Cannabis Therapeutics for Pediatric Care: Dr. Bonni Goldstein, MD video

In the latest installment of our video series, Cannabis Conversations, we speak with Dr. Bonni Goldstein on how she integrates cannabis therapeutics into her clinical practice. She discusses the use of cannabis therapeutics in her pediatric practice for patients with various conditions such as seizures, cancer, autism, and mental health conditions. She discusses some positive case reports and addresses the dosage issues.
Project CBD: I’m here with Dr. Bonni Goldstein from Los Angeles. Please introduce yourself, Bonni.
Dr. Goldstein: My name is Bonnie Goldstein. I’m a physician and I am the medical director at Canna-Centers, a group of medical practices throughout California that educate patients on the use of cannabis therapy. And I also do some medical consulting for Ghost Group, the parent company that owns Weedmaps.
Project CBD: So we have heard a lot over the years, in terms of the “reefer madness” context about marijuana being the “assassin of youth.” But in your practice, as a pediatrician, you’ve seen different results. Maybe you can tell us about that.
Dr. Goldstein: That’s true, Martin. So, remember, healthy kids are not coming to a doctor for help with cannabis. It’s the children that are sick. And, in my practice I’m seeing the sickest of the sick. I’m seeing children who have intractable epilepsy, that means they’re not responding to any treatment that’s available. And there’s some aggressive treatments – brain surgery, special diets that are very difficult to keep, lots of different medications that have toxic side effects. I’m also seeing children with autism. And we know, really there is no medicine for autism. There’s therapy, which can be very helpful, but there’s only two approved medications, and both of them are anti-psychotics, not great for children (many bad side effects). As well as children with cancer. And also I’m seeing some children with severe psychiatric disease where current conventional medication hasn’t helped.
What we have to remember is that the endocannabinoid system, the part of the brain that’s required for many physiologic processes throughout the body, this system helps with homeostasis. It keeps the brain in balance. And, in certain patients – people with illness – that system is the core of the problem. In most healthy children, their endocannabinoid system is functioning and actually adding cannabis to that endocannibinoid system may actually interfere with developing brains. So I don’t encourage teenagers – and I’m the mom of a teenage boy – to use cannabis until their endocannabinoid system is “finished developing the brain.” But in children who are sick, these are special cases. These are children who sometimes are not finding the answers. Years go by, and when you lose years of a child’s life, you’re losing development, quality of life – the burden of illness is tremendous, not only for the child but for the whole family.
Project CBD: So what have you seen in terms of your practice that has surprised you?
Dr. Goldstein: Well, with the group of patients with intractable epilepsy, the average number of medications that the children who come to me – by the time they get to me – they have usually tried 12 medications that have failed them. They often have developmental delay. They often have significant other problems, pulmonary problems, GI problems, immune function problems, which all can be interrelated with the endocannabinoid system. They also aren’t living what I would call a “normal” life. They’re not going to school. They’re not able to go to school. The school doesn’t want to have them there if they are having lots of seizures and so on. So, what I’m seeing is, when we add CBD-rich medicine – so basically an oil that the children take under the tongue or they swallow it or it goes through a G-tube – what we’re seeing is that number of seizures is reduced. Many parents report frequency down, severity down, duration down. And interestingly, they say, where my child had a seizure before and it would take all day to recover, my child just bounces back. And then we can get up and go do things. So that was very interesting to see that the positive response, not only in less seizures and so on, but even when they still continue to have seizures they’re not as disruptive. So that was an interesting thing to see.
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