Cannabis oil is an umbrella term for oily extracts from the plant Cannabis sativa with varying concentrations of THC and other cannabinoids, such as cannabidiol. Products containing even low amounts of THC is often classed as an illegal substance in many countries where cannabis is illegal.
For cannabis apologists, it is a miracle cure for a large number of diseases, ranging from cancer and HIV to autism and epilepsy. For critics of alternative medicine and opponents of drug fetischizing, it is just another drug product that criminals attempt to con people into using by making unsupported claims about products that haven ever been sufficiently tested for safety and efficacy.
Throughout the Internet and in newspapers like Metro, one can find many testimonials from alleged parents that swear that it works. But this is not scientific evidence. There are people who force bleach on their autistic children or treat children who have meningitis with maple syrup and swear that their products work when they demonstrably do not. It is easy to be convinced by testimonials, but it is just a form of emotional manipulation, often with financial motives, to trick people into buying their products. Let us look at two such testimonials that recently appeared in an issue of Metro newspaper.
Why do parents think that cannabis oil help against epilepsy in children?
The first testimonial covered a parent who claimed that mainstream epilepsy medication made her daughter whiny and difficult to contact as well as giving her high blood pressure and stomach problems. The parent said that it was not fun to stuff her daughter with such things. Yet this mother does the exact same thing when she later bought cannabis oil on the Internet. The mother reports that the child is now more focused, perkier, more frolicsome, smiles and laughs more. Also, she reports that the number of seizures have gone up and down, but gotten fewer after starting to use cannabis oil. However, this seems suspicious because of three reasons: (1) THC is not a stimulant, (2) it looks like this very well could merely be regression to the mean; the mother tried it when the chronic condition was at its worse, and it spontaneously regressed to the average experience over time and (3) the mother admits that they also made changes to the epilepsy medication, which could be an important factor in the alleged changes. The alleged changes might be due to the cannabis oil product containing something else (see below about contamination).
The second testimonial is not even for a child, but for an adult. Her epilepsy was difficult to treat and did not seem to respond to several different medications. She also reports a number of side-effects and decided to start taking cannabis oil after a major seizure. Afterwards, she testifies that she now feels more in control during seizures and a general improvement in her condition. However, she also points out that she continues taking mainstream prescription medication against epilepsy, which opens up for regression to the mean like in the previous testimonial. The person tried cannabis oil when she was at her worst and her condition regressed to the mean afterwards, the cannabis oil being merely a confounder.
What does the science says about cannabis oil for epilepsy?
Performing a search in the Pub Med database with the query cannabis oil epilepsy gives two papers. The first paper is a paper detailing Israeli experience with treating children with treatment resistant epilepsy with medical cannabis oil. Most children experienced a reduction in seizures, but there was no control group and no randomization. In other words, it was not even a clinical trial. The second paper is a review paper on the potential benefits and risks with cannabidiol oil.
So what about cannabidiol oil more specifically? Perhaps smoking total cannabis might not have any robust scientific evidence for epilepsy treatment, what about this component? Searching Pub Med with a second query, namely cannabidiol epilepsy gives 92 hits, but specifying clinical trial in the left-hand menu eliminates all of them besides 3. These are all from the mid-70s or early 80s.
Examining all of the 92 papers reveal only one study on humans that had sufficient sample size to be considered. Devinsky et al. (2016), an open-label interventional trial, enrolled a little over 200 children with treatment resistant epilepsy and then measured the response. They researchers found that children had a 36.5% median reduction in motor seizures after 12 weeks. However, all of these children were also taking mainstream epilepsy medication and there was no control group. Thus, they cannot eliminate effects of the epilepsy medication or regression to the mean. They conclude that “[r]andomised controlled trials are warranted to characterise the safety profile and true efficacy of this compound.”
To sum up, there are no robust randomized controlled trials currently published on cannabis or cannabidiol oil for epilepsy in children. Even if cannabidiol did turn out to work against seizures, it would be licensed as a pill like other pharmaceuticals containing any substance found in the cannabis plant. At no point does it validate the safety and efficacy of smoking cannabis joints against seizures or even cannabidiol oils prepared by other people than pharmaceutical experts or their robots (as there might not be pure enough or have a consistent dosage of the active substance).
What is the problem with ordering supplements online?
The products you buy on the Internet (or even in some grocery stores) can contain illegal or even dangerous levels of heavy metals or pesticides. It might not even contain the substance that you are buying. It can even contain other, undisclosed, prescription drugs, such as antidepressants, sedatives and so on. This can be deadly for some people, and for others it can increase the risk that you as a customer thinks it works when it does not. A chilling and through-provoking documentary about the U. S. supplements industry is PBS Frontline: Supplements and Safety.
So even if there was solid evidence that cannabis oil was a good treatment for epilepsy, it still would be dangerous to order it online.
Do not buy supplements on the Internet and do not feed cannabis oil to children for epilepsy. There are currently no methodologically rigorous randomized controlled trials that show efficacy or safety, but scientists are working on finding out if it really works.
Don’t take medical advice from testimonials in newspapers.