All posts tagged: Pediatrics

The Possible Effects of Cannabis Use in Adolescent Females

What Every Pediatric Gynecologist Should Know About Marijuana Use in Adolescents

In summary

A recent article has called for pediatric gynecologists to ward against the use of cannabis in adolescent females. By pointing out the inconsistent conclusions from multiple papers discussing the effect of cannabis use on neural development and fertility the author hopes to reduce the number of adolescent females utilizing cannabis. It is also pointed out that very little is known about the association between cannabis and mental health problems such as various forms of psychosis, anxiety, and depression. Considering how little conclusive evidence has been agreed upon by overarching associations of medical professions it does seem appropriate to warn against the risks of recreational cannabis but not without also acknowledging the possible benefits of medical cannabis. 

While there are many inconsistencies surrounding cannabis research some of the inconsistent conclusions can be heavily biased by funding parties. Biased articles are difficult to get around because they require fully delving into the material listed analyzed in the paper and looking into the studies that were included and left out of the meta-analysis to determine the validity of their findings. It is extremely frustrating to have articles presented to the public that are so heavily biased they cherry-pick data just to prove their side of a politically controversial therapy. Not all cannabis use is beneficial and is not well understood, but posting articles like this one give fodder to people attempting to prevent the rescheduling of cannabis so that specific chemicals can be harnessed for novel therapies to treat ailments we have no effective treatment for, such as Alzheimer’s, specific cancer types, and a slew of psychiatric disorders. Scientists have a responsibility to remain objective and this type of biased research is disappointing to come across.

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Benjamin Caplan, MDThe Possible Effects of Cannabis Use in Adolescent Females
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Brief Interventions by Pediatricians can Reduce Adolescent Alcohol and Drug Abuse

Understanding Which Teenagers Benefit Most From a Brief Primary Care Substance Use Intervention

In Summary

A recent study has revealed that brief interventions given by primary care physicians can reduce alcohol and drug abuse among at-risk adolescents. This study aimed to address only alcohol and cannabis use disorders in teenagers who already reported the misuse of such substances. Participants were randomly assigned to receive an intervention from their physician or assigned as controls and then asked about their substance use habits 12 months later. Those who received an intervention reported a marked decrease in substance use through self-reporting and chemical screening. This research suggests that pediatricians and other general practitioners should speak candidly about the risks of substance use disorders with their patients. 

Pieces like the featured article highlight the importance of responsible cannabis use. Cannabis is becoming more socially acceptable as states continue to put forth policies that legalize medical and recreational use. Like alcohol and other drugs, cannabis should remain a semi-controlled substance whose availability is restricted by age or other factors so that at-risk youth are unable or less likely to abuse its benefits. State laws currently decide who has access to cannabis but as at-home cultivators become more prominent it will be necessary to ensure the security of those plants to prevent adolescents from misusing plants grown by family or friends. 

The study is available for review or download here

View more studies like this in the CED Foundation Archive 

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Benjamin Caplan, MDBrief Interventions by Pediatricians can Reduce Adolescent Alcohol and Drug Abuse
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Adolescent Cannabis Use Linked to Sleep Disturbances

Sleep Disturbances, Psychosocial Difficulties and Health Risk Behavior

Summary info:

A Dutch study investigated sleep disturbances in adolescents. Sleep disruption was linked to cannabis use, psychosocial difficulties, health risk behavior, and increased suicidality. Additionally, gender disparity in results suggests that girls may be more susceptible to sleep disturbances than boys , a result consistent with past recognition of some gender discrepancies in cannabis activity. These results highlight the importance of discouraging haphazard cannabis use, during adolescence, and the need for further gender-focused research surrounding sleep habits and cannabis use.

Dr Caplan, CED Foundation, and the #MDTake:

There are a few important issues that converge in this review. Generally, the question of adolescents’ use, (as an alternative way of describing the question of effects on a developing brain.) Also, this paper raises valuable questions about how cannabis may be interacting with sleep hygiene, for better or for worse. Psychosocial impact and risky behaviors are very complex topics to engage, even with a fairly large population sample of (n=16,781.) There are lots of intercorrelated topics assessed, analyzed, and discussed in the review, and it is all-too-easy to want to find causal patterns that are not apparent, again for better or worse, unless one chooses to construe the results or interpretation with causation in mind. Realistically, it is very likely to find overlap in a population of adolescents who have psychosocial difficulties, engage in risky behaviors, have increased risk of suicidality, and consume cannabis. To point to one of the components, arbitrarily, as the primary cause of the others is to unnecessarily and unjustly oversimplify a complex set of circumstances. The essential tenet, different genders seem to react differently with cannabis, is an excellent take-away, and also that we have much more still to learn.

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This paper is also stored here:    http://bit.ly/314TsEC     inside the CED Foundation Archive

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Benjamin Caplan, MDAdolescent Cannabis Use Linked to Sleep Disturbances
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Case Studies Reveal Difficulties in Differences between State Cannabis Laws

Crossing the Line: Care of a Pediatric Patient with Intractable Seizures and Severe Neuropathic Pain in Absence of Access to Medical Marijuana

A recent case report discussing a six-year-old patient suffering from a seizure disorder has exposed the difficulty is receiving treatment across state lines. The patient was prescribed medical marijuana that alleviated the severity and duration of her seizures but was weaned off of that medication when traveling to Nebraska for a therapeutic surgery, due to the legal status in the state. This case study exposes the difficulty of treating patients across the country due to the legal variability of cannabis across states.  

Author’s summary reflections:

“The current state-specific approach to medical marijuana notably burdens patients, families, and health care systems with a fragmented approach to symptom management based on local context. The stigmatization or legal implications of medical marijuana in certain settings may lead well-meaning providers to avoid asking about use or to struggle with appropriate response. Provider response to parents reporting medical marijuana use in Schedule I settings notably varies from direct inquiry, feigned ignorance, or informed ignoring. Ideally, providers would compassionately and competently inquire about pharmaceutical and nonpharmaceutical interventions (to include medical marijuana use) as part of comprehensive palliative care symptom assessments.”

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This paper is also stored here:     http://bit.ly/2IxPoWN    inside the CED Foundation Archive

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Benjamin Caplan, MDCase Studies Reveal Difficulties in Differences between State Cannabis Laws
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Video: Do-It-Yourself Cannabis Tinctures

One of the terrific realities of modern Cannabis is that it is possible, and often quite simple, to make effective products at home. With suitable education and access to testing facilities, the soil, nutrients, and plant growth can be supported at home, lab-tested for make-up and potency, as well as safety-checked for potential microscopic contaminants, and ultimately, individualized medicine can be created right at home!

Here is a sample instructional for just one way that cannabis tincture can be made at home. There are countless others and hopefully, many that are yet to be discovered!

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Benjamin Caplan, MDVideo: Do-It-Yourself Cannabis Tinctures
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A Call for More Research: Adolescent Cannabis Use and Mental Health Risks

Title: Adolescent Cannabis Use and Risk of Mental Health Problems – The Need for Newer Data

Here, an article presenting a case, justifying the need for new research to determine how cannabis use in adolescents may affect their risk for mental health. Few recent studies have come out discussing mental health and adolescent use. This is problematic because, over the years, cannabis products have been curated to be significantly more potent than in the past. Considering how vulnerable the brain is, during adolescence, because it is still developing, longitudinal studies need to be conducted to fully elucidate the effects of cannabis on development. 


This review highlights how poorly adolescents consuming cannabis seem to be at titrating their dose, or correctly self-regulating consumption of cannabis. There is an overall need for greater education before cannabis is acquired, from a dispensary or otherwise. For adults and teens seeking to self-regulate their use of cannabis, irrespective of the consumption method, it is difficult to succeed, considering the gross lack of knowledge and sophistication around the dosage. The wide variability in choice and make-up of cannabis products, added to the complexity associated with how each patient may process the myriad of cannabinoids within the products consumed leads to a complexity of confounding variables, and here, a call for more studies to be conducted on more than just adolescents. 

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This paper is also stored here:   http://bit.ly/2XGXNLC      inside the CED Foundation Archive

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Benjamin Caplan, MDA Call for More Research: Adolescent Cannabis Use and Mental Health Risks
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Pediatric Oncology Center Justifies the Use of Medical Cannabis

Pediatric oncologists from Minnesota recently published an article justifying their use of medical cannabis as palliative care for their patients.

The majority of patients at the oncology center were approved for medical cannabis use during their first round of treatment, in order to immediately address the negative side effects of chemotherapy such as nausea, pain, and cancer cachexia. The data provided from the center described much higher chemotherapy compliance rates among patients, and that patients have a much better quality of life when utilizing cannabis.

This article highlights a few promising trends and issues with using medical cannabis; one promising trend is the hope for cannabis to provide antitumor effects. Cannabis has been a subject of exploration for antitumor effects and it has shown promising results. But, there are many limitations to the few studies that have been published, leading the authors to defer any definitive conclusions. The center in Minnesota noted that many of the patients diagnosed with brain tumors were especially hopeful that cannabis would aid in curing them of cancer, second to utilizing the drug for nausea. This is a promising trend because it means the greater public is showing interest in the therapeutic possibilities of cannabis and their support and call for research will aid the drive for the federal rescheduling of marijuana. 

Also highlighted in this article is that, of all the patients certified to use medical cannabis, a subset of 24% never actually registered through the state to receive it. The authors have no firm explanation for these circumstances but seem to suspect that the $200 annual certification fee, on top of the cost for each additional dispensed product may be limiting of patients abilities to afford cannabis. Without the backing of the federal government, insurance companies are unable to cover medical cannabis. As the depth and reach of cannabis research grow, there are good reasons for patients to feel optimistic about medical cannabis.

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This paper is also stored here:    http://bit.ly/2Xb2O3N     inside the CED Foundation Archive


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Benjamin Caplan, MDPediatric Oncology Center Justifies the Use of Medical Cannabis
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Case Studies Reveal Difficulties in Differences between State Cannabis Laws

Crossing the Line: Care of a Pediatric Patient with Intractable Seizures and Severe Neuropathic Pain in Absence of Access to Medical Marijuana

A recent case report discussing a six-year-old patient suffering from a seizure disorder has exposed the difficulty is receiving treatment across state lines. The patient was prescribed medical marijuana that alleviated the severity and duration of her seizures but was weaned off that medication when traveling to Nebraska for a therapeutic surgery due to the legal status in the state. This case study exposes the difficulty of treating patients across the country due to the legal variability of cannabis across states.  

An interesting question brought up in this case study is how to handle palliative care in the absence of opioids and without synthetic products. A combination of massage, essential oils, and salt light therapies were able to compensate for medical marijuana, but not without great effort. Natural therapies like the ones administered here are costly and highlight the simplicity and effectiveness of medicinal cannabis.

View this review (yellow link) or download:

This paper is also stored here:   http://bit.ly/2IxPoWN      inside the CED Foundation Archive

To explore related information, click the keywords below:

Benjamin Caplan, MDCase Studies Reveal Difficulties in Differences between State Cannabis Laws
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Cost-effectiveness of treating pediatric drug-resistant epilepsy

Cannabis-based treatments may reduce seizures among children with drug-resistant epilepsy, but are these treatments cost-effective? 

Economic evaluations of cannabis treatments are needed, and they should address issues including weight-gain over time, switching or discontinuation of treatments, the effectiveness of interventions, and long-term success, beyond the duration of available clinical studies.

This paper is also stored here:     http://bit.ly/2INWAOJ    inside the CED Foundation Archive

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Benjamin Caplan, MDCost-effectiveness of treating pediatric drug-resistant epilepsy
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Vaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA

Out of 2,835 high school students from North Carolina, 272 students (or 9.6%) reported ever vaping cannabis. Interestingly, the odds of ever vaping cannabis were significantly higher among males (11.0%) compared with females (8.2%), and significantly higher among non-Hispanic white students (11.3%) compared with non-Hispanic black students (5.0%).

It’s clear that white males are the most likely to have ever vaping cannabis. Why might minority students engage less with recreational drug use?

View this review (yellow link) or download:

This paper is also stored here:    http://bit.ly/2L6zYdv     inside the CED Foundation Archive

Benjamin Caplan, MDVaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA
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