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      Children and Youth Who Use Cannabis for Pain Relief: Benefits, Risks, and Perceptions

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          Abstract

          We provide up-to-date perspectives on the benefits and risks of medical cannabis for pain management in children and youth. To date, only two studies (a case report and a small observational study) have examined the effects of medical cannabis on pain in children and youth. No controlled trial has commented on long-term safety of medical cannabis. Findings from the recreational cannabis literature reveal significant potential short- and long-term risks of regular cannabis use, including impaired driving, depression, suicidality, psychosis, and tolerance. Despite this, many children and youth are self-medicating with cannabis, and perceive regular cannabis use to be safe. There is a need for better education and counselling of patients regarding the benefits and risks of medical cannabis use.

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          Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects.

          Ethan Russo (2011)
          Tetrahydrocannabinol (THC) has been the primary focus of cannabis research since 1964, when Raphael Mechoulam isolated and synthesized it. More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated. Other phytocannabinoids, including tetrahydrocannabivarin, cannabigerol and cannabichromene, exert additional effects of therapeutic interest. Innovative conventional plant breeding has yielded cannabis chemotypes expressing high titres of each component for future study. This review will explore another echelon of phytotherapeutic agents, the cannabis terpenoids: limonene, myrcene, α-pinene, linalool, β-caryophyllene, caryophyllene oxide, nerolidol and phytol. Terpenoids share a precursor with phytocannabinoids, and are all flavour and fragrance components common to human diets that have been designated Generally Recognized as Safe by the US Food and Drug Administration and other regulatory agencies. Terpenoids are quite potent, and affect animal and even human behaviour when inhaled from ambient air at serum levels in the single digits ng·mL(-1) . They display unique therapeutic effects that may contribute meaningfully to the entourage effects of cannabis-based medicinal extracts. Particular focus will be placed on phytocannabinoid-terpenoid interactions that could produce synergy with respect to treatment of pain, inflammation, depression, anxiety, addiction, epilepsy, cancer, fungal and bacterial infections (including methicillin-resistant Staphylococcus aureus). Scientific evidence is presented for non-cannabinoid plant components as putative antidotes to intoxicating effects of THC that could increase its therapeutic index. Methods for investigating entourage effects in future experiments will be proposed. Phytocannabinoid-terpenoid synergy, if proven, increases the likelihood that an extensive pipeline of new therapeutic products is possible from this venerable plant. http://dx.doi.org/10.1111/bph.2011.163.issue-7. © 2011 The Author. British Journal of Pharmacology © 2011 The British Pharmacological Society.
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            Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood

            Gabriella Gobbi, Tobias Atkin, Tomasz Zytynski … (2019)
            Cannabis is the most commonly used drug of abuse by adolescents in the world. While the impact of adolescent cannabis use on the development of psychosis has been investigated in depth, little is known about the impact of cannabis use on mood and suicidality in young adulthood.
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              Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.

              Marcus A Bachhuber, Brendan Saloner, Chinazo Cunningham … (2014)
              Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Adolesc Health Med Ther
                Journal ID (iso-abbrev): Adolesc Health Med Ther
                Journal ID (publisher-id): AHMT
                Journal ID (pmc): ahmt
                Title: Adolescent Health, Medicine and Therapeutics
                Publisher: Dove
                ISSN (Electronic): 1179-318X
                Publication date (Electronic): 21 May 2020
                Publication date Collection: 2020
                Volume: 11
                Pages: 53-61
                Affiliations
                [1 ]Faculty of Medicine, University of Toronto , Toronto, ON, Canada
                [2 ]Faculty of Medicine, McMaster University , Hamilton, ON, Canada
                [3 ]Department of Psychiatry and Behavioural Neurosciences, McMaster University , Hamilton, ON, Canada
                Author notes
                Correspondence: Zainab Samaan St. Joseph’s Healthcare Hamilton, West 5th Campus , 100 West 5th Street, Hamilton, ONL9C 0E3, CanadaTel +1-905-522-1155 x39215 Email samaanz@mcmaster.ca
                Author information
                http://orcid.org/0000-0002-3823-8394
                http://orcid.org/0000-0001-7406-4056
                http://orcid.org/0000-0002-5974-9361
                Article
                Publisher ID: 254264
                DOI: 10.2147/AHMT.S254264
                PMC ID: 7247732
                PubMed ID: 32547283
                SO-VID: d3c3d528-aa15-42a1-b542-87da433270a3
                Copyright © © 2020 Woo et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 17 March 2020
                Date accepted : 24 April 2020
                Page count
                References: 72, Pages: 9
                Categories
                Subject: Perspectives

                Keywords: marijuana,thc,cbd,adolescents,pediatrics
                Data availability:
                Keywords: marijuana, thc, cbd, adolescents, pediatrics

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