Improving the regulation of medical cannabis in Canada to better serve pediatric patients

摘要

Children with chronic debilitating illness and pain are increasingly using cannabis for medical purposes, particularly when conventional treatment options have limited benefit or substantial adverse effects. Caregivers are becoming aware of evidence that suggests medical cannabis provides benefit for children with conditions that include drug-resistant epilepsy, cancer pain and autism. At present, children and youth aged 18 years and younger (henceforth referred to as children) access medical cannabis through a framework regulated by Health Canada. In 2018, the Cannabis Act (Bill C-45) created separate medical and recreational streams for purchasing cannabis. Under the law, cannabis treatment for children must be authorized by a physician or nurse practitioner, which provides an opportunity for patient counselling. Strict production and labelling requirements that limit contaminants and create some consistency in cannabinoid concentrations have been instituted, which is good for pediatric cannabis users. However, requirements for physician authorization are outdated and do not reflect the needs of pediatric patients, and product labelling remains inadequate, as does surveillance for adverse drug reactions in children. Improvements in regulation are needed.