Many people have asked me whether medical cannabis might be able to help someone who has debilitating ADD/ADHD, and if I would be willing to facilitate the treatment.
Because one of the known side effects of recreational marijuana is the possibility of reducing attention, memory, and cognitive function (especially in children), one could reasonably ask if it is wise to entertain this as a viable treatment modality for such patients. After contemplating this topic extensively, I am now ready to share my current perspective.
Before we can consider medical cannabis for any patient, we must determine whether the patient will qualify under the applicable laws. In Florida, where I practice, in addition to other legal criteria, patients qualify for medical cannabis based on having one or more listed medical conditions or a medical condition of the “same kind or class as or comparable to those enumerated” in the statute.
In my medical opinion, a debilitating medical condition is one that causes a person to rely on some form of therapy (e.g., medicine, talk therapy, physical therapy, etc.) on a regular basis. Without such treatment, the medical condition has a significant negative impact on the person’s life and their ability to lead a fully functional life. For example, if a person’s behavior is so hyperactive, or their attention and focus is so lacking, they cannot function in a classroom or a workplace environment without intervention, then that patient is debilitated.
While doing research recently on the debilitating effects of HIV/AIDS, I was reminded that both HIV-Associated Neurocognitive Disorder and Attention Deficit Hyperactivity Disorder (ADHD) are known to produce similar deficits in attention, learning, and concentration. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998228/). Because HIV/AIDS is one of the enumerated debilitating medical conditions under Florida law, a person with debilitating ADD/ADHD symptoms suffers from a medical condition of the same kind or class as one of the listed conditions. If all other criteria are met, including determining that the potential benefit of medical cannabis outweighs the potential risks, this ADD/ADHD patient would have a qualifying medical condition.
Before considering treatment, though, I must have some medical justification that cannabis may help reduce the impact of the debilitating medical condition. In a 2014 article published in the Hawai’i Journal of Medicine & Public Health (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998228/), hand-delivered surveys were given to one hundred consecutive patients returning for their annual medical cannabis re-certification consultation. Of all patients surveyed (i.e., not just those with ADD/ADHD), 9% reported a significant improvement in focus/concentration. I also discovered a non-published study of 30 adult ADHD patients who showed similar improvements in focus/concentration (page 85: (cannabis-med.org/nis/data/file/abstractbook.pdf). Another scientific article documented improvements in hyperactivity levels of a boy treated for six months with daily doses of dronabinol (synthetic THC, the psychoactive/euphoric component of cannabis). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318349/)
While I have concerns that exposing people with attention-deficit issues to THC (the “euphoric” cannabinoid) may worsen their attention and focus, I believe CBD (the main “non-euphoric” cannabinoid) could be a safe and effective treatment for some patients with ADD/ADHD. For such patients, after discussing the pros, cons, and alternatives, if the patient/family chooses to proceed, I initiate treatment with a low dose of CBD. I then gradually increase the dose to determine its’ effects. In some cases, adding a small, non-psychoactive dose of THC to the therapeutic CBD dose, brings a synergistic response with even further benefits.
Significantly more research is needed before making conclusive statements about whether medical cannabis may be a helpful ADD/ADHD treatment. However, considering the low-risk potential of exposing patients to CBD, the potential benefits will outweigh the risks for many patients. When appropriate, I am comfortable certifying such qualified patients and look forward to together learning more about the possible benefits medical cannabis as treatment for ADD/ADHD.
To learn more about medical cannabis treatment at Wholistic Pediatric and Family Care and Family Medical Cannabis Clinic, visit our website here. To learn more about Dr. David, read his full biography here.