The evidence for medical cannabis in children and adolescents is still limited | Research

The takeaway

A systematic review found the strongest evidence for cannabinoid treatment in children was for chemotherapy-induced nausea, with growing evidence for epilepsy, but most studies were small and lacked controls.

Read this if you are a parent considering medical cannabis for your child and want to know what the research actually shows.

22 studies, 795 pediatric participants, only 5 randomized controlled trials

What the researchers found

Researchers systematically reviewed 2,743 citations from medical databases and identified 22 studies involving 795 children and adolescents who received cannabinoid treatments. The evidence was strongest for treating chemotherapy-induced nausea and vomiting, an area where cannabinoids have been studied longest in pediatric populations.

Evidence for epilepsy treatment was described as increasing, reflecting a growing body of research. For other conditions including spasticity, neuropathic pain, PTSD, and Tourette syndrome, the evidence was considered insufficient to draw conclusions.

The quality of most studies was limited. The majority lacked control groups, had small sample sizes, and used varying cannabinoid formulations and doses. Only five of the 22 studies were randomized controlled trials. Long-term follow-up to identify potential adverse effects was largely absent.

Why it matters

As medical marijuana becomes legal in more jurisdictions, parents increasingly seek cannabinoid treatments for their children. This review provides a clear-eyed assessment of what the evidence actually supports, highlighting the gap between public enthusiasm and scientific documentation. The lack of long-term safety data in developing brains is a particular concern that warrants more research.

The numbers in context

2,743 citations screened. 22 studies met inclusion criteria. 795 total participants across all studies. Only 5 were randomized controlled trials. Study types: 5 RCTs, 5 retrospective chart reviews, 5 case reports, 4 open-label trials, 2 parent surveys, 1 case series.

How the study worked

Following PRISMA guidelines, researchers searched PubMed, Medline, and CINAHL databases through May 2017. They screened 2,743 citations, reviewed 103 full texts, and included 21 articles containing 22 studies. Study types included five RCTs, five retrospective chart reviews, five case reports, four open-label trials, two parent surveys, and one case series.

What this study cannot tell us

The review was limited by the heterogeneity and small size of available studies. Different cannabinoid formulations, doses, and delivery methods across studies make direct comparisons difficult. Publication bias may overrepresent positive results. The search was conducted in 2017 and does not include more recent pediatric CBD studies.

How to read the evidence

This is a systematic review, but the underlying studies it reviews are mostly low quality with small samples and lack of controls, yielding moderate overall evidence.

When this study was published

Published in 2017 with a search through May 2017. The pediatric CBD landscape has evolved since, particularly for epilepsy.

The bigger picture

Pediatric cannabinoid research faces unique ethical and regulatory challenges. The tension between expanding legal access and limited evidence is particularly acute for children, where both the potential benefits and the risks of cannabinoid exposure during brain development carry high stakes. This review underscores the need for rigorous pediatric trials rather than reliance on adult data or anecdotal reports.

Questions still open

What long-term neurocognitive effects might cannabinoid treatments have on developing brains? Can the epilepsy evidence from pediatric CBD studies translate to other pediatric conditions? How should clinicians weigh the risk of cannabinoid side effects against the risks of conditions being treated?

Common questions

Is medical cannabis approved for any pediatric condition?

Since this review was published, Epidiolex (pharmaceutical CBD) received FDA approval for certain pediatric epilepsies. At the time of the review, evidence was strongest for chemotherapy-induced nausea and was growing for epilepsy.

Why are there so few pediatric studies?

Ethical considerations around exposing children to psychoactive substances, regulatory barriers to cannabis research, and the relatively recent legalization of medical cannabis have all limited pediatric research.

Read the original research

Medical Cannabinoids in Children and Adolescents: A Systematic Review.

Pediatrics, 140(5)

View on PubMed ↗Publisher’s paper ↗

Citation

Wong, Shane Shucheng; Wilens, Timothy E. (2017). Medical Cannabinoids in Children and Adolescents: A Systematic Review.. Pediatrics, 140(5). https://doi.org/10.1542/peds.2017-1818