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Can cannabis improve children’s palliative care? 

Oct 14, 2022 | Media Partners, The GrowthOp

This post is presented by our media partner The Growth Op
View the original article here.

Symptoms experienced by children in palliative care include pain, irritability, seizures and spasticity

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Australian researchers have received $65,250 in state funding to explore whether or not using medicinal cannabis can help reduce the symptoms of young people undergoing palliative care for non-cancerous conditions.

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Murdoch Children’s Research Institute investigators say the pilot study will involve 10 participants aged six months to 21 years who have symptoms that are affecting their quality of life and are receiving care in the Victorian Paediatric Palliative Care Program.

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The program at Murdoch, the largest child health research institute in Australia, treats children with non-oncological conditions such as cerebral palsy, neurodegenerative disorders and progressive cardiac disease.

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Recruitment for trial participants is expected to begin later this year.

Currently prescribed medications may have ‘significant side effects’

Some symptoms experienced by pediatric patients in palliative care include pain, irritability, gastrointestinal issues, seizures, spasticity and dystonia, a disorder characterized by involuntary muscle contractions.

“These symptoms are difficult to control with currently prescribed medications, most of which cause significant side effects,” says Daryl Efron, an associate professor with the research institute who’s leading the study.

“Medicinal cannabis is a new therapy with great hope, but there is little evidence from clinical trials, particularly in children,” Efron relays in an institute statement.

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“The trial will evaluate the study design spanning recruitment strategy, medication tolerability, duration and outcomes to determine acceptability and feasibility for participating families and our research team,” he points out. Data collected will then be used to design a full-scale multi-centre trial.

Parents, doctors at odds over willingness to try medical cannabis

Efron sees a divide between treatments that doctors and parents of ill children are willing to try. “In our experience, parents are interested in obtaining medicinal cannabis for their child’s symptoms, but physicians are reluctant to prescribe it because of the lack of quality research,” he explains.

Add to that existing hurdle that survey results published in The Journal of Primary Care & Community Health two years ago showed just 18 per cent of respondents in Vermont felt their physician was a good source of information on marijuana.

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Efron emphasizes “there is an urgent need for clinical trials to properly evaluate the role of medicinal cannabis for use in these highly vulnerable patients.”

Released earlier this year, a nationally representative poll in the U.S. involving responses from almost 2,000 parents of children aged 3 to 18 found that 73 per cent of respondents would entertain the possibility of their children using CBD if other medications weren’t working.

Health conditions that would see some parents consider using CBD include anxiety, sleep problems, attention deficit hyperactivity disorder, muscle pain, autism and to make their child feel better in general.

Citing the lack of data when it comes to children and CBD, Sarah Clark, co-director of the Mott Poll, says research has not yet fleshed out how use might “impact children’s developing brains” and adds “only certain types of situations” would likely be appropriate to consider CBD use.

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As for the Australian study, Efron contends that “if medicinal cannabis is shown to be effective, it will represent an important treatment breakthrough for this patient group.”

Researchers agree more evidence needed on pediatric palliative care and cannabis

A study published in the Italian Journal of Pediatrics in 2021 noted, “Our experience suggests that a titrated plant extract preparation of medical cannabis may be useful to control treatment-resistant pain and epilepsy in pediatric palliative care patients.”

Considering palliative care in general, Indian researchers reviewed related medical literature. “Clinical evidence for cannabis products in treating various ailments has been far from robust. Their use is based on anecdotal and low-quality evidence,” study authors wrote two years ago in Anesthesiology.”

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“Before cannabinoids enter the broader market with patient-driven and industry-driven hype, high-quality clinical evidence is emergently needed,” they added.

With regards to cancer and children, authors of a Canadian research article published last year note their “findings indicate that most pediatric oncologists and palliative care physicians recognize a potential role for cannabis in symptom control in children with cancer. Well-conducted studies are required to create evidence for cannabis use and promote shared decision-making with pediatric oncology patients and their caregivers.”

The Australian pilot study has received support through the Victoria Medical Research Acceleration Fund — launched in 2017 to accelerate health and medical research and fast-track innovative projects — and medicinal cannabis company, Cannatrek. The latter reports it allows prospective medical patients to use a single platform to do everything from checking their eligibility for plant-based medicine to booking telehealth appointment and filling prescriptions online.

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