Cannabis use for therapeutic purposes by children and youth at a tertiary teaching hospital in Canada: A retrospective chart review

Background: The study of the use of cannabis for therapeutic purposesin the pediatric population is increasing, yet data on efficacy and safety are limited. Characterization of pediatric cannabis use for therapeuticpurposes will improve understanding of the circumstances under which it occurs and the associated outcomes.

Objective: To describe the use of cannabis for therapeutic purposes, regardless of authorization, in a pediatric tertiary teaching hospital.

Methods: A retrospective chart review was completed for patients 18 years of age or younger who used cannabis for therapeutic purposes, regardless of authorization, between May 1, 2014, and May 1, 2017. Patients whose cannabis use was documented as recreational were excluded.

Results: In total, 300 patients were identified, of whom 37 met the inclusion criteria. Of these, 30 patients had documentation of medically supervised cannabis use. Most were using cannabis for seizures (n = 28), and many of these (n = 23) were patients with seizures described as intractable or refractory. Of the 27 patients who were experiencing seizures at initiation of medical cannabis, 21 had documentation of a decrease in seizure frequency. This decrease was transient for 16 patients, with a mean duration of 130.4 days (standard deviation 99.1 days). Seven patientsself-medicated with cannabis. They obtained cannabis without author-ization and used it for chronic pain (n = 5) and/or anxiety (n = 5).

Conclusions: Medically supervised cannabis use occurred most often in patients with intractable or refractory seizures. According to these data, seizure response is variable, and initial decreases may be transient for pediatric patients using cannabis. To ensure greater consistency and rigour in the conduct of prospective research and thus to generate better-quality research on the therapeutic effects of medical cannabis, development of a standardized care record is needed.