Ask Us Anything About… Marijuana use in teens

Description – The video begins inside an office within the Penn State Children™s Hospital. Two individuals are standing in front of windows next to a desk and shelves. The two individuals are looking at the camera. Standing from left to right is Scott Gilbert and Dr. Walker-Harding, Chair of Pediatrics at Penn State Health Children’s Hospital

Scott Gilbert – Ask Us Anything About Marijuana Use in Teens. I’m Scott Gilbert. In many parts of the U.S., laws and some would say attitudes regarding marijuana use are easing, Now this trend has sparked a new policy statement from the american Academy of Pediatrics, emphasizing the group’s opposition to marijuana use by children. Here to give us some context around that statement and why it was issued is Dr. Leslie Walker-Harding, she’s Chair of pediatrics here at Penn State Health Children’s Hospital, and also an expert on substance use by adolescents. Dr. Walker-Harding, thanks for making the time today.

Dr. Walker-Harding – Yeah, thank you for asking me to come.

Scott Gilbert – So, let’s talk a little bit about this statement here, and the fact that the AAP issued this. To clarify though, the laws legalizing marijuana only pertain to adult use of the substance. So why address the potential use by children?

Dr. Walker-Harding – Yes, that’s actually something that came up in Washington, that they had to play catch up with, because they thought they didn’t need to address it. But it’s important to address it, because if there’s more access, we know if drugs are in the home, if cigarettes are in the home, if alcohol’s in the home, it’s more likely the kids are going to use those things as well. So we have to be able to have a message for parents to know if it’s safe or not, and how to store it, and, you know, how to address it with their kids.

Scott Gilbert – Must be an issue, because according to statistics, that 40 percent of U.S. high school kids have tried marijuana, 20 percent are regular users. Should we, as parents, be shocked by those statistics?

Dr. Walker-Harding – I don’t think right now you should be shocked about it, but I do think as — if you begin to look at the states that have legalized marijuana, they’re higher than that. That’s the country average. The average number of people in states that are using marijuana, the kids are using more. So, you know, yes, I do think we need to pay attention to that.

Scott Gilbert – You’re watching Ask Us Anything About Marijuana Use in Teens from Penn State Health Children’s Hospital. We encourage you to add your questions to the comment field just below the Facebook post here, and we can pose those to Dr. Leslie Walker-Harding live, or we can pose those to her after the fact. If you’re watching this video on playback, we’ll track down an answer to your question. You know, Dr. Walker-Harding, in this policy statement, the American Academy of Pediatrics notes adverse effects of marijuana that have been well-documented, including those on memory, attention, and concentration, we’ve heard about that for both adults and children, how might these effects be different in children?

Dr. Walker-Harding – It’s very different in children, because children have developing brains. And this drug works right on the receptors that help develop the brain, even before the baby is born to — up to in the 20’s. The brain’s are still developing, and this particular drug, different from alcohol and other drugs, this particular drug hooks right into the receptors in the brain that help develop the brain, help it think better, help it make connections, help it make good decisions and have the right emotions, this gets in there, in the way, and it changes all the connections. And so, for that, the outcome of that, is sometimes people have lower IQs, they have difficulty with depression, and a lot of other emotional problems with it, as well as other things.

Scott Gilbert – And I imagine that the degree to which they experience those problems would be proportionate to the amount of use.

Dr. Walker-Harding – We don’t know all of that information. We think so, and what’s interesting about that is the studies that we do have are actually done on much lower amounts of marijuana, strengths of marijuana, than what’s actually available today, by 10, 20, 30 percent. So, it’s unclear, if it’s much stronger, will it be much worse? We know we see much more hospitalization of kids who have psychosis, have schizophrenia, have hyperemesis syndrome, than we did with the lower strengths of marijuana. So we need to do more research to find out if it’s higher, is going to have even more a long-lasting or quicker effects.

Scott Gilbert – There’s some debate out there as to whether marijuana is addictive, but there is some data, evidently, that shows that a dependence can form later in life, especially among people who begin marijuana use earlier in life, can you tell us about that?

Dr. Walker-Harding – Yeah, there is no debate about it being addictive, it absolutely is addictive. It hits the rewards center just like any other drug. It’s a chemical in the head, you know, just like, you know, people talk about it being a plant, it’s a chemical, it breaks down to that, goes into your brain, it hits the rewards center, anything that hits rewards center causes — can cause an addiction. Now whether or not it causes an addiction faster or slower than something like heroin or nicotine, you know, is up to date. It may take a little more time, but a kid that uses marijuana at least 10 times in a month is going to be at very high risk. A teenager, a little kid even less than that, but it’s going to be a high risk to have an addiction to it.

Scott Gilbert – There is an addiction factor there, an important takeaway. You’re watching Ask Us Anything About Marijuana Use in Teens from Penn State Health Children’s Hospital. I’m Scott Gilbert, alongside Dr. Leslie Walker-Harding, we’re talking about a range of issues around this, especially around this American Academy of Pediatrics statement issued recently about this — this issue, as marijuana use becomes more prevalent and really more legal in many parts of the country. One of the discussions around marijuana that’s been going on for quite some time is around so-called medicinal marijuana, okay, cannabinoids, cannabidiol, that kind of thing, that is derived from marijuana, that may have a medical benefit. There was a comment on our one Facebook post that we put up yesterday, mentioning this interview, kind of promoting this interview, from Maria, she said, I think more studies need to be done for children and adolescents because it can have benefits medicinally, but we need to know more of what it does brain and body chemistry. That really sums up the AAP’s position it seems like.

Dr. Walker-Harding – In some ways. I think what we have to think about for adults, there’s actually research that shows that there may be some benefits in some ways. We have next to 0 research in children, and children are not little adults. Children’s brains are developing, they are maturing, a lot of things are happening in their bodies, and we have no research. And — and there’s reasons why, I mean, the way the drug was scheduled, it made it so that is was extremely difficult to do research, and the AAP and I and many people that work in this field are very adamant that we need to be able to have more research, especially on these stronger forms of the chemical. And so the AAP does not recommend using marijuana for medical reasons, there are no medical reasons that we can weigh the risks and benefits, because we don’t actually know the benefits. We know some of the risks, which would lend you to not want to have those outcomes in kids, especially something like being addicted to a drug. But, you know, we don’t know the answer to that yet, so, we don’t really — the only one that’s close to really being researched and looked at right now is looking at people who never stop seizing, people who have continuous seizures. Not the, you know, every once in awhile, but the kids who have seizures constantly and are unable to develop and unable to move. Well, maybe the — the risk/benefit is — it’s, you know, the risk of hurting their IQ is way outweighed by the fact that they’re having seizures every day and they can’t even learn to speak. And so there’s a lot of research that’s looking very promising with using cannabinoids, but, again, you know, the plant is not a medicine, so we don’t know, how much do you give? How long do you give it? When does it wear off? How does it work in the body? You know, marijuana’s very interesting, because it sits in the fat, in the body, so different people have different amounts of fat, and so the drug can work differently in different people.

Scott Gilbert – Another issue I’ve heard of too is that you can get different dosages from different suppliers, because we know how it’s created, but something from this part of the country, this grower, may be very different, and when you’re talking medicine, that sounds dangerous.

Dr. Walker-Harding – Yes. There’s no way — we don’t have any — it’s not an FDA-approved drug, which means that there is no regulation on how much is in there compared to what people say. When I lived in Seattle and they would do kind of spot checks, what was said on the — the label, of how strong it was, had no relation to how strong it was. You don’t really know, and, you know, that’s one of the concerns we have, is you could go out and buy it at one place, one lot of marijuana, one, you know, chemically, you know, engineered marijuana, you could go somewhere else and get another one, and think that it’s the same dose, and then you have an effect that you didn’t expect. So, yes, there’s a lot of caution we have with that.

Scott Gilbert – We welcome your questions for Dr. Leslie Walker-Harding here on You’re watching Ask Us Anything About Marijuana Use in Teens from Penn State Health Children’s Hospital. We’re talking about the AAP’s policy statement in which they also mention they do strongly support research and development of pharmaceutical cannabinoids, and reviewing policies, including moving it from a schedule I drug to a schedule II drug. What — what does that mean?

Dr. Walker-Harding – It means that we’d be able to do research on it. And have the right kind. Right now, even the people doing the research on cannabis formulations, they’re not — they’re not the same strength as what you can actually get right now on the street, especially in places where it’s legalized, and you have oils and many different ways that the THC has been extremely concentrated. And we don’t have access to those kind of drugs to test them.

Scott Gilbert – Now, they also mention in the statement, they say, pediatricians should advocate the state’s regulate their product as closely as possible to the ways that tobacco and alcohol are regulated, only making it available to people over age 21. And why is that a common sense stance?

Dr. Walker-Harding – One, because we know that most of the brain development is over, you know, in the early 20’s. Two, we know that if you do not begin to use something like marijuana as a kid, you’re much less likely to use it ever as an adult. You know, you get 10 kids who try marijuana, three or four of them are going to become addicted to it. And addiction isn’t like it goes away, it’s a lifelong addiction. Your brain never changes back once it’s changed. If you have 10 adults, only one may become dependent on it. So, you know, it’s a high-risk proposition when you’re talking about a kid and addiction.

Scott Gilbert – Again, you’re watching Ask Us Anything About Marijuana Use in Teens. We welcome your questions for Dr. Leslie Walker-Harding, and you can add them to the comment field, whether you’re watching this interview live or if you’re watching it on playback, we would welcome your questions, whether it’s possible medicinal marijuana, or the other issues that we’re talking about here that are a subject to this American Academy of Pediatrics’ statement. They say that they strongly support the decriminalization of medical — of marijuana, rather, and refocusing on treatment for adolescents. So it sounds like, you know, they’re saying that those hundreds of thousands of teens that are ending up behind bars, they’re not getting rehabilitated.

Dr. Walker-Harding – Yeah, I think people do still need to remember, even in places where it’s legalized, it is not legal for anybody under 21. So if kids are found with that, and the law enforcement wants to press charges, they can, it’s illegal. And if you’re dependent on a drug, being — that’s an organic brain disease, that your brain is changed, and so your brain’s telling you that you must have that drug. And putting somebody in jail isn’t going to be helpful to that. What you really need is to get treatment, and so, yes, we strongly recommend treatment, punishing people for a brain disease, just like punishing people if they have diabetes isn’t the way to make it better.

Scott Gilbert – We do have a question from Emily online, she’s asking about the difference between CBD and THC. Can you break that down for us?

Dr. Walker-Harding – Yes, people have been looking at research using C — CBD as, there’s CBD-1, CBD-2, looking at that as more medicinal, because it has a lower THC content. Right now, people cannot completely — there’s no pure THC and pure CBD, but there are people that can get the ratios higher for CBD to THC, and the thought is that that could be better without this. The THC is what we call psychoactive part of marijuana, and so what that is, that’s the area that hits the reward center that makes you more likely to become addicted to it. But, you know, we don’t know yet, fully, what CBD does. Because, again, there hasn’t been

to look at it and see if that could be a way to begin to move.

Scott Gilbert – And when we talk about medicinal marijuana, especially

get better, right? We’re talking about extracts, and that cannabidiol, those substances you’re talking about, they’re derived from the plant, correct?

Dr. Walker-Harding – Yes.

Scott Gilbert – So, let’s talk a little bit about the key takeaways for parents here. Parents who are watching, what do we want them to know about marijuana use, especially parents who may be using marijuana and they have young children around the house, what your advice for them?

Dr. Walker-Harding – Yeah, well, first of all, young children can actually have a problem if they accidentally ingest that, they can actually have a problem with breathing. You know, little kids, 2-years-olds have been in the hospital with difficulty breathing, not able to walk, you know, unable to respond, something we call obtunded. So, you do not want your little kids to have marijuana. It’s — and so you need to have it locked up. You need to know that there are effects that happen to kids that are different from adults. And if you’re using and you have teenagers, you know, teenagers know where everything is. So, you really need to have some discussions about whether, you know, the differences between you and your child, and that you do not endorse kids using marijuana. That helps, that’s one of the most powerful things we can do to have a parent endorse that they do not want their child to use drugs, especially marijuana.

Scott Gilbert – We have a question from Hailey, who’s watching our video live today. She asks — she says, CBD is the non-psychoactive component of marijuana that helps kill cancerous cells and helps patients that have epilepsy lower the rate of their seizures, will Hershey introduce CBD to patients that qualify for treatment in the…it looks like it cuts off there, but, yeah, so we can get the gist of her…

Dr. Walker-Harding – Yeah, well, I would like to correct a little bit. There’s actually no evidence, at all, in the scientific world, that THC kills cancer cells. None whatsoever. There’s a lot on the internet that you see and you read, and it’s sometimes hard to tell the difference between the two, but there is no evidence that THC helps cancer in any way. In the past, early on, in, you know, the early 90’s, 80, 70, people used marijuana to help with nausea when somebody had cancer, but there is no evidence that it helps. So, no, that would not be something that we would be even close to using. Maybe one day research could find that, you know, it could find a lot of things, but right now, that — there isn’t — and the same thing with seizures. Again, they’re in the process of studying that. There are some studies that are coming out of Colorado that it seemed to help some people, some people it hurt. So, there’s more research that needs to be done before it’s actually used as a medication, right now it is not a medication. But there are some promising aspects around epilepsy.

Scott Gilbert – And one of the common threads I’m hearing both today and seeing in the AAP statement is the fact that there does need to be more research done about the effects, or the possible benefits of medicinal marijuana in children. And until that evidence is out there, it’s not for doctors to say, well, sure, I’m just going to prescribe this.

Dr. Walker-Harding – Yeah, you know, I think the — the way the medicinal, the laws written here, people can recommend — no doctor can actually write a prescription for marijuana anywhere in the country, because, of course, it is not a medication, it is not approved by the Federal Drug Administration, so there is no way to write a prescription, but in different places, doctors can recommend it in different fashions, which is what can happen here. Any doctor can make that decision to do so. However, most pediatricians do go by the American Academy of Pediatric recommendations, which have been very strong about the risk and the dangers of giving kids something like marijuana that has not been fully vetted, or even, you know, almost fully vetted, we don’t sometimes have to wait for everything to be found out, but we need to know more than we know now before we can confidently say this is something that will be helpful for your child.

Scott Gilbert – Dr. Walker-Harding, this has been very, very informative. Any other takeaways you want for parents, and other people, as we wrap this up?

Dr. Walker-Harding – Just, you know, I think the message to parents is be aware of what’s happening in the community, be aware of the impact you have on your children, and what you say and what you don’t say is very powerful to them. So it’s actually saying the words about what you believe, about drug use and your children, has a huge impact. Much more than anything else you can imagine. So, please, speak to your children about drugs. Tell them what you believe about it, and help them to live as healthy a life as they can.

Scott Gilbert – And thank you for making the time today!

Dr. Walker-Harding – Thank you!

Scott Gilbert – Dr. Leslie Walker-Harding is Chair of Pediatrics here at Penn State Health Children’s Hospital. She’s also an expert on substance use by teens. We thank her for her time today, thank you for the good questions, and, again, keep those coming as you continue to watch this video, perhaps on playback, you can add your questions to the comment field, not too late to pose a question to Dr. Walker-Harding, which we’ll get to her and get you an answer. Thank you, again, for watching Ask Us Anything About Marijuana Use in Teens from Penn State Health Children’s Hospital.