title: Medical marijuana: review of the science and implications for developmental-behavioral pediatric practice.
abstract: Marijuana policy is rapidly evolving in the United States and elsewhere, with cannabis sales fully legalized and regulated in some jurisdictions and use of the drug for medicinal purposes permitted in many others. Amidst this political change, patients and families are increasingly asking whether cannabis and its derivatives may have therapeutic utility for a number of conditions, including developmental and behavioral disorders in children and adolescents. This review examines the epidemiology of cannabis use among children and adolescents, including those with developmental and behavioral diagnoses. It then outlines the increasingly well-recognized neurocognitive changes shown to occur in adolescents who use cannabis regularly, highlighting the unique susceptibility of the developing adolescent brain and describing the role of the endocannabinoid system in normal neurodevelopment. The review then discusses some of the proposed uses of cannabis in developmental and behavioral conditions, including attention-deficit hyperactivity disorder and autism spectrum disorder. Throughout, the review outlines gaps in current knowledge and highlights directions for future research, especially in light of a dearth of studies specifically examining neurocognitive and psychiatric outcomes among children and adolescents with developmental and behavioral concerns exposed to cannabis.
authors: *Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA; †Department of Pediatrics, Harvard Medical School, Boston, MA; and ‡Division of Developmental Medicine, Center for Adolescent Substance Abuse Research, Boston Children's Hospital, Boston, MA.
authors: Scott E
authors: SE
authors: Hadland
authors: John R
authors: JR
authors: Knight
authors: Sion K
authors: SK
authors: Harris
mesh_terms: D000293:Adolescent; D041923:Adolescent Development / Q000187:drug effects*; D000818:Animals; D002188:Cannabis / Q000009:adverse effects*; D002648:Child; D006801:Humans; D064086:Medical Marijuana / Q000009:adverse effects / Q000627:therapeutic use*; D065886:Neurodevelopmental Disorders / Q000188:drug therapy*
chemical_list: D064086:Medical Marijuana
references: J Clin Psychiatry. 2000 Apr;61(4):244-51
references: 10830144
references: Neurotoxicol Teratol. 2000 May-Jun;22(3):325-36
references: 10840176
references: Pediatrics. 2003 Jan;111(1):179-85
references: 12509574
references: Clin Pharmacokinet. 2003;42(4):327-60
references: 12648025
references: J Abnorm Psychol. 2003 Aug;112(3):497-507
references: 12943028
references: Am J Public Health. 2004 May;94(5):836-42
references: 15117709
references: Pediatrics. 2004 Jun;113(6):1825-6
references: 15173518
references: Am J Psychiatry. 2004 Nov;161(11):1967-77
references: 15514394
references: J Ethnopharmacol. 2006 Apr 21;105(1-2):1-25
references: 16540272
references: Clin Pharmacol Ther. 2007 Nov;82(5):572-8
references: 17429350
references: Am J Addict. 2007;16 Suppl 1:14-21; quiz 22-3
references: 17453603
references: Lancet. 2007 Jul 28;370(9584):319-28
references: 17662880
references: J Int Neuropsychol Soc. 2007 Sep;13(5):807-20
references: 17697412
references: Arch Gen Psychiatry. 2007 Oct;64(10):1145-52
references: 17909126
references: Chem Res Toxicol. 2008 Feb;21(2):494-502
references: 18062674
references: J Can Acad Child Adolesc Psychiatry. 2006 Aug;15(3):105-25
references: 18392181
references: Addict Biol. 2008 Jun;13(2):253-63
references: 18482434
references: Drug Alcohol Depend. 2009 Apr 1;101(1-2):1-7
references: 19081203
references: Eur Arch Psychiatry Clin Neurosci. 2009 Oct;259(7):371-82
references: 19588184
references: Lancet. 2009 Oct 17;374(9698):1383-91
references: 19837255
references: J Stud Alcohol Drugs. 2009 Nov;70(6):850-8
references: 19895761
references: Expert Opin Pharmacother. 2010 Jan;11(1):17-31
references: 20001426
references: Addiction. 2010 Jun;105(6):1080-7
references: 20331551
references: BMJ. 2010 Apr 01;340:c1571
references: 20360216
references: J Forensic Sci. 2010 Sep;55(5):1209-17
references: 20487147
references: J Am Acad Child Adolesc Psychiatry. 2011 Jan;50(1):9-21
references: 21156266
references: J Addict Med. 2011 Mar;5(1):1-8
references: 21321675
references: Res Dev Disabil. 2011 Nov-Dec;32(6):2981-6
references: 21640553
references: Psychol Med. 2012 Jun;42(6):1321-8
references: 21999906
references: Future Neurol. 2011 Jul 1;6(4):459-480
references: 22229018
references: BMJ. 2012 Feb 09;344:e536
references: 22323502
references: Res Dev Disabil. 2012 Jul-Aug;33(4):1147-56
references: 22502840
references: Brain. 2012 Jul;135(Pt 7):2245-55
references: 22669080
references: Neuropsychopharmacology. 2012 Oct;37(11):2368-76
references: 22669173
references: MMWR Surveill Summ. 2012 Jun 8;61(4):1-162
references: 22673000
references: Drug Alcohol Depend. 2012 Dec 1;126(3):369-78
references: 22749560
references: Addiction. 2013 Jan;108(1):124-33
references: 22775447
references: Proc Natl Acad Sci U S A. 2012 Oct 2;109(40):E2657-64
references: 22927402
references: Nat Commun. 2012;3:1080
references: 23011134
references: Drug Alcohol Depend. 2013 Apr 1;129(1-2):49-53
references: 23041136
references: N Engl J Med. 2013 Feb 28;368(9):866-8
references: 23425133
references: Addiction. 2013 Aug;108(8):1503-11
references: 23506232
references: Nat Med. 2013 May;19(5):603-7
references: 23542787
references: Neuron. 2013 May 8;78(3):498-509
references: 23583622
references: JAMA Pediatr. 2013 Jul;167(7):630-3
references: 23712626
references: JAMA Pediatr. 2013 Jul;167(7):600-2
references: 23712691
references: N Engl J Med. 2013 May 30;368(22):e30
references: 23718175
references: JAMA Psychiatry. 2013 Jul;70(7):740-9
references: 23754458
references: Am J Public Health. 2013 Aug;103(8):1500-6
references: 23763418
references: Drug Test Anal. 2014 Jan-Feb;6(1-2):39-45
references: 23836598
references: Front Psychiatry. 2013 Jul 01;4:53
references: 23847550
references: Epilepsy Behav. 2013 Dec;29(3):574-7
references: 24237632
references: BMJ. 2013 Dec 13;347:f7499
references: 24336526
references: Ann Emerg Med. 2014 Jun;63(6):684-9
references: 24507243
references: Cochrane Database Syst Rev. 2014 Mar 05;(3):CD009270
references: 24595491
references: Neuropsychopharmacology. 2014 Aug;39(9):2041-8
references: 24633558
references: J Stud Alcohol Drugs. 2014 Mar;75(2):211-21
references: 24650814
references: Neurology. 2014 Apr 29;82(17):1556-63
references: 24778283
references: JAMA Pediatr. 2014 Jul;168(7):618-24
references: 24820649
references: Int J Biochem Cell Biol. 2014 Aug;53:121-6
references: 24831882
references: N Engl J Med. 2014 Jul 31;371(5):399-401
references: 24918955
references: N Engl J Med. 2014 Aug 28;371(9):879
references: 25162899
references: Rand Health Q. 2012 Sep 1;2(3):2
references: 28083261
references: Pediatrics. 1996 Dec;98(6 Pt 1):1089-95
references: 8951258
references: Am J Addict. 1997 Summer;6(3):205-17
references: 9256986