**2. Therapeutic applications**

Many studies report the use of *Cannabis* to aid treatment of a diverse range of health conditions and symptoms. Although *Cannabis*' medical use dates back centuries with the first written records in China and India around 2900 BC and 900 BC, respectively, *Cannabis* was introduced to western medicine only in the nineteenth century [1, 2]. Today, potential indications for medical *Cannabis* include appetite stimulation, chronic pain, spasticity from multiple sclerosis or paraplegia, depression, anxiety, sleep problems, psychosis, glaucoma, Tourette's syndrome, epilepsy, dementia, cancer, post-traumatic stress disorder, and osteoarthritis [3]. Δ9 -Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most extensively studied cannabinoids for medical use. Individually, these cannabinoids have demonstrated therapeutic benefit and pharmaceutical grade products are available on the market today. However, CBD's ability to modulate THC's well-known intoxicating activity along with a growing body of evidence for an entourage effect among the many cannabinoids of the *Cannabis* plant may extend therapeutic benefit beyond the purified cannabinoid leading to greater interest in the use of *Cannabis* herbal extract preparations [4]. Such entourage properties may explain the varied therapeutic applications of *Cannabis* over the centuries.

Limited information is available on the therapeutic use of *Cannabis* in pediatric patients. *Cannabis* is usually considered when the clinical condition becomes intractable to other types of treatments [5]. This is seen, for example, in treatment of children with refractory epileptic encephalopathy, in particular Lennox-Gastaut syndrome and Dravet syndrome [6]. However, studies supporting medical *Cannabis* suffer from small sample sizes and lack of dose standardization with variations in dose size, formulation, and frequency of administration. These limitations make it difficult to extrapolate data to the larger pediatric population [7]. Furthermore, *Cannabis* extract use has predated the usual pharmacology and toxicology testing applied to other marketed drugs. With virtually no toxicity and efficacy data, doseplasma concentration-response data, and information on *Cannabis*-drug interactions, the prescribing caregiver is apprehensive to recommend a *Cannabis* extract dosage regimen to a pediatric patient. This inability to define age-appropriate dosage regimens has compromised the acceptability of medical *Cannabis* as a viable therapeutic for pediatric medical conditions.
