Cannabidiol (CBD) oil is quickly gaining traction as a possible treatment for certain seizure disorders, especially in children, but as a recent U.S. incident illustrates, not all CBD oil is created equal.
The case, which led to the hospitalization of an eight-year-old boy from Washington state in 2018, was recently published in the medical journal Clinical Toxicology.
The young patient had a seizure disorder. After consulting with a neurologist, his parents decided to start the boy on CBD oil to help control his seizures. Even though the family lived in Washington, where cannabis is legal, they ordered the CBD oil from an online vendor based in another legal-cannabis state, Colorado.
"They had started giving their child the CBD oil, and what they observed was a nine or ten day period of fairly good seizure control, from what they reported," Portland, Ore. emergency room physician Dr. Tony Rianprakaisang, who helped treat the boy, said in an interview with The Leaf News.
"And then all of a sudden he started have these episodes, he'd had something like more than 14 seizures in a 24-hour period, which was significantly more than normal."
On top of the unusual amount of seizures, the boy was agitated and his pupils were dilated, symptoms that didn't match his existing seizure condition. Doctors decided to remove the CBD oil from the equation while the boy was being treated in hospital, and his symptoms subsided after a few days.
The doctors sent a sample of the CBD oil off for laboratory testing, which determined the oil contained cannabidiol along with a synthetic cannabinoid known as AB-FUBINACA, which has been implicated in various overdose incidents including a 2018 mass overdose in New Haven, Conn. that sent more than 70 people to hospital.
Rianprakaisang said he and his colleagues can't conclusively say AB-FUBINACA caused the boy's unusual symptoms, but those symptoms were consistent with the drug's known effects.
He declined to name the specific brand of CBD oil that the boy's parents bought from Colorado, but plans to enter it into the U.S. Food and Drug Administration's MedWatch database.
Rianprakaisang hasn't heard of a case of contaminated CBD oil before, but they have occured in the U.S. In 2018, dozens of people fell ill in Utah after using CBD oils that reportedly contained synthetic cannabinoids.
"These things here are not regulated the same way that medications are regulated, by the FDA, and so supplements have in the past been contaminated with other substances that are not listed on the ingredients," said Rianprakaisang.
Ultimately, Rianprakaisang believes the story highlights the importance of government regulation.
"The important take-home message would be that we need stricter laws in place to regulate supplements, and regulate these things so that this sort of thing doesn't happen."
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