CBD Oil- Which Side Are You On?

Today the news was all abuzz with the FDA approval of Epidiolex, a cannabis-based drug that is approved to treat two very rare forms of childhood epilepsy (respectively Dravet syndrome and Lennox-Gastaut syndrome). In effect, a prescription formula for CBD oil, purified in a medical lab, for a very specific use.

I have been asked by several parents what my view of CBD oil is for the treatment of ADHD. While I suspect that this will be a hot topic at the November International Conference on ADHD ,the jury is still far "out" from where I sit. Like many of my colleagues, I am still waiting for more data to show the effects of CBD oils on the ADHD brain. Given the rapid fire development that occurs in the adolescent brain, I am even more cautious about its use for developing minds. The damaging effects of marijuana on a growing brain is impactful, and not in a good way. You can read more about the studies here, and you can read more about a study of cannabis and CBD in adolescence here as well. For a brain that is already compromised and operating at a 3-5 year developmental delay, the addition of marijuana products feels like adding fuel to the fire.

Now, now, my cannabis-friendly readers...please put your pitchforks down. I'm not sure that the reported decrease in anxiety from using CBD oil warrants adding it to my child's treatment regimen just yet, but the fact that there is something on the medical market for cannabidiol to treat another health disorder in pediatrics is intriguing. And the product IS controlled and measured. In other words, what you see on the label IS what you get. Remember, I'm a bit of a science geek when it comes to "proven treatments". I'm looking at this through the ADHD lens. There are many anecdotal stories of people self-medicating with both cannabis and CBD oils claiming to find relief from some of their ADHD symptoms. There just isn't good scientific evidence to support either. In fact the evidence is damning for marijuana.

I would love to see alternatives to Adderall and Ritalin, for sure. Right now, the best non-medication options are therapy, coaching, adequate sleep, a healthy diet, regular exercise and mindfulness. Now, for those of you reading between the lines, CBD oil in a Rx form like Epidiolex is technically medication. It is created in a sanitary laboratory setting and measured for potency and quality with the same rigor as other prescription medications. Does it mean that we can make a leap to treating ADHD?

Here's why I'm not yet convinced:

  1. Quality: it's still very much the wild west when it comes to refined CBD oils. There is no way of knowing the quality of the plants or the processing procedures from one product to the next.

  2. Quantity: As with quality, there is no way to know if you are actually getting the dosage that is listed on the packaging. In other words, "buyer beware". There is no regulation in this arena - it's like buying vitamins and hoping you are actually getting a quality supplement when you purchase a product off the shelf.

  3. Sources: hemp vs cannabis - which one is better or worse? Hemp has less cannabidiol than CBD derived from marijuana. Neither contain THC, the component in marijuana that gives you that signature high.

  4. Long-term data: Remember cigarettes? low-fat diets? sugar substitutes like saccharine? All were once touted as a good option for consumption, and the data has come out against all 3 of them. We have no idea what the long-term effects of this might be. Perhaps cannabis growers will see a little redemption, like olive oil and butter have, through the extraction of CBD oil for medicinal purposes? 

There are all sorts of studies under way regarding cannabis and CBD Oil. The fact that the FDA has endorsed the first medical use of CBD Oil for epilepsy is promising..for epilepsy. Until the data for ADHD starts rolling in for the positive and the market is regulated for consistency and quality, I am sitting on the sidelines. I'll say it again...There is no good quality data to support the use of CBD oil for ADHD at this time. There is, however, some intriguing data on it's use for pain, sleep and anxiety disorders. Still, I keep coming back the above 4 concerns. I don't begrudge anyone who decides to try it out. I just encourage you to educate yourself on the risks and understanding the unknowns that exist for anything that hasn't been full tested. We're all on a journey for relief, growth, and symptom control. I am thankful that my family's personal journey is not in need of self-experimentation at this moment. You can also read an interview here from understood.org with some of my favorite ADHD experts on this topic: https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/add-adhd/marijuana-and-adhd

This is a hot topic. I'm certain it will produce many conversations online and in person for the next few years to come. I'll be following the studies as they come out. This one development could be a start of something so much bigger, and I hope that the patients that begin their Epidiolex treatments find a much better quality of life using this treatment, because that, my friends, is always what begets the #goodstuff.