legalizing the drug for recreational use.
"The academy feels strongly that it should be taken out of the criminal justice system and put into healthcare system," Ammerman said. "Kids who possess marijuana should not be punished for it but should get education and help and proper treatment if they need it, and that doesn't really happen in the criminal justice system."
But the group is not so fast to endorse widespread legalization for recreational use. Ammerman noted that in states where medical marijuana is legal there has not been a clear indication of an increase or decrease in marijuana use among young people; that is, they don't seem to be getting unauthorized access to the drug. The doctors aren't so sure that would remain true if marijuana were legalized for recreational use across the country.
"We're skeptical because of the history of what is happening with the tobacco industry and the rules and regulations with tobacco and youth and youth use," Ammerman said. "For decades tobacco companies have ignored them or gotten around them, they denied they were marketing to youth, and they still do."
"We know that adolescents are particularly prone to the adverse effects of marijuana because of the developing brain," he added. "If you legalize this product and it's mass produced and mass sold and advertised and so on, it's very likely to increase youth access and cause more youth more problems. We're pediatricians, we're coming at it from the viewpoint to protect and promote youth health."
The DPA applauded AAP's official change of opinion, though Netherland said it did not go far enough, arguing that legalizing and regulating the drug would allow authorities to better prevent it from getting into the hands of young kids through prevention programs and identification checks.
"It's good to see the recognition that there are kids facing epilepsy and other serious conditions who could benefit from marijuana," she said, and the "acknowledgment that some kids are not going to be able wait for — like in New York — the government to get its act together to expedite it for the children who need it."
Ultimately, though, Netherland said her organization agrees with the AAP that kids shouldn't be using marijuana, except in emergency medical conditions.
Follow Colleen Curry on Twitter: @currycolleen
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