Epileptic children may be high on illegal cannabis
Australian families dosing their epileptic children with extracts of illicit cannabis to slow or halt damaging seizures were mostly unaware the drugs they were using had low concentrations of cannabidiol (CBD), the cannabis constituent thought to have the most health benefits, yet every sample contained amounts of tetrahydrocannabinol (THC), the psychoactive constituent that can give users a high, a new university study has found.
Seventy-five per cent of the surveyed families said the cannabis was an “effective” treatment for their epileptic children. “There’s an emerging literature now that THC in relatively low doses can have a variety of therapeutic actions, and that might include effects on epilepsy,” said Iain McGregor, academic director of the University of Sydney’s Lambert Initiative for Cannabinoid Therapeutics, which conducted the study.
However the study noted that concerns remained about the effects of THC on the developing brain, with some children found to have levels of THC metabolites in their urine that would be associated with intoxication and possible impairment in adults.
“We’d done earlier work that showed that recreational cannabis in Australia has very little CBD in it,” Professor McGregor said. “I guess if you’re making a medicinal product out of the cannabis that’s available illicitly, invariably it will tend to be THC-dominant, not so much CBD.”
It has been estimated that about 100,000 Australians now use illicit cannabis for medicinal purposes. Medicinal cannabis was legalised in Australia in late 2016, but the rollout has been slow. To date, about 700 Australian patients had been prescribed legal medicinal cannabis, Professor McGregor said, many of them children with epilepsy.
The study consisted of semi-structured interviews of 65 families with children with diverse forms of epilepsy, who were asked whether the cannabis was an effective treatment, and in most cases asked for a sample of the drug for analysis. It included technical analysis of the cannabis the families were using.
Lead author and PhD candidate with the Lambert Initiative Anastasia Suraev said THC was not necessarily high in all the samples: some had ultra-low doses of THC, while others were in the higher range.
Just fewer than half the families using medical cannabis had reduced their children’s anti-epileptic medication. “Our findings highlight the huge unmet clinical need in the management of treatment-resistant epilepsy in childhood,” Ms Suraev said.
Launched in 2016, before medicinal cannabis was legalised in Australia, the study found that families using cannabis extracts to treat their children’s epilepsy were more likely to report their children as being “treatment-resistant” or, in some cases, experiencing intolerable side-effects from standard epilepsy treatments.
Sixty-one cannabis extract samples were collected from families who were using or had previously used cannabis for their children’s epilepsy. Only 6 per cent of the extracts had doses of CBD that approached the minimum doses used in recent clinical trials, whereas 98 per cent of the extracts contained THC or THCA (found in fresh cannabis, before it is dried and the THCA becomes THC).
Chronic epilepsy in childhood is mostly characterised by repeated seizures and developmental delay, and treatment-resistant epilepsy affects between 20 and 30 per cent of patients.