Anecdotal information from friends, family and neighbors has more people interested in trying medical cannabis for autism spectrum disorder (ASD) than ever before.
ASD is a neurodevelopmental disorder that causes alterations in social interaction and the patient’s surroundings. But it can also cause verbal and non-verbal communication issues, as well as restricted and typically repetitive behavior.
As more autistic people and their families experiment with medical cannabis as a treatment, they hope that the cannabinoids will alleviate the traits and problems associated with the diagnosis.
But what does science say? Is medical cannabis safe and effective for those on the autism spectrum?
How can medical cannabis help autism patients?
In severe ASD instances, it’s common for children and adolescents to display unstable and aggressive behavior. This can include and is not limited to self-harm, resulting in significant struggles to keep patients under control. Neuroleptic drugs or benzodiazepines are commonly used to solve these behavioral issues.
The endocannabinoid system (ECS) plays a role in controlling the processes ADS impacts. Since phytocannabinoids (plant-extracted cannabinoids) influence this system, it’s possible that these compounds can help treat severe ASD symptoms.
Mariano Garcia de Palau, an advisor on treatments with cannabinoids and a member of the Spanish Observatory for Medicinal Cannabis, explained the efficacy of cannabinoids for ASD treatment to Fundación CANNA, a non-profit initiative responsible for carrying out studies and conducting research on cannabis and its active compounds.
Palau claims that some studies show that receptors in the central nervous system have functional alterations in the cerebral regions involved in ASD. For example, the hippocampus and basal ganglia.
Some studies show that THC influences CB2 receptors. Since studies also imply that the CB2 receptor plays a role in ASD or could be a decisive factor, it’s possible that THC administration could be an effective treatment.
Palau also highlighted CBD as a potential intervention in ASD. This cannabinoid produces a “conduct normalizing” effect without signs of sedation. The patients stay alert and find it easy to do so. But often, their behavior stabilizes. However, an assessment of the severity of the patient’s condition is crucial.
He explains that some patients treated with medical cannabis acquire skills they’d either lost or never had. For example, a patient might find they can get dressed without assistance, listen to music and pay attention to their surroundings while walking and more. They become less likely to reject physical contact and might even offer a hug, sometimes for the first time in years.
Some patients’ facial expressions improve. They can also gain the ability to hold eye contact.
Palau explains that while many children with ASD seem unhappy and suffering. But after starting cannabinoid treatment, their situations can improve. Some might smile or laugh, and while these changes might seem insignificant, to the families, these are major breakthroughs that can inspire hope and reveal a chance for treatment that might not have been a possibility before.
Both CBD and THC can be useful for treating cases of ASD. But a professional must analyze the most effective ratio of THC to CBD to use and assess the need to change proportions to achieve desirable changes in the patient. This requires close monitoring for the potential appearance of side effects, including displaying psychoactive effects from the THC.
Have any cannabis-derived drugs been approved for autism treatment?
At this point, the U.S. Food and Drug Administration has approved just one cannabis-derived drug called Epidiolex. This drug contains a liquid cannabis extract of purified CBD and decreases seizures in Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) patients. These are severe types of epilepsy that can co-occur with ADS, as well as patients with tuberous sclerosis complex.
Although Epidiolex hasn’t been approved for treating ADS, clinical studies show that it reduces seizure frequency.
During one study, researchers conducted two randomized, double-blind, placebo-controlled trials in patients aged 2 to 55 years to determine the effectiveness of Epidiolex. The subjects experienced significant reductions in total seizure frequency when given Epidiolex versus the placebo.
Another study tested the effectiveness of Epidiolex to treat seizures of DS patients. This was conducted in a single randomized, double-blind, placebo-controlled trial in 120 patients aged 2 to 18 years. The results showed that DS patients taking Epidiolex had 26 percent fewer seizures than those given a placebo.
Is there a reason for concern?
As interest in using CBD spreads throughout the autism community, the chances of self-medicating with cannabis rise. While anecdotal reports of improvements in anxiety, restlessness and depression have increased experimentation with medical cannabis for ASD patients, more studies must be done to ensure these patients appropriate clinical guidance on cannabinoid use.
Even though the FDA has loosened its regulatory demands to study CBD, human research is still challenging. The DEA still has cannabis listed as a Schedule I drug, and until it’s moved to a Schedule II compound, research on how cannabinoids can be used to treat ASD and other conditions will remain limited.