Many of you may have heard anecdotes on how Cannabidiol (CBD) oil has helped them or their children overcome Attention Deficit Disorder (or ADD) or Attention Deficit Hyperactivity Disorder (ADHD). But, that shouldn’t be the basis of trying out a drug, even if it’s supposed to be a “natural” or a non-pharmaceutical one.
We should only rely on hard scientific facts, proven by research and clinical tests. We must remember:
- CBD is a cannabinoid (1*), a chemical compound that influences our nervous system
- ADD and ADHD are neurodevelopmental disorders that mostly affect children (or start manifesting during the early childhood years of adults).
Some research and studies have suggested that CBD may help patients:
- Overcome symptoms of epilepsy
- Relieve pain
- Alleviate anxiety, mood swings, mental disorders, and even
- Help cure acne.
But, does it have any positive impact on people, especially children with ADD or ADHD?
Before we discuss that, we first need to understand what is ADD or ADHD and why it occurs only among some individuals.
Table of Contents
ADD/ADHD – A Brief
ADD and ADHD are neurodevelopmental disorders that affect around 6-9 percent of children and young adults worldwide. It also occurs among some adults, but only among around 5 percent of the global population.
Generally speaking, Attention Deficit Disorder or ADD is a disorder in which a person is unable to focus his or her attention on current tasks, and in turn, learn new things.
In the case of Attention Deficit Hyperactivity Disorder (or ADHD), the individual also lacks control over his or her impulses and actions. They act or speak in ways that are socially deemed as inappropriate or even irresponsible. They are basically not in control over their own elements.
Symptoms/manifestations of ADHD are:
- Inability to concentrate on tasks at hand
- Continually abandoning a current task for another
- Carelessness, like making careless mistakes, mistakes that they are aware of
- Constant forgetfulness, losing or misplacing objects of importance
- Unable to carry out instructions
- Fidgeting uncontrollably, restlessness
- Inability to stay calm or quiet, or sit still when required
- Speaking out of turn and inability to stop oneself from doing so, interrupting others’ conversations
- Overly talkative
- Acting without any thought of consequences
- Little or no sense of danger
Such issues often wreak havoc on a child’s life. They may lead to:
- Poor performance at school,
- Poor social interaction with other kids and adults, and
- Disciplinary issues.
Later on in their lives, they face further problems in establishing meaningful relationships and achieving their goals in life, despite normal or superior intellectual abilities.
Why does it happen: ADD/ADHD often tends to run in the family, ie, it is usually genetically inherited. Scientists are divided over the reasons why it occurs only among some people.
Some researchers have concluded that people with ADHD may have an imbalance in the level of a neurotransmitter in the brain, called dopamine (or that this chemical doesn’t work properly).
Other studies have suggested the possibility that certain areas of the brain, particularly the gray matter, may be smaller among people with ADHD, compared to other areas.
Why dopamine is significant: Dopamine controls process like attention, memory, as well as pleasure and reward reactions. Cannabinoids have a lot to do with these aspects of our bodily functions.
Usual Treatment: Doctors generally prescribe stimulants like Ritalin or Adderall to children with ADD/ADHD to help correct their dopamine levels in the brain.
However, they may have unpleasant side effects. Owing to this, many parents look for alternative treatment methods. This is where CBD oil, which is believed to have a calming effect on the mind, comes into play.
Research into CBD oil for ADD/ADHD or the lack thereof
At the very onset, let’s be clear that there haven’t been any large-scale or extensive research or clinical trials carried out on the effects of CBD on patients with ADD or ADHD. Additionally, it is also not known if it is safe for children since very little human trials have been conducted.
That being said – let us look at the little work that HAS been done.
- In a 2008 case (1) report on cannabis for ADHD, positive results were observed in a 28-year old male patient with a history of criminal drug abuse and numerous cases of traffic violations. His condition was later attributed partly to a medical diagnosis of ADHD. A team of German researchers from the Heidelberg University Medical Centre, who conducted the test, administered high-potency THC. The young man not only “benefited from the cannabis treatment”, but the treatment also seemed to “regulate activation to a level which was considered optimum for performance … having a positive impact on performance, behavior and mental state”. Note that this study DID NOT test CBD’s effects specifically. It was also observed that cannabis use enabled the patient to improve his driving skills, indicating that cannabis can have positive effects on people with ADHD.
- A 2012 study (2) in the Journal of Psychopharmacology suggested that CBD inhibits hyperactivity and normalizes social behavior. This study was conducted on lab (Sprague-Dawley) rats, treated with a substance that induces ADHD symptoms. On being treated with 3mg per kg dose of CBD, it was seen that hyperactivity in the rats was inhibited. Additionally, their social behavior not only “normalized”, but was “increased beyond control levels”. However, there were no noticeable improvements on their attention span. Note that this study does not confirm its safety or efficacy on human subjects.
- According to a 2016 study (3) on 268 separate online forum threads, “25% of individual posts indicated that cannabis is therapeutic for ADHD, as opposed to 8% that it is harmful, 5% that it is both therapeutic and harmful, and 2% that it has no effect on ADHD”. This was a unique study that used online forums to gauge the prevalence and effectiveness of cannabis use among real-life ADHD patients.
- Another study, published in 2017 (4), observed the effects of Sativex, a cannabis-based pain reliever, on ADHD patients. In this study, Sativex, a synthetic FDA-approved cannabis-based medication with equal parts of THC and CBD, was administered to patients diagnosed with ADHD. Of the 30 sample subjects, 15 were administered the cannabis drug, while the rest were given placebo. “Nominal” improvements in inattention, hyperactivity, and impulsivity were noticed in the group members who were given Sativex, leading researchers to conclude that “adults with ADHD may… experience a reduction of symptoms and no cognitive impairments following cannabinoid use”. This study offers some preliminary evidence in support of the self-medication theory of cannabis-use for ADHD. However, it is by no means advisable since 13 percent of the subjects experienced adverse side-effects from the drug, which is, after all, synthetic, pharmaceutical drug (and not “natural”, as it is subjected to several chemical cleansing processes to create the drug). Besides, the study also suggested that adults with ADHD react better to cannabinoids and experience fewer side effects than children.
Unfortunately for those looking to treat patients with ADD or ADHD, these four case studies are the only research work that has been carried out and published on this subject.
However, Dr. David Bearman, MD, University of Washington School of Medicine, who is considered to be a “clinically knowledgeable physician in the field of medicinal marijuana”, claims that “cannabis appears to treat ADD and ADHD by increasing the availability of dopamine, [which] has the same effect but is a different mechanism of action [than] stimulants like Ritalin”.
Research-based Safety Concerns
Even as some studies seem to back the claim that CBD, and cannabis in general, has therapeutic effects on patients of ADD and ADHD, there are still some very critical safety concerns – both for children and adults.
Safety concern of CBD oil For Children
As apparent in the studies cited above, no definitive clinical tests relating to CBD’s effects exist so far. Besides, the tests (4) have also suggested that the potential harmful effects of using cannabis for treating ADD/ADHD on children far outweigh any potential benefits. Since children are, by nature, more vulnerable, it is not advisable to self-medicate them with cannabinoids. Even if you consider CBD oil as comparatively safe, there is no denying that traces of THC remain in all CBD products.
- Children can’t handle inebriants: In all the above studies, there have been large doses of THC involved, which is a psychoactive, chemical component of marijuana. This means it can have hallucinatory effects on the patients. Children are far less equipped to handle intoxicating substances such as cannabinoids. Hence, it is never safe to administer them such substances in the absence of direct supervision by a certified medical practitioner with knowledge of and experience with cannabinoids.
- Long-term adverse impact of THC: Besides, a 2017 study, which was published in the journal, Nature (6), discussed the dopamine-releasing action of tetrahydrocannabinol (THC) and the source of its pleasure sensation, in which the researchers established that though THC boosts short-term dopamine levels, it may eventually dull the system that releases dopamine in long term, which is detrimental for children’s development for obvious reasons. A child’s brain is still developing, and using marijuana products may hinder normal neurological development, leading to harmful cognitive and other effects.
- Resultant dependence: There is also the fear of a resultant dependence on cannabinoids (5). According to the National Institute on Drug Abuse (NIDA), (10) those who start using marijuana before the age of 18 are four to seven times more vulnerable to drug dependence than others. They also run the risk of developing addictions to other, more harmful drugs, especially later during their early teens or young adulthood (7).
Research shows a direct relationship between marijuana dependence and ADHD, ie to say, marijuana addiction or dependence may heighten symptoms of ADHD and even create ADHD-like symptoms among people who did not previously suffer from this disorder.
- A 2017 study (9) by the University of Washington, in association with the Alcohol & Drug Abuse Institute, came up with the following conclusions:
- Evidence suggests that those with ADHD are at increased risk for developing cannabis use disorders (See also Ref 9).
- Despite the widespread belief that marijuana has medicinal benefits for ADHD, there is virtually no research evidence to support this belief.
- Marijuana cannot be safely recommended for the treatment of ADHD at this time; at best, it might be considered as a last-line therapy when all other conventional therapies have failed.
These conclusions are in conformity with the earlier discussed studies, owing to the fact that NO SPECIFIC DATA is available regarding treating ADD/ADHD with CBD alone.
- Additionally, a 2014 study, published in the Clinical Nuclear Medicine journal (8) has clearly suggested that people with ADHD are rendered more vulnerable to their symptoms if they get hooked on to dopamine-spiking substances.
- To make matters worse, Methylphenidate (MPH), a commonly prescribed ADHD medication, interacts with marijuana, especially if smoked. A 2015 study (11) revealed that the two substances interacted significantly due to the presence of THC, substantially increasing the strain on the heart.
Final Thoughts: What does the research say about CBD & ADHD
Cannabidiol oil has reportedly helped quite a few children suffering from epilepsy. However, there is no substantial data available on CBD’s effect on children with ADD and ADHD. Although researchers admit that treating ADHD with cannabis products may show short-term improvements in symptoms, they firmly believe that it can potentially worsen the underlying disorder in the long run. Since ADD/ADHD is an ongoing disorder and not disease that can be cured within days, the long-term effects of any kind of treatment must be considered before initiating it.
Until and unless more evidence of CBD’s usefulness in treating ADHD is found through scientific investigation, it is not safe to self-medicate. Also, taking into consideration children’s inability to efficiently tolerate cannabinoids, and the lack of a suitable regulation for CBD products in the market, it is best to follow your doctor’s advice with regards to your child’s health.
Cannabinoid: Cannabinoids are chemical compounds that act directly and/or indirectly on the cannabinoid receptors of the endocannabinoid system (ECS) to help the body maintain stability and health. Our bodies make their own cannabinoids – called endocannabinoids because they are produced internally – to work on cannabinoid receptors, while CBD and THC are cannabinoids found in nature — in plants of Cannabis Sativa species – hence called phytocannabinoids. Our body’s endocannabinoid system that responds to the cannabinoids with the help of its cannabinoid receptors was discovered during the ongoing research on cannabis in 1988; hence the name. Also read: CANNABIDIOL 101: ULTIMATE GUIDE FOR BEGINNERS 2019 https://greenthevoteok.com/cbd-oil/
Reference (Research) links:
1: Cannabis improves symptoms of ADHD [Case report]; Peter Strohbeck-Kuehner, Gisela Skopp, Rainer Mattern; Institute of Legal- and Traffic Medicine, Heidelberg University Medical Centre, Voss Str. 2, D-69115 Heidelberg, Germany; https://www.cannabis-med.org/data/pdf/en_2008_01_1.pdf & https://www.daggaparty.org.za/downloads/Legal_Resources/Emerging%20Clinical%20Applications%20For%20Cannabis.pdf [Case 14]
- Cannabidiol and clozapine reverse MK-801-induced deficits in social interaction and hyperactivity in Sprague-Dawley rats; Gururajan A1, Taylor DA, Malone DT; Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia. email@example.com; J Psychopharmacol. 2012 Oct;26(10):1317-32. doi: 10.1177/0269881112441865. Epub 2012 Apr 9. https://www.ncbi.nlm.nih.gov/pubmed/22495620
- PLoS One. 2016; 11(5): e0156614. Published online 2016 May 26. doi: 10.1371/journal.pone.0156614; PMCID: PMC4882033. PMID: 27227537; “I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD; John T. Mitchell, Maggie M. Sweitzer, Angela M. Tunno, Scott H. Kollins, and F. Joseph McClernon1, Karen Lidzba, Editor; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4882033/
- Eur Neuropsychopharmacol. 2017 Aug;27(8):795-808. doi: 10.1016/j.euroneuro.2017.05.005. Epub 2017 May 30. Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial. Cooper RE1, Williams E2, Seegobin S3, Tye C2, Kuntsi J2, Asherson P4. https://www.ncbi.nlm.nih.gov/pubmed/28576350
- Understanding Drug Use and Addiction [National Institute on Drug Abuse https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
- Nature. 2016 Nov 17; 539(7629): 369–377. doi: 10.1038/nature20153 PMCID: PMC5123717, EMSID: EMS70462, PMID: 27853201; The effects of Δ9-tetrahydrocannabinol on the dopamine system; Michael A P Bloomfield, Abhishekh H Ashok, Nora D Volkow, and Oliver D Howes1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123717/
- Drug Alcohol Depend. 2014 Feb 1;135:88-94. doi: 10.1016/j.drugalcdep.2013.11.013. Epub 2013 Nov 25. Childhood and current ADHD symptom dimensions are associated with more severe cannabis outcomes in college students; Bidwell LC, Henry EA, Willcutt EG, Kinnear MK, Ito TA. https://www.ncbi.nlm.nih.gov/pubmed/24332802
- Clin Nucl Med. 2014 Feb;39(2):e129-34. doi: 10.1097/RLU.0b013e31829f9119. Searching for a neurobiological basis for self-medication theory in ADHD comorbid with substance use disorders: an in vivo study of dopamine transporters using (99m)Tc-TRODAT-1 SPECT. Silva N Jr1, Szobot CM, Shih MC, Hoexter MQ, Anselmi CE, Pechansky F, Bressan RA, Rohde LA. https://www.ncbi.nlm.nih.gov/pubmed/23856832
- Effects of Marijuana on Mental Health: Attention Deficit-Hyperactivity Disorder (ADHD; Alcohol & Drug Abuse Institute and University of Washington, June 2017; Susan A. Stoner, PhD, Research Consultant
- National Institute of Drug Abuse; Research Report: Is marijuana addictive? https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive
- J Subst Abuse Treat. 2015 Jan; 48(1): 96–103. An exploratory study of the combined effects of orally administered methylphenidate and delta-9-tetrahydrocannabinol (THC) on cardiovascular function, subjective effects, and performance in healthy adults; Scott H. Kollins, Ph.D., Erin N. Schoenfelder, Ph.D., Joseph S. English, M.S., Alex Holdaway, Elizabeth Van Voorhees, Ph.D., Benjamin R. O’Brien, Rachel Dew, M.D., and Allan K. Chrisman, M.D.; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250392/
- Alvarez, F. J., Lafuente, H., Rey-Santano, M. C., Mielgo, V., Gastiasoro, E., Rueda, M., . . . Martínez-Orgado, J. (2008). Neuroprotective Effects of the Nonpsychoactive Cannabinoid Cannabidiol in Hypoxic-Ischemic Newborn Piglets. Pediatric Research, 64(6), 653-658. Retrieved 8 9, 2018, from http://medicinalgenomics.com/wp-content/uploads/2013/11/neuroprotective-effects-of-cbd-in-hypoxic.pdf
- Asherson, P., & Cooper, R. E. (2017). Treatment of ADHD with cannabinoids. European Psychiatry, 41. Retrieved 8 9, 2018, from https://sciencedirect.com/science/article/pii/s0924933817300366#!
- Bergamaschi, M. M., Queiroz, R. H., Chagas, M. H., Oliveira, D. C., Martinis, B. S., Kapczinski, F., . . . Crippa, J. A. (2011). Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients. Neuropsychopharmacology, 36(6), 1219-1226. Retrieved 8 9, 2018, from https://ncbi.nlm.nih.gov/pubmed/21307846
- Burstein, S. (2015). Cannabidiol (CBD) and its analogs: a review of their effects on inflammation. Bioorganic & Medicinal Chemistry, 23(7), 1377-1385. Retrieved 8 9, 2018, from https://sciencedirect.com/science/article/pii/s0968089615000838
- Campos, A. C., Ortega, Z., Palazuelos, J., Fogaça, M. V., Aguiar, D. C., Díaz-Alonso, J., . . . Guimarães, F. S. (2013). The anxiolytic effect of cannabidiol on chronically stressed mice depends on hippocampal neurogenesis: involvement of the endocannabinoid system. The International Journal of Neuropsychopharmacology, 16(6), 1407-1419. Retrieved 8 9, 2018, from https://ncbi.nlm.nih.gov/pubmed/23298518
- Crippa, J. A., Zuardi, A. W., Garrido, G. J., Wichert-Ana, L., Guarnieri, R., Ferrari, L., . . . Busatto, G. F. (2004). Effects of Cannabidiol (CBD) on Regional Cerebral Blood Flow. Neuropsychopharmacology, 29(2), 417-426. Retrieved 8 9, 2018, from http://nature.com/npp/journal/v29/n2/full/1300340a.html
- Deiana, S., Watanabe, A., Yamasaki, Y., Amada, N., Arthur, M., Fleming, S., . . . Riedel, G. (2012). Plasma and brain pharmacokinetic profile of cannabidiol (CBD), cannabidivarine (CBDV), Δ9-tetrahydrocannabivarin (THCV) and cannabigerol (CBG) in rats and mice following oral and intraperitoneal administration and CBD action on obsessive–compulsive behaviour. Psychopharmacology, 219(3), 859-873. Retrieved 8 9, 2018, from https://link.springer.com/article/10.1007/s00213-011-2415-0
- El-Remessy, A. B., Al-Shabrawey, M., Khalifa, Y. M., Tsai, N. T., Caldwell, R. B., & Liou, G. I. (2006). Neuroprotective and Blood-Retinal Barrier-Preserving Effects of Cannabidiol in Experimental Diabetes. American Journal of Pathology, 168(1), 235-244. Retrieved 8 9, 2018, from https://sciencedirect.com/science/article/pii/s000294401062086x
- Filippis, D. D., Esposito, G., Cirillo, C., Cipriano, M., Winter, B. Y., Scuderi, C., . . . Iuvone, T. (2011). Cannabidiol Reduces Intestinal Inflammation through the Control of Neuroimmune Axis. PLOS ONE, 6(12), 28159. Retrieved 8 9, 2018, from https://ncbi.nlm.nih.gov/pubmed/22163000
- Hampson, A. J., Grimaldi, M., Axelrod, J., & Wink, D. (1998). Cannabidiol and (−)Δ9-tetrahydrocannabinol are neuroprotective antioxidants. Proceedings of the National Academy of Sciences of the United States of America, 95(14), 8268-8273. Retrieved 8 9, 2018, from http://pnas.org/content/95/14/8268
- Izzo, A. A., & Sharkey, K. A. (2010). Cannabinoids and the gut: New developments and emerging concepts. Pharmacology & Therapeutics, 126(1), 21-38. Retrieved 8 9, 2018, from http://advancedholistichealth.org/pdf_files/endocannabinoid system in gi disease.pdf
- Jones, N., Glyn, S. E., Akiyama, S., Hill, T., Hill, A. J., Weston, S. E., . . . Williams, C. M. (2011). Cannabidiol exerts anti-convulsant effects in animal models of temporal lobe and partial seizures. Seizure-european Journal of Epilepsy, 21(5), 344-352. Retrieved 8 9, 2018, from http://advancedholistichealth.org/pdf_files/the anti-convulsant activity of cbd.pdf
- Jones, N., Hill, A. J., Smith, I., Bevan, S. A., Williams, C. M., Whalley, B. J., & Stephens, G. J. (2010). Cannabidiol Displays Antiepileptiform and Antiseizure Properties In Vitro and In Vivo. Journal of Pharmacology and Experimental Therapeutics, 332(2), 569-577. Retrieved 8 9, 2018, from https://ncbi.nlm.nih.gov/pmc/articles/pmc2819831
- Liput, D. J., Hammell, D. C., Stinchcomb, A. L., & Nixon, K. (2013). Transdermal delivery of cannabidiol attenuates binge alcohol-induced neurodegeneration in a rodent model of an alcohol use disorder. Pharmacology, Biochemistry and Behavior, 111, 120-127. Retrieved 8 9, 2018, from https://sciencedirect.com/science/article/pii/s0091305713002104
- Massi, P., Solinas, M., Cinquina, V., & Parolaro, D. (2013). Cannabidiol as potential anticancer drug. British Journal of Clinical Pharmacology, 75(2), 303-312. Retrieved 8 9, 2018, from https://ncbi.nlm.nih.gov/pubmed/22506672
- Romano, B., Borrelli, F., Pagano, E., Cascio, M. G., Pertwee, R. G., & Izzo, A. A. (2014). Inhibition of colon carcinogenesis by a standardized Cannabis sativa extract with high content of cannabidiol. Phytomedicine, 21(5), 631-639. Retrieved 8 9, 2018, from https://sciencedirect.com/science/article/pii/s0944711313004728
“I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD; John T. Mitchell, Maggie M. Sweitzer, Angela M. Tunno, Scott H. Kollins, and F. Joseph McClernon1, Karen Lidzba, Editor; Published May 2016; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4882033/