“Medical marijuana” effective for children with epilepsy, approved worldwide

Between countries where science and ethics are advancing and countries where they can't even debate

The "last option" that stopped the seizures

Florida, USA. Seven-year-old Charlotte Figi was diagnosed with severe Dravet syndrome and suffered from hundreds of seizures a day. Dozens of anti-epileptic drugs were ineffective, and doctors said, “There’s nothing more we can do.” Her family’s last resort was a CBD (cannabidiol) preparation extracted from cannabis. When a doctor in Colorado administered CBD oil under the supervision of a doctor, Charlotte’s seizures dramatically decreased within a few weeks. She was eventually able to return to her daily life, and this episode was reported throughout the United States as “Charlotte’s Miracle,” which prompted a medical reevaluation of cannabis. Based on the accumulation of clinical data including this case, the US Food and Drug Administration (FDA) officially approved the CBD preparation “Epidiolex” for intractable epilepsy in 2018. Since then, the preparation has been prescribed by the National Health Service (NHS) in the UK, and CBD is establishing its position as **one of the standard options for epilepsy treatment**.

The scientific evidence has already been presented

The effectiveness of CBD preparations has been confirmed in multiple double-blind randomized controlled trials. A major clinical study published in 2017 reported that seizure frequency in refractory epilepsy patients administered Epidiolex was reduced by an average of 39%. In particular, clear improvements were observed in children with Dravet syndrome and Lennox-Gastaut syndrome, even in cases where conventional medications were ineffective. In addition, the WHO has stated that side effects are mostly mild, such as drowsiness and loss of appetite, and the risk of abuse and dependence is extremely low. In 2020, the United Nations Commission on Narcotic Drugs also adopted a resolution to remove CBD preparations from the international list of controlled substances, accelerating the trend toward global legalization.

However, it cannot be prescribed in Japan.

On the other hand, the situation is very different in Japan. Although the import and sale of CBD itself is legal, it is virtually impossible to prescribe it for “medical use” under the jurisdiction of the Ministry of Health, Labor and Welfare. To use CBD as a medicine, a long process of clinical trials, approval applications, and drug review is required in Japan, but to date Epidiolex remains an unapproved drug. Clinical trials in Japan are also extremely limited. Therefore, even if a child has a medical condition where CBD can be expected to reduce seizures, it cannot be prescribed through official medical channels in Japan. If a family decides to import it for themselves, there is even a risk of arrest for violating the Cannabis Control Act if traces of THC are detected at customs. There is no choice if you follow the law, and if you choose to do so, you will be charged with a crime. This is a situation in which the value of life is determined by the system, not by medical care.

Who is responsible for that “reasonable delay”?

Medical marijuana, especially the use of CBD for pediatric epilepsy, is not just a matter of “medicinal approval.” There is an “unupdated structure of Japanese society” between science and ethics, between the system and the field. Internationally, medical marijuana has shifted from an “exceptional option” to a “limited but scientifically valid option.” Many countries, including the UK, Germany, Israel, Australia, and Canada, have made efforts to build a bridge between the medical field and the legal system. What Japan needs now is not the legalization of marijuana, but a “medical system that can be discussed based on scientific facts.” Just one drop can stop a child’s seizures. We live in a society where the legal system pushes back that one drop.