A jar of cannabis inside a Good Meds medical cannabis center in Lakewood, Colo. (Matthew Staver/For the Washington Post)

??Across the country, thousands of children use medical marijuana for a range of ailments including intractable epilepsy, pain, anxiety and symptoms of multiple sclerosis. As the number of pediatric medical users grows, so do issues that confront parents, patients, doctors and policymakers. There are no federal laws specifically covering children’s use of medical marijuana, and state laws on the subject are a complex and sometimes contradictory patchwork.

Twenty-nine states and the District have made medical marijuana of all kinds legal. Among those state is Maryland, which has not yet set up a system for distribution.

Another 15 states, including Virginia, allow people to use cannabis containing high levels of CBD and low levels of the psychoactive component THC. In large part, these laws have come in response to pressure from parents of children with severe epilepsy and other illnesses that may be treated with CBD. However, none of these states has a distribution system with licensed dispensaries. As a result, parents are left to find cannabis through other sources, either buying it in another state and bringing it home or buying it from a dealer — both of which are illegal under federal law.

(Florida has CBD-only dispensaries, and it will be expanding to full medical marijuana as the result of an amendment to the state constitution that was approved by voters in November.)

Some states require that parents get permission from two doctors before their children can receive the drug rather than the single practitioner required for adults. Many states limit pediatric use to high-CBD doses. Advocates say that this limits options for children who may find relief with higher levels of THC. They also note that states rarely limit children’s access to medicines that can have powerful psychoactive side effects, such as opioids and stimulants.

At the same time, many doctors are unwilling to prescribe medical marijuana to children. “They tend to be very suspicious of it,” says Beth Collins, senior director of government affairs for Americans for Safe Access, an advocacy group for wider access to medical cannabis. Moreover, she says, many hospitals are worried about legal liability, and discourage their practitioners from helping pediatric patients get marijuana.

“Parents who want to try this for their kids have more options than they did five years ago,” she says. “But there are still a lot of hoops to jump through, a lot of hurdles to get over.”

— David Kohn