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Neurocognitive Impact of Exposure to Cannabis Concentrates and Cannabinoids Including Vaping in Children and Adolescents: A Systematic Review

During adolescence, significant changes unfold in the brain’s maturation process. The density of white matter increases, accompanied by the pruning back of gray matter. This critical and vulnerable period becomes especially noteworthy in the context of drug use, as adolescents are extensively exposed to substances such as tobacco, alcohol, and cannabis. The concern is heightened now that cannabis has been legalized for recreational use in many places, leading to increased exposure levels. Additionally, knowledge about the impact of cannabis on neurocognitive development during this stage is limited. This knowledge gap compounds the issue, making it even more concerning. Therefore, a systematic review was carried out based on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using medical databases such as PubMed, PubMed Central (PMC), Medline, Cochrane Library, Internet Archive Scholar, and Embase-Elsevier for relevant medical literature. The identified articles were reviewed, eligibility criteria were applied, and 19 research articles were identified. The final papers explored the correlation between children’s and adolescents’ exposure to cannabis-containing compounds and subsequent changes in the central nervous system (CNS).

The role of cannabinoids in neurodevelopmental disorders of children and adolescents

Neurodevelopmental disorders have a multifactorial etiology that results from the interaction between biological and environmental factors. The biological basis of many of these disorders is only partially understood, which makes therapeutic interventions, especially pharmacological ones, particularly difficult. The impact of medical cannabis on neurological and psychiatric disorders has been studied for a long time. This study aimed to review the currently available clinical and pre-clinical studies regarding the use of cannabinoids in pediatric neurodevelopmental disorders and to draw attention to the potential therapeutic role of cannabidiol in this field.

Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis.

Authors: Antti Mustonen, Solja Niemelä, Tanja Nordström, Graham K. Murray, Pirjo Mäki, et al
The British Journal of Psychiatry, April 2018

BACKGROUND: The association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial. Aims To examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodro…

Efficacy of artisanal preparations of cannabidiol for the treatment of epilepsy: Practical experiences in a tertiary medical center.

Authors: Giulia S. Porcaria, Cary Fub, Emily D. Doll, Emma G. Carter, Robert P. Carson
Epilepsy & Behavior, March 2018

Medically refractory epilepsy continues to be a challenge worldwide, and despite an increasing number of medical therapies, approximately 1 in 3 patients continues to have seizures. Cannabidiol (CBD), one of many constituents of the Cannabis sativa or marijuana plant, has rece…

Δ9-THC Intoxication by Cannabidiol-Enriched Cannabis Extract in Two Children with Refractory Epilepsy: Full Remission after Switching to Purified Cannabidiol.

Authors: José A. S. Crippa, Ana C. S. Crippa, Jaime E. C. Hallak, Rocio Martín-Santos, Antonio W. Zuardi
Frontiers in Pharmacology, 30 September 2016

Animal studies and preliminary clinical trials have shown that cannabidiol (CBD)-enriched extracts may have beneficial effects for children with treatment-resistant epilepsy. However, these compounds are not yet registered as medicines by regulatory agencies. We describe the c…

Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy.

Authors: Alexandra L. Geffrey, Sarah F. Pollack, Patricia L. Bruno, Elizabeth A. Thiele
Epilepsia, August 2015

OBJECTIVE: Under an expanded access investigational new drug (IND) trial, cannabidiol (CBD) is being studied as a possible adjuvant treatment of refractory epilepsy in children. Of the 25 subjects in the trial, 13 were being treated with clobazam (CLB). Because CLB and CBD are…

Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: results from annual, repeated cross-sectional surveys.

Authors: Deborah S. Hasin, Melanie Wall, Katherine M. Keyes, Magdalena Cerdá, John Schulenberg, et al
The Lancet Psychiatry, July 2015

BACKGROUND: Adolescent use of marijuana is associated with adverse later effects, so the identification of factors underlying adolescent use is of substantial public health importance. The relationship between US state laws that permit marijuana for medical purposes and adoles…

Psychotic experiences are linked to cannabis use in adolescents in the community because of common underlying environmental risk factors.

Authors: Sania Shakoor, Helena M.S. Zavos, Philip McGuire, Alastair G. Cardno, et al
Psychiatry Research, 30 June 2015

Cannabis users are more likely to have psychotic experiences (PEs). The degree to which these associations are driven by genetic or environmental influences in adolescence is unknown. This study estimated the genetic and environmental contributions to the relationship between…

Use of cannabis in severe childhood epilepsy and child protection considerations.

Authors: Megan Yap, Laura Easterbrook, Jan Connors, Laura Koopmans
Journal of Paediatrics and Child Health, May 2015

The use of medical cannabis in chronic illness is increasingly investigated, yet little is known about its use in paediatric populations. As child protection clinicians are often asked to provide advice around whether parents’ actions to give medical cannabis to their chronica…

The impact of marijuana policies on youth: clinical, research, and legal update.

Authors: COMMITTEE ON SUBSTANCE ABUSE, COMMITTEE ON ADOLESCENCE
Pediatrics, March 2015

This policy statement is an update of the American Academy of Pediatrics policy statement “Legalization of Marijuana: Potential Impact on Youth,” published in 2004. Pediatricians have special expertise in the care of children and adolescents and may be called on to advise legi…

Young adult sequelae of adolescent cannabis use: an integrative analysis.

Authors: Edmund Silins, L. John Horwood, George C. Patton, David M. Fergusson, Craig A. Olsson, et al
The Lancet Psychiatry, September 2014

BACKGROUND: Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal app…

Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy.

Authors: Brenda E. Porter, Catherine Jacobson
Epilepsy & Behavior, December 2013

Severe childhood epilepsies are characterized by frequent seizures, neurodevelopmental delays, and impaired quality of life. In these treatment-resistant epilepsies, families often seek alternative treatments. This survey explored the use of cannabidiol-enriched cannabis in ch…