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Medical marijuana for children?



Doctors explain the benefits of cannabis in pediatric medicine

When Dr. Amy Piperato saw a CNN special on Charlotte Figi, a child with a severe form of epilepsy called Dravet Syndrome, she immediately took notice. That's because Dr. Piperato's son suffers from Dravet syndrome as well. The news story on CNN focused on the only treatment that had successfully stopped Charlotte's seizures: medical marijuana.

Dr. Piperato, an internist with a practice in Stony Point, began researching medical marijuana, and, she says, "found the science behind how it works in the body fascinating." So she joined advocacy efforts for the state legislature to pass the Compassionate Care Act which would legalize medical marijuana in New York.

Those efforts paid off in July 2014, when the bill passed and New York became the 23rd state to legalize medical marijuana. The first medical marijuana dispensaries in the state opened in January of last year, creating a promising new treatment option for children like Dr. Piperato's son.

Although now legal, there are many regulations restricting who is eligible to be prescribed medical marijuana. "New York requires a patient to have one of 10 'qualifying conditions' for acceptance into the medical marijuana program: cancer, inflammatory bowel disease (Crohn's and ulcerative colitis), ALS, Parkinson's disease, Huntington's disease, spinal cord injury, AIDS/HIV, neuropathy, multiple sclerosis, or epilepsy," Dr. Piperato says.

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"Patients also need to have specific symptoms to go with one of these diagnoses to qualify: severe nausea, severe pain, seizures, wasting syndrome, or severe muscle spasm." Qualifying patients must then find a physician who is registered to prescribe medical marijuana, of which there are currently only 849 throughout the state of New York. And many of the doctors registered to prescribe medical marijuana only see adult patients.

Dr. Junella Chin is an exception.

A Bronx native who moved back to New York from California two years ago, she has extensive experience integrating medical cannabis into treatment for her juvenile patients. Dr. Chin has offices in New York City and White Plains and treats more than 40 pediatric patients with medical marijuana. Her practice is open to accepting new patients.

"In my practice, I'm seeing the sickest of the sick," she says. "Children who have intractable epilepsy, seizures as a result of traumatic brain injury, spinal cord injuries... cancer and colitis." Dr. Chin said she has turned to treating some young patients with medical marijuana after having exhausted both pharmaceutical options, and other forms of treatment, including brain surgery or ketogenic diets.

For children with cancer, medical cannabis can help with nausea and pain and stimulate their appetites while they are being treated with chemotherapy and radiation. For children with intractable epilepsy, parents report less frequent, less severe, and briefer seizures. But there can be side effects.

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"Although these cannabinoids are extremely safe and they reduce seizures, each of them has the capacity to increase seizures or the intensity of seizures in certain patients as well," Dr. Chin says. It could also interact with other drugs the patient is taking. To prevent negative effects, Dr. Chin monitors her patients very closely and works holistically with the child's other doctors.

Dr. Chin also cautions that cannabis can affect children and teens' developing brains. "Adding cannabis to the functioning endocannibinoid system may actually interfere with developing brains," she says. Medical cannabis can be a game changer for kids who do not respond to traditional medications.

"The children who come into my office are special cases," Dr. Chin says. "These are children who cannot find solutions with conventional treatments." Ever since New York legalized medical cannabis last year, families from across the United States have contacted Dr. Chin.

"There are very few physicians who specialize in cannabis medicine that are willing to treat children and work closely with the parents to monitor the child closely every step of the way," she says. "I feel that we have enough scientific evidence to support reform of existing laws that would bring about broad and reasonable access to medical cannabis for any patient that could benefit," Dr. Piperato says.

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Elora Tocci is a freelance writer in Newburgh. She is the public affairs associate at Citizens' Committee for Children of New York.