Abstract and Introduction
Abstract
This article focuses on the use of non-intoxicating, over-the-counter (OTC) cannabidiol (CBD) preparations in children. Evidence of therapeutic benefits of OTC CBD is minimal and evolving. Much of what is available to review regarding OTC CBD use in pediatric patients is anecdotal based on real-world utilization, which creates a challenge for the pediatric nurse when defining best practices. The use of OTC hemp products containing CBD with less than 0.3% tetrahydrocannabinol (THC) is increasingly common in adults. Many adults use these non-hallucinogenic CBD products regularly. The use of these readily available CBD products in children is more controversial, with conflicting evidence regarding safety and efficacy. Federally, use of OTC CBD products with less than 0.3% THC is legal; however, state laws vary. Commonly, pediatric nurses encounter patients who have an interest in or are currently using CBD. Legal implications coupled with the lack of U.S. Federal Drug Administration approval of these OTC products may lead to difficulty educating patients about CBD. This fact also complicates development of associated policies or procedures for usage. Pediatric nurses should know about OTC CBD, the endocannabinoid system's physiology, and legal implications of CBD in the pediatric population, and provide education to patients and families who consider CBD as part of a treatment plan.
Introduction
The use of over-the-counter (OTC) hemp products containing cannabidiol (CBD) with less than 0.3% tetrahydrocannabinol (THC) has increased in popularity (Consumer Reports, 2019). To date, the U.S. Food and Drug Administration (FDA, 2021) has not approved any OTC CBD products to prevent or treat disease, yet use of CBD is rising. Increasingly, pediatric nurses see patients who use CBD products or have questions about use of these products (Schuman, 2019). For example, parents are asking pediatricians about use of CBD gummies for irritable infants or treatment of attention deficit/hyperactivity disorder (Schuman, 2019). Approximately 64 million adult Americans have tried CBD products, with one in seven using CBD products daily (Consumer Reports, 2019). In 2018, the U.S. CBD industry recorded an estimated 534 million dollars in sales (Congressional Research Service, 2019). These sales included hemp-derived CBD products with less than 0.3% THC, marijuana-derived CBD products with more than 0.3% THC, and pharmaceutical CBD (Congressional Research Service, 2019). OTC CBD products containing less than 0.3% THC are easily accessible at standard retailers, such as gas stations, drug stores, and online vendors.
Commonly reported uses for these CBD products include, but are not limited to, stress relief, anxiety, joint pain, generalized pain, muscle spasms, migraines, mental health disorders, skincare, and improved sleep (Brennen, 2019; Consumer Reports, 2019). CBD is used as a supplement and alternative form of medication; however, there has been little FDA oversight. CDB use in adults is generally considered safe; however, there is more controversy concerning CBD use in children. Some experts advise against the use of CBD in minors unless in medically indicated circumstances, such as for treatment of seizures (Schuman, 2019).
Pediatr Nurs. 2023;49(1):40-44. © 2023 Jannetti Publications, Inc.
