Children's Hospital Colorado Introduces Pediatric Medical Marijuana Policy

A children’s hospital in Colorado has created a revolutionary new way to approach medical marijuana use for minors. Children’s Hospital Colorado crafted a medical marijuana use policy that combines the use of a clinical pharmacist and social worker to offer support to patients and families that are either using medical marijuana or are considering its use.

The hospital is located in Colorado, where medical and recreational marijuana use is legal. However, the hospital does not dispense medical marijuana.

“Our hospital neither advises the use of it nor recommends nor prescribes, or even talks with patients about how to use it,” Jennifer Jorgensen, PharmD, clinical pharmacist at The Children’s Hospital Colorado, tells Verywell. “But families in our communities are coming into the hospital and they’re already reading about medical marijuana online and seeking it out.”

"Some parents have already started their children on medical marijuana before they talk to staff about it," Jorgensen says. "The goal of Children’s Hospital Colorado’s policy is to talk to parents about safety concerns," she says.

The policy is the subject of a July research article published in the journal Pediatrics. The article details data from 50 patients who were seen by Children’s Hospital Colorado’s medical marijuana consulting service. Of those patients, 80% were diagnosed with cancer and were interested in exploring how medical marijuana could help with nausea and vomiting, appetite stimulation, seizures, and pain. In 64% of patients, medical marijuana use was found to be potentially unsafe, usually due to the potential of interactions with other drugs the patient was taking. 

The article makes the case that more pediatric hospitals should strive to address medical marijuana use with their patients, as well as develop institutional policy and clinical support services to answer questions parents and patients have.

What Is Medical Marijuana?

Medical marijuana consists of using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions, according to the National Institutes of Health (NIH). Currently, the Food and Drug Administration (FDA) has not recognized medical marijuana or approved its use.

However, the FDA has approved the use of two medications that contain cannabinoids, the chemicals in marijuana, in pill form. Additional research may lead to more of these medications, the NIH says.

The two main cannabinoids that are used in FDA-approved medication are THC and cannabidiol (CBD). THC can stimulate appetite and lower levels of nausea, while CBD may help reduce pain and inflammation, and control epileptic seizures, Jamie Alan, PhD, an assistant professor of pharmacology and toxicology at Michigan State University, tells Verywell.

Is Medical Marijuana Legal?

Yes and no. Marijuana in any form is illegal on a federal level. However, some medications derived from marijuana have been approved for use by the FDA. Marijuana is currently legal in some form in 14 states, and 33 states have medical marijuana programs.

How Is Medical Marijuana Currently Used?

In a hospital setting, it’s not.

“It's kind of a new frontier for pediatric patients,” Alan says.

Tetrahydrocannabinol (THC), the component of marijuana that produces a high, is a schedule I controlled substance by federal law, per the U.S. Drug Enforcement Administration. “This means that if hospitals receive federal funding, they can lose federal funding if they dispense marijuana,” Alan says.

However, according to Alan, “this doesn't mean that the patient can't get a medical marijuana license or buy recreational marijuana, but this means there is less physician oversight, so there is more likelihood of adverse events. There are just so many unknowns at this point.”

While the American Academy of Pediatrics (AAP) recognizes that anecdotal reports have shown that medical marijuana can benefit some children with chronic or life-limiting conditions, the organization’s position is that it opposes the use of medical marijuana “outside the regulatory process of the U.S. Food and Drug Administration.”

How Does The Children’s Hospital Colorado’s Policy Work?

Jorgensen says that parents often approach them with questions.

“It’s very tricky to navigate, but our attempt is to manifest this open dialogue with families,” she says. “We don’t want them to be afraid to tell us that they’re using marijuana.”

When parents do bring up the topic, Jorgensen says she and her colleagues will ask what the parents are using marijuana for, whether they can show it to their provider, and if they’ve noticed that it’s been helping or hurting.

“We don’t comment on whether we think it’s useful or not,” she says. “But we say, in our opinion as far as safety, this will or will not interact with other medications.”

Safety concerns are a big topic of conversation, Jorgensen says. However, there’s “no great literature” to support its use, she says, and that means “we can’t cite safe dosing and what they should or shouldn’t use it for.”

“We don’t really say, ‘You should continue to use it,’” Jorgensen says. “Instead, we say, ‘It’s your decision.’”

The hospital does, however, prescribe THC-derived medications that are approved by the Food and Drug Administration (FDA). The includes a drug called Dronabinol (Marinol), which contains THC and is used to treat nausea caused by chemotherapy and extreme weight loss caused by AIDS. The organization also prescribes the drug Nabilone (Cesamet), which contains a synthetic cannabinoid similar to THC and is also used to treat nausea and extreme weight loss.

As medical marijuana is legalized in more states, Jorgensen says she’s hopeful other organizations will take note of what Children’s Hospital Colorado is doing.

“A big thing for us was to try to approach this without them feeling like we were passing judgment or telling them what they can and can’t do," she says. "It has been very successful in opening the dialogue."