Zack~
Medical Marijuana: Finding Relief For Childhood Epilepsy
Cannabis has been recognized for its medical properties around the world. According to Thomas, "Healers have turned to cannabis, known in the vernacular as marijuana, for its medicinal qualities for more than 5 millennia. Indeed, the world's oldest surviving medical text, the Chinese Shen-nung Pen-tshao Ching, recommends marijuana to reduce the pain of rheumatism and to address digestive disorders" (2010, p. 1). Originating in China, marijuana migrated into western civilization by the 17th Century. By the year 1900, marijuana had found its way into over 100 medical journals in the Americas and Europe. It had been praised enthusiastically for its therapeutic virtues. Medical marijuana has been used to treat cases of hydrophobia, epidemic cholera, convulsions, chorea, hysteria, mental depression as well as many other debilitating conditions (Thomas, 2010, p. 1). Some of the current uses of medical marijuana range from nausea and vomiting, loss of appetite, muscle tension and spasm, pain, insomnia, and epilepsy.
In the early 20th Century, The Marijuana Tax Act was the first federal restriction on the herb's use and distribution in the United States. It would impose a tax on marijuana’s use in the form of federally issued stamps. Due to the large amounts of paperwork involved in prescribing marijuana to patients, doctors stopped prescribing the drug soon after the act was enacted. In 1970, the Controlled Substances Act was enacted by then president Richard Nixon. The act laid out a structure of five schedules incorporating variables of medicinal value, potential for abuse, and psychological and physical effect. Marijuana,along with heroin, ecstasy, LSD and a few others were placed in Schedule I; the only category that prohibits use of any kind, medical or other wise (Thomas, 2010, p.2-3). Currently, Schedule I houses over 100 substances, including cannabis. The American people started to see a change in medical marijuana reception in 1996 when California passed Proposition 215, the Compassionate Use Act(CUA). The CUA provides protection for patients, a “patient's primary caregiver,” and physicians from prosecution when using medical marijuana to treat illnesses including, but not limited to cancer, anorexia, AIDS, and chronic pain (Thomas, 2010, p.3). Currently twenty states and the District of Columbia have passed similar laws to California's Proposition 215 legalizing the medical use of marijuana. Thirteen states have pending legislation to legalize medical marijuana as of April 2014, including Florida. Unfortunately, the federal government still sees cannabis as a Schedule I drug; an illegal narcotic with no medical value.
Parents across the United starts are starting to turn to medical marijuana to help treat not only their own illnesses, but the illnesses of their children as well. A case study was done in 2002 on a seven year old boy in California suffering from PTSD, bipolar disorder, and impulse control disorder. Over the course of four years, the child had been prescribed over nineteen medications to help control his symptoms, often causing the child to be over medicated. The medication failed, mostly resulting in undesired outcomes or an increase in symptoms. In May of 2011, his mother discovered that medical marijuana could help her son. The child started a regimen of edible cannabis in the form of muffins. The dose, one half of a muffin containing one-forty-eighth of a cup of dry leaves, was controlled and monitored by his pediatrician. He would consume one half in the morning, and the other half in the afternoon (O'Brien & Clark, 2002). According to O'Brien and Clark (2002), “The results have been very good. JJ's social worker and teachers report that his behavior has taken a dramatic turn. His demeanor is very polite and he interacts enthusiastically with staff and students” (p.11). His mother knows that it is far too early to know what the long term effects of prolonged marijuana use will be and will discontinue use of the drug if it no longer helps her son's symptoms (O'Brien & Clark, 2002).
While case studies involving patients under medical marijuana do exist, finding scientific data in the past was relativity hard due to the fact that cannabis is a Schedule I narcotic. A drug under Schedule I indicates the federal government does not recognize medical properties. It has been next to impossible to get funding for studies in the medical use of marijuana. Studies conducted on children at this juncture was out of the question. More specificity, studies into marijuana's effect on epilepsy have been disregarded in the past. In a study to review the safety effects of marijuana and alcohol on epilepsy patients, research by Gordon and Devinsky (2001) suggests that, “Few clinical studies have examined the effects of cannabinoids on seizure frequency or severity in epilepsy patients. No large double-blind or controlled studies have evaluated marijuana, or the cannabinoids, in treating epilepsy patients” (p.1270). The report continues stating that there have been clinical anecdotes and single cases to show marijuana may help with epilepsy, but in most cases, does not effect seizure activity (Gordon & Devinsky, 2001). Studies concerning medical marijuana and its effects on epilepsy continued to have this opinion till a girl by the name of Charlotte Figi changed everything.
Matt and Paige Figi gave birth to twins Charlotte and Chase Figi on October 18th, 2006. Both children were carried to forty weeks and born completely healthy. At the age of three months Charlotte had her first seizure after her nightly bath. That first seizure lasted approximately thirty minutes and she was rushed to the hospital soon afterword. The doctors at the hospital gave her a comprehensive exam including tests such as a MRI, EEG, spinal tap, and blood work. After all tests came back negative, the Figi family was sent home. Within the next week, Charlotte had a second seizure; this was only the beginning. Over the next few months, Charlotte experienced frequent seizures lasting upwards to four hours. With all tests coming back normal, the doctors informed the Figis that the seizures would go away with time (Young, 2013).
Unfortunately, Charlotte Figi's seizures continued to only get worse. One of the main doctors treating Charlotte advised the parents about 3 possible disorders that could be the culprit with Dravet Syndrome being the worst case scenario (Young, 2013). According to Young (2013), “Dravet Syndrome is a rare, severe form of intractable epilepsy. Intractable means the seizures are not controlled by medication” (p.1). Charlotte was developing normally, but the medications began to take their toll on her. She had been taking drugs such as barbiturates and benzodiazepines. While the medication would work for a time, the seizures would always return. By the age of two Charlotte began to show declines in cognitive development (Young, 2013).
Six months later, the Figis decided to take Charlotte to Children's Hospital Colorado to see a neurologist. The doctor did a DNA test for Dravet Syndrome. After waiting two months for the results, the test came back positive. While this was the worst case scenario, the Figis felt relieved to know the cause of the seizures (Young, 2013).
At this point, the Figis were beginning to run out of treatment options for Charlotte. While considering a drug from France and another experimental drug showing success in treating seizures in dogs, Paige took her daughter to see a Dravet specialist in Chicago. The specialist placed Charlotte on a ketogenic diet to increase her ketone count, a natural chemical that helps to suppress seizures. At first the diet seemed to work, but it came with adverse side affects. She incurred bone loss and a drop in her immune system as well as odd behavioral issues, such as eating pine cones. After two years the seizures returned in full force (Young, 2013).
Colorado voted in favor of medical marijuana in 2000. The Figis had never supported medical marijuana ballot measures in the past. The Colorado measure covered seizures as one of the debilitating illnesses on its list of approved ailments. Matt Figi had discovered a video on the internet about a California boy who suffered from Dravets and used medical marijuana to successfully treat his symptoms. The video said that the cannabis was a strain low in THC and high in CBD which means it has medicinal properties but little to no psychoactive cannabinoids. Scientists could only speculate, but they believed that CBD quiets the excessive electrical activity in the brain, preventing the seizures (Young, 2013). At this point, Charlotte was having up to 300 grand mal seizures a week and was losing the ability to walk, eat, or talk. At age five, the hospitals no longer had any other treatment options available to offer the Figis (Young, 2013).
The Figis were at the end of the line and decided to give medical marijuana a chance. It took the Figis quite a long time to find the two necessary doctors needed to sign for a medical marijuana card for what would be the youngest cannabis patient in Colorado's history. Paige located a dispensary that had a small amount of the cannabis they had interest in trying and purchased two ounces, the whole stock. After having a friend extract the oils from the plant, the Figis had the oil tested for proper levels of THC and CBD. After giving Charlotte her first dose of the oil in her food, they were stunned at the results. After being seizure free for over an hour, her parents wrote it off as a fluke, but Charlotte did not have another seizure for seven days. Although the medicine seemed to be working, their supply was running low (Young, 2013).
Paige Figi came across the Stanley brothers, one of Colorado's largest marijuana growers and dispensary owners. The brothers had developed a strain of cannabis that was low in THC and high in CBD, but at the time, the public had little to no interest in the strain. Although reluctant at first due to Charlotte's age, after meeting the child, they agreed to release the medication. Charlotte had started on a dose of the oil twice a day on her food. Dr. M. Gedde, one of the two doctors that had signed for Charlotte's Medical Marijuana card, found that a dose of 4 milligrams of the oil per pound of the child's body weight was enough to stop the seizures. Charlotte is now six years old and is mostly seizure free. She has approximately two to three seizures per month, almost always while she is asleep. This is a dramatic difference compared to 300 grand mal seizures per week. Her cognitive development returned to average levels of a child in her age range. She is able to walk and talk, ride a bicycle, and even fed herself. The strain of marijuana that helped save Charlotte's life is now being used to treat forty-one other patients suffering from illnesses such as epilepsy and cancer. The Stanley brothers named the strain after Charlotte, Charlotte's Web (Young, 2013).
Charlotte Figi's fight with Darvet Syndrome and the wide spread news of the success of the Charlotte's Web cannabis strain used in treating Charlotte's seizures has spawned legislation moments across the United States. In Utah, a child named Charlee Nelson was suffering from Batten disease, a rare, fatal neurodegenerative disorder. One of the major symptoms of Battens is severe seizures. She passed away in March 2014 while sitting on a waiting list for Colorado's cannabis oil. Thanks to families like the Nelsons, Utah HB105 was signed into law two weeks after Charlee passed. The law, Charlee's Law, allows epilepsy trial access and use of the seizure-stopping cannabis oil in Utah (Stewart, 2014, p.1). In Alabama, Gov. Bentley signed into law SB 174, Carly's Law, witch allows the state to establish a program for cannabinoidol treatment for seizures. A program is already underway at the University of Alabama to begin trials on the cannabis oil (Oliver, 2014). On April 10th, 2014, Kentucky Gov. Beshear signed into law SB 124 witch allows doctors at the research hospitals University of Louisville and University of Kentucky the ability to prescribe cannabis oil to patients having seizures. The oil can only be used with the permission from a doctor from a research hospital or someone participating in a trial administered by the FDA (Associated Press, 2014). Several other bills and measures are making their way through state legislators across the country, but none are close to being signed into law. Most lawmakers are awaiting results from the states that are allowing the trials before making a discussion.
Currently, the longitudinal effects of using medical marijuana to treat childhood epilepsy are still unclear. With the passing of recent laws and the beginning of research trials across the country, hopefully within the next five to ten years we will have concrete evidence whether or not medical marijuana could become a viable, main stream treatment for childhood epilepsy. With continued support from families with suffering children and the fantastic work of state lawmakers and lobbing groups we can help push forward medical marijuana reformation. Hopefully in the not to distant future, we can raise our children knowing that something like childhood epilepsy can be completely controlled and that our children can grow up to be healthy, seizure free adults.
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Zackary Bruley ©2014
This work is licensed under a Creative Commons Attribution-NoDerivs 3.0 United States License.
