Is CBD Oil Safe For Children With Anxiety And ADHD?
Dr. Mubina Agboatwalla is a well-known pediatrician, practicing paediatrics since the last 20 years in Karachi Pakistan. She is the head of the department of Pediatrics in Karachi Liaquat Hospital, as well as her private practice in three s. more
Swati Patwal is a clinical nutritionist and toddler mom with over eight years of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and. more
MomJunction believes in providing reliable, research-backed information to you. As per our strong editorial policy requirements, we base our health articles on references (citations) taken from authority sites, international journals, and research studies. However, if you find any incongruencies, feel free to write to us.
If you are unaware of using Cannabidiol or CBD oil for kids, you should be reading this post. CBD oil is a component found in the Cannabis Sativa family’s hemp and marijuana plants, making individuals feel high. (1). The oil has gained popularity in recent years for treating various conditions, including chronic pain, stress, insomnia, nausea, and vomiting.
Different procedures are used to extract the oil, including carbon dioxide extraction, ethanol extraction, and hydrocarbon extraction (2). After extraction, the oil is refined and marketed as tinctures, capsules, topicals, chewable gummies, beverages, and other products.
This post discusses the safety of CBD oil for children, including its advantages, age-appropriate dosage, and potential side effects and hazards associated with its use.
Is CBD Oil Safe For Children?
There’s no scientific evidence to prove the safety and efficacy of CBD oil for children. However, one CBD product, namely Greenwich Biosciences’ Epidiolex, has been approved for use as a part of a regulated medication to treat epilepsy in children by the US FDA (3). This prescription drug contains a purified form of CBD that helps treat seizures in children that occur in rare and severe epilepsy forms, such as Lennox-Gastaut syndrome and Dravet syndrome (4).
Since these epilepsy forms do not respond to anti-seizure medications, CBD use becomes crucial. However, remember that using CBD oil as a standalone medication to treat epilepsy in children isn’t well-researched. Thus, if you want to use CBD oil for treating epilepsy or any other ailment in your child, consult a pediatrician.
Note: CBD is often confused with THC (tetrahydrocannabinol), another cannabinoid found in hemp and marijuana. THC is a psychoactive compound that makes a person feel “high” and causes addiction and psychosis. However, CBD doesn’t have these effects and affects separate brain regions than THC (5).
Uses Of CBD Oil For Children
Apart from treating epilepsy, the FDA doesn’t approve CBD oil’s use to treat any ailment in children. However, studies suggest that CBD oil may be an effective treatment for the treatment of several ailments.
- Anxiety: Some recent studies show that CBD oil use may help reduce anxiety (6) (7). Preclinical evidence from animal studies demonstrates that CBD oil use can reduce anxiety associated with multiple disorders, such as post-traumatic stress disorder (PTSD), generalized stress disorder, and social anxiety disorder (8 ). It helps in relaxing the brain and musculoskeletal system. However, there’s a need for further study to make any recommendations for children.
- Autism: A 2019 study on 188 autism spectrum disorder (ASD) patients showed that the use of cannabis oil containing 30 percent CBD and 1.5 percent THC appears to be a “well-tolerated, safe, and effective option to relieve symptoms associated with ASD” (9). Another study involving 60 children also showed some promising results (8 ). However, these results aren’t sufficient for clinical validation as the research samples are quite small.
- Attention deficit hyperactivity disorder(ADHD): A systematic review conducted in 2020 highlighted that CBD could help alleviate symptoms of ADHD (10). It helps in calming the child and lowers the hyperactivity. However, currently, no targeted research studies are available to support the use of CBD oil for treating or managing ADHD in children.
- Multiple sclerosis (MS): A 2019 study by Thorsten Rudroff and Jacob Sosnoff suggests that CBD use may be associated with less pain and spasticity, ultimately leading to improved mobility and proper sleep (11). The release of musculoskeletal spasms is the mainstay of treatment. Yet, more research is warranted to derive any conclusions about CBD oil use for MS treatment in children.
Side Effects Associated With CBD Oil Use
CBD oil use for children isn’t well-researched, and its unguided use may cause certain side effects, such as
- Gastrointestinal disturbances: Upset stomach and abdominal pain are common side effects of CBD oil use in sensitive individuals. So, always consult a doctor or alternative medicine expert before using CBD oil for children.
- Toxicity: If CBD oil isn’t used under guidance, there’s a potential risk of overdose and toxicity. Therefore, it’s essential to use CBD oil only after consulting an expert. Some of the symptoms you may see in CBD toxicity are severe nausea or vomiting, high blood pressure, anxiety, paranoia, rapid heart rate, and hallucinations (12).
- Possible drug interaction: CBD is a bioactive compound that can interact with other chemicals and compounds in the medications. Since CBD affects the brain and the central nervous system, antidepressants and antipsychotics are the most obvious drugs that can interact with CBD.
Some other drugs that can interact with CBD are blood thinners and thyroid and heart medications (13). Therefore, if your child is on any medication, consult your doctor before using CBD for any purpose.
Besides these, CBD oil can also cause headaches, drowsiness, dry mouth, and low blood pressure (14).
Note: Milk and foods containing high amounts of fats can increase the absorption of CBD in the body, thus increasing the effects and side effects of CBD on an individual (12).
Possible Risks Associated With CBD Oil Use In Children
Baring Epidiolex, which contains CBD, CBD oil isn’t regulated by the US FDA, making its use in children and teens risky as (5) (8 )
- The ingredients of CBD oil can’t be determined accurately, meaning the products can have ingredients that aren’t mentioned on the label. For instance, several products that claim to contain only CBD may also contain high doses of THC, a psychoactive compound.
- CBD oil’s quality can’t be ascertained, as there are chances that the oil may be contaminated with microorganisms, pesticides, and heavy metals. Consuming contaminated CBD oil can cause severe effects in sensitive individuals.
- The efficacy and safety of CBD oil in children and teens are unclear, and research on this subject is still in its early stages. Also, existing studies have been either done on animals or human adults and not on pediatric patients. Further, the studies that involve children have small sample sizes.
- The dosage guidelines aren’t clear, except for CBD used in the drug Epidiolex to treat Epilepsy. Thus, using CBD oil at home is tricky, especially when you aren’t aware of how much CBD oil you can administer to a child to get the desired effect. Also, there is no way to know which mode of use is best and how much CBD would be absorbed in the body based on the method of administration.
Besides these, the legality of the use of CBD oil varies from one country to another and state to state. For instance, according to the US FDA, THC or CBD can’t be sold legally as a dietary supplement, food, or therapeutic product (4). Instead, it can only be included in cosmetics when its THC content is less than 0.3 percent (14). So, check your state’s legal requirements for CBD oil purchase and use before you make any purchases.
How To Choose CBD Oil?
Proper selection of a CBD oil brand can be tricky as it’s manufactured by several companies globally. So, here are some tips that could help (15).
- Buy the product from a trusted manufacturer and seller. It will ensure the product you’re buying is of good quality and is not contaminated. Some manufacturers may dilute CBD isolate with hemp seed oil, which can make the product comparatively ineffective as they lack the balance of beneficial components found in broad-spectrum CBD oil (2).
- Read the product label carefully and determine the
- Oil source: The oil should be extracted from hemp or marijuana. Typically, hemp has a significantly less amount of THC when compared to marijuana. THC is a psychoactive chemical that can create dependence over long-term use. So, ensure you buy CBD oil extracted from hemp plants cultivated by domestic farmers. Domestic hemp is typically free of toxins and pesticides.
- Extraction method: The extraction method indicates how the oil has been extracted from the hemp plant. Typically, CBD oil is extracted using carbon dioxide (CO2) extraction or by using solvents such as ethanol, propane, and butane. Out of these, propane and butane extraction isn’t considered safe as these solvents are toxic and hazardous for children. On the other hand, ethanol and CO2 extraction techniques are safe and potent as they leave no harmful chemicals in the oil.
- Chemical composition: It signifies whether the oil is full-spectrum or isolate. Full-spectrum CBD oil will contain several phytonutrients, such as flavonoids, terpenes, and trace amounts of THC. If THC’s presence concerns you, look for CBD isolates, which are the pure form of CBD oil.
But, while you make that choice, consult an expert as concentrated CBD has high amounts of CBD per serving, increasing the chances of overdose.
- Product certification: Ensure the product has been certified by a reputable third-party testing lab or organization. The lab will test the oil quality and certify that the oil is true to its claim about its chemical composition. It’s best to buy oil that has testing information attached.
CBD oil for children and adults is the same. However, since children weigh less and are comparatively sensitive, using CBD oil with lower potency is advisable.
CBD Oil Dosage For Children
The appropriate dosage of CBD oil for children depends on their body weight, metabolism, medical condition, overall health, and intent of use. For instance, the US FDA has approved the daily oral use of 25mg per kg of body weight for Epidiolex, the prescription drug that contains CBD (14). Its use is approved for children aged one and above.
However, this dosage may or may not be suitable for every child. So, consult a doctor or alternative medicine expert to determine the appropriate CBD oil dosage and suitable mode of use for a child.
While CBD oil has gained popularity over the past few years as a remedy for various ailments, it is important to remember that the FDA does not approve CBD oil for kids. More research is needed to support and establish the safety of CBD oils in the treatment of ailments such as anxiety, autism, and ADHD. In addition, it is advisable to refrain from using these oils if your children are on any other medications. Further, consult your pediatrician before using this oil on your child.
- CBD oil or Cannabidiol, a derivative of the cannabis plant, is reportedly used to treat certain neurological ailments, such as epilepsy, in children.
- It is essential to use this oil only when prescribed by an expert since it poses the risk of side effects such as CBD toxicity, gastric problems, and drug interactions.
- The oil is not approved for use in children in some countries. Therefore, seek professional advice before using it.
MomJunction’s articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
CBD Oil for ADHD? Despite Scarce Research, Patients Are Trying It
Early research suggests that cannabidiol (CBD) may help patients with epilepsy. It is also believed to relieve pain, anxiety, mood disorders, and even acne. But what about ADHD or ADD? So far, research linking CBD oil to ADHD symptom relief does not exist. That isn’t stopping patients from trying it.
Verified Medically reviewed by Roberto Olivardia, Ph.D. Updated on January 5, 2022
UPDATE: On November 25, 2019, the Food and Drug Administration (FDA) published a revised consumer update regarding safety concerns about cannabidiol (CBD) products. Due to limited research data, the FDA is unable to declare CBD products safe, according to the updated statement. The FDA warns that CBD can cause liver damage, increased drowsiness, and a number of other side effects. The impact of daily CBD use over a sustained period of time is unknown. Likewise, the FDA says there is insufficient research on the effect of CBD on the developing brain, on fetuses, and on the male reproductive system. The FDA has approved only one CBD product, which treats two rare forms of epilepsy. In late November, it issued warning letters to 15 companies for illegally selling products containing CBD.
These days, it’s tough to find an online community or social media group not singing the praises of cannabidiol (CBD) oil. This helps to explain why so many people are exploring its benefits for diseases and disorders ranging from Alzheimer’s and Parkinsons to PTSD and, yes, attention deficit disorder (ADHD or ADD). Though research suggests that CBD oil may benefit patients with epilepsy and other disorders, any such claims around ADHD are only that: claims.
What Is CBD? Does It Help ADHD?
CBD is a product of the marijuana (cannabis) plant with the high-inducing THC (tetrahydrocannabinol) compound removed, which means it is not psychoactive. CBD — often in the form of an oil, a tincture, or an edible — has been rumored to reduce anxiety, a common symptom among those diagnosed with ADHD symptoms. No one, though — not even the drug’s most hardcore advocates — claims CBD is a treatment for ADHD.
According to Mitch Earleywine, professor of psychology at SUNY-Albany and an advisory-board member of the National Organization for the Reform of Marijuana Laws (NORML), there is “no published data, let alone randomized clinical trials, [that] support the use of CBD for ADHD.”
Even so, word of CBD’s potential benefits — proven or otherwise — are often enough to compel some patients with ADHD to experiment. Dr. John Mitchell of the Duke University ADHD Program says that one of his patients, an adult woman with ADHD, tried CBD. Twice. On her own. Without his approval or supervision.
“I bought one vial for $50 that contained 30 gel tablets, and I took all of them over a few weeks,” says Mitchell’s patient, who preferred to remain anonymous. “I’d never tried CBD or any type of cannabis before, and I felt no changes. But I didn’t have any adverse effects, either.”
Anecdotally, this outcome appears common for half of those trying CBD on their own — regardless of the quantity, quality, or type used. The other half claim some positives with regard to CBD and ADHD: “I was able to relax” or “I felt less manic” are common refrains. The problem, as Dr. Mitchell and the broader community of ADHD and CBD researchers point out, is a dearth of studies around CBD. No single research team has yet studied the possible effects — good or bad — of CBD oil for ADHD symptoms specifically.
“There are anecdotes that CBD may help with ADHD,” says Dr. Robert Carson, an assistant professor of neurology and pediatrics at Vanderbilt University who co-authored a 2018 study on the efficacy of CBD on epilepsy, “but this is true for many other symptoms or diseases. Thus, there may be patients whose ADHD symptoms improve after adding CBD, but we cannot generalize that anecdote more broadly. Secondly, the cases we’re most likely to hear about are the one where somebody had a great response — not the 10 who did not.”
“I am not aware of any scientific or clinical data that would speak to the safety or efficacy of using CBD in the treatment of ADHD,” says Ryan Vandrey, Ph.D., a member of John Hopkins University School of Medicine’s Behavioral Pharmacology Research Unit. “There is no scientific basis from which CBD should be recommended for use as a treatment for ADHD, nor is there any data that could speak to which product or dose would be appropriate.”
The American Academy of Pediatrics (AAP) recommends treating ADHD in children and adolescents aged 6 to 18 with FDA-approved medications, plus parent training in behavior modification and behavioral classroom interventions. Likewise, research confirms that “stimulant medications are most effective, and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.” All ADHD treatment decisions should be made in consultation and coordination with a licensed medical provider.
Is CBD Legal? Is It Safe?
To date, 33 states and the District of Columbia have passed laws broadly legalizing marijuana in some form; 10 other states and Washington, D.C., have adopted laws legalizing marijuana for recreational use. Even so, the U.S. Drug Enforcement Administration considers CBD, like all cannabinoids, a schedule 1 drug — making it as illegal as heroin and ecstasy. Despite this, one cannabis industry expert predicts that CBD products alone will comprise a nearly $3 billion market by 2021.
With all that profit on the horizon, why so few studies? At least partially to blame is the legality of CBD; it’s difficult to attain a federal grant to study a federally illegal drug. Politics also come into play, as do lingering public perceptions of cannabis as a gateway drug that may lead to serious mental disorders, lethargy, or both.
Nevertheless, Dr. Mitchell feels that “The perception that [CBD] can have a negative effect has gone down because it’s becoming more available.”
This is not a perception shared by all of Dr. Mitchell’s peers, who note professional resentment and stigma regarding funding for cannabis research. “There’s a lot of political opposition coming from the business and scientific communities,” asserts Dr. Jacob Vigil, director of the University of New Mexico’s Medical Cannabis Research Fund. “It’s still highly stigmatized, and we need more studies.”
The studies done on CBD and ADHD to date amount to… practically nothing. One 2011 study showed that, among a group of 24 people with social anxiety disorder, the half who’d taken CBD were able to speak in front of a large audience. In 2015, researchers in Germany examined the relationship between cannabis (CBD and THC) and ADD in 30 patients, all of whom said they experienced better sleep, better concentration, and reduced impulsivity while using the cannabis products. Finally, a 2017 study looking at CBD oil and ADHD in adults found that the oil improved some symptoms, but that more studies were needed to confirm its findings.
The Dangers of Experimenting with CBD for ADHD
The Netherlands’ self-professed “cannabis myth buster,” Arno Hazekamp stated in a recent paper, “While new CBD products keep entering the market virtually unchecked, effective regulatory control of these products has stayed far behind. As a result, unknown risks about long-term effects remain unaddressed, especially in vulnerable groups such as children.”
“During [a person’s] development, I worry about cannabinoids, both CBD and THC,” says UCLA’s Evans. “There are adenosine receptors (and CB2 receptors) on the microglia that are critical for brain development, and CBD inhibits adenosine uptake. This may be a beneficial factor for epilepsy and autoimmune and inflammatory diseases, but who knows for ADHD.”
And while CBD may potentially benefit some patients with ADHD, “One is doing an experiment on oneself by taking CBD for ADHD,” Evans adds. “CBD is anti-inflammatory and I’m not sure there is good evidence mechanistically that for ADHD it might be helpful.”
It’s also unknown how CBD may interact with other medications. “CBD in any form is a drug, and thus has a potential for side effects or interactions with other drugs, specifically those metabolized through the liver [CBD is metabolized by the same enzyme in the liver that metabolizes many other medicines and supplements],” Carson says. “And with other ADHD medications that have sedating qualities, such as guanfacine or clonidine, there may be additive effects that may not be beneficial.”
Also potentially harmful is the non-standard and wildly fluctuating amount of CBD in most CBD products, even those labeled as “pure CBD oil.” Some such products may also contain other ingredients — pesticides, additives, herbs, and even THC. “CBD alone has multiple actions on the cells in the brain and we don’t know which ones are clearly responsible for its known benefits,” Carson says. “It gets more complicated when we have less purified products that also include THC and CBDV [cannabidivarin].”
Dangers may also exist in the method of delivery. CBD is packaged and consumed in oils, tinctures, or edibles — each one absorbed differently by a person’s body. “The labeling in this industry,” says Vigil of UNM, “is horrific.”
‘Natural’ Doesn’t Necessarily Mean ‘Safe’
Once CBD enters the body, no one yet knows how it works. Its long-term effects are a mystery. Exactly how does CBD work — in the brain and over many years? As Dr. Carson bluntly puts it: “We don’t know and we don’t know.”
None of this will stop some people from self-medicating with CBD or trying it on their children. “Apparently there are products offering about 30mg of CBD per dose,” Earleywine says. “I rarely see published work with humans that shows much of an effect below 300mg, which… would get quite expensive… So it’s probably a waste of time and money.”
“The bottom line,” Evans says, “is that there is a dearth of research on all cannabinoid actions — because of its schedule 1 classification — and no clear scientific evidence I can find to endorse or not endorse CBD use for ADHD.”
Perhaps because researchers have documented no negative links between CBD and ADHD, some “patients go through trial and error with CBD,” Vigil says. “First they go on the Internet, where they start with an isolate CBD. Then they try the vanilla products — only to find they get more benefits when they add THC.
“They do that because cannabis is so variable that patients are forced to experiment. Also because clinical trials can’t really tell you anything about the decisions that patients actually make in the real world. And finally because there’s not going to be a uniform solution for everybody.”
“Families need to think very hard about potential risks versus benefits for treating other disorders, including ADHD,” Carson advises. “So please discuss what you are thinking about doing with your child’s physician. In the absence of good data, a dose of 1 milligram per kilogram of body weight per day is where most patients start when using CBD for epilepsy — and this seems to be well tolerated. But if the side effects from any medication are worse than the problem was to begin with, that patient might be on too much.
“I like to remind families,” Carson adds, “that just because something is natural does not mean it is safe.”