Data from the Center for Disease Control and Prevention (CDC) indicates that about 1 in every 100 persons globally suffers from autism. This translates to about 75 million people globally. In the last few years, people with autism and their families have increasingly turned to medical cannabis treatment to manage their symptoms with the hope of effective treatment. Though scientists are still in the initial stages of rigorous research on the safety and effectiveness of cannabis for autism and other such conditions, anecdotal evidence abounds that indicates it holds great promise.
We will look into medical cannabis treatment for autism and weigh in on properties supporting this form of treatment as well as the research that supports its use. Let’s dive right in.
Autism Treatment for Adults
A few clinical trials have been carried out to investigate the safety and efficacy of medical cannabis treatment for various conditions. Cannabis research has been conducted to determine the safety and efficacy of cannabis use in adults. The question of whether adults living with autism can also benefit from this herb is far less discussed. Whether an adult living with autism is high functioning or dependent, research is finding that medical cannabis treatment holds great potential for both its treatment and management.
Children with autism grow up to be adults with autism and though they might have learned some coping skills, a good number still suffer symptoms. Aggression also tends to linger in some beyond the years of childhood and teenage. While some high-performing autistic adults tend to excel in arts and sciences, their social and emotional connections might still suffer.
Autism, also called Autism Spectrum Disorder, usually refers to a number of complex disorders which affect brain development. The term “spectrum” refers to its tendency to affect different people in varying degrees. However, the symptoms of autism can be broadly classified into three distinct clusters.
Symptoms of Autism
ASD is a spectrum disorder. This means that ASD patients will present with symptoms that have different levels of severity. These symptoms usually fall into the following categories:
- Communication difficulties
- Difficulties in social interaction
- Repetitive and sometimes even self-injurious behaviors
While AD patients might have intellectual difficulty starting in childhood, others are characterized as “high-performing” and may excel in math, art, and music. It is also of note that a good number of children with autism improve especially with early intervention. According To the Centre for Disease Prevention (CDC), the prevalence of autism has increased 10 fold in the last 40 years with boys being up to 5 times more likely than girls to be diagnosed.
Risk factors for autism spectrum disorders
Though the exact cause of autism spectrum disorders is unknown, research has shown that rare gene changes or mutations may act as catalysts. Some risk factors for autism spectrum disorder include the following:
- Age of either one or both parents at the time of conception
- Maternal illness in the pregnancy
- Birthing difficulties such as the baby’s brain being deprived of oxygen
Notably, none of these factors cause autism independently but may increase the risk in conjunction with genetic factors. Folic-rich foods alongside prenatal vitamins have also been shown to decrease autism chances.
How Cannabis is Used For Treating Autism
Cannabis research supporting cannabinoid treatment for ASD is chiefly based on its effect on the Endocannabinoid system (ECS). The ECS is a dynamic system in the body that maintains homeostasis or a state of physiological balance in the body. The ECS regulates vital functions that include the following:
- Pain perception (chronic pain)
- Hormone function
- GI function
The ECS is made up of endocannabinoids and receptors. When any of these vital functions are out of balance, the ECS is stimulated and restores a state of balance. It manages the interactions between the organ systems in the body and helps maintain a balance.
Autism is characterized by core functions being askew which may include neurotransmitter balance, inflammation, and immune modulation. Actually, a major contributor to genetic ASD is “Endocannabinoid System receptor mutations” which lead to ECS deficiency.
Whole plant extract from cannabis contains over 500 different bioactive molecules. Out of these, there are about 100 unique phytocannabinoids, including the popular tetrahydrocannabinol (THC) and cannabidiol (CBD). These phytocannabinoids act in a similar way to the body’s endogenous phytocannabinoids. It is no surprise that cannabis is a wonder plant that uniquely restores balance in the human body.
The prolific phytocannabinoids found in cannabis may supplement what the ECS of those with ASD might be lacking which explains why medical cannabis treatment in autism has profound benefits.
The effects of cannabis on autism
Preliminary cancer research has shown that cannabis oil may help to relieve core symptoms of ASD as well as other related symptoms.
They include the following:
- Minimizing or completely ending extreme Autism behaviors (before, during, or after puberty).
- Reduces anxiety disorder symptoms
- Reduce social anxiety disorder symptoms
- Relieve chronic pain
- Relieve inflammation
- Relieve behavioral symptoms
- Improve autism-related social impairment
- Improve speech impairment
- Reduce psychotic symptoms
The cause of autism is a combination of both genetic and environmental factors that lead to pervasive imbalances predominantly in the brain, gut, and immune systems. The ECS is involved in the modulation of these systems.
Cannabis has the ability to activate the Endocannabinoid System, which in turn balances the three major organs associated with ASD. Theoretically speaking, phytocannabinoids in cannabis oil may produce a similar effect, but clinical trials are required to confirm this. The binding action of these phytocannabinoids to the CB1 and CB2 receptors found in the body’s endocannabinoid system may lead to positive effects on autism.
Beneficial effects of phytocannabinoids
- Immune modulating
- Neurotransmitter balancing/neuroprotection
- Anti-inflammatory to the gut and brain
- The anxiolytic properties of cannabis aid in easing the stress caused by overstimulation which may trigger social anxiety disorders. This also prevents the incidence of self-injurious or repetitive behavior.
- It has been suggested that it could also help synthesize sensory experiences making them more tolerable and pleasurable
- Helps reduce the need for antipsychotics, antidepressants, and stimulants further improving adult autistic management.
- Cannabis may help in the regulation of synapse signaling problems experienced by some autistics, especially anandamide signalling.
- Blocking CB1 receptors can help to treat seizures, anxiety, memory issues, and other related symptoms
- Improves the quality of life of autistic patients
Cannabis treatment in autism refers to the use of cannabis compounds as the active treatment to relieve symptoms of autism. While the safety and efficacy of this form of treatment are still under investigation, preliminary evidence suggests that autistic patients may achieve significant improvement of symptoms and improved quality of life.
What exactly is cannabis?
Cannabis is a genus of flowering plants that belongs to the Cannabaceae family and includes 3 species: Cannabis indica, cannabis Sativa, and ruderalis. Marijuana specifically refers to the parts of this plant which contain high amounts of THC (delta-9-tetrahydrocannabinol). Though the use of medical cannabis treatment to resolve autism spectrum disorders is only just catching on, the use of medicinal cannabis dates back thousands of years in cultures all around the world. Today, cannabis is commonly used in the treatment of an array of conditions including cancer, arthritis, seizures, HIV/AIDS, glaucoma, and more.
A lot of controversy surrounds the use of medical cannabis due to the mind-altering effects of some strains that are high in a component called THC. The definition of medical cannabis according to the National Institute on drug abuse is “using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions.”
The 100 or so unique cannabinoids found in cannabis bind to the CB1 and CB2 receptors of the endocannabinoid system. CB1 receptors are commonly found in both the central and peripheral neurons, as opposed to CB2 receptors which are only expressed in peripheral tissues, which predominate the immune system.
THC and CBD are the 2 cannabinoids found in cannabis that are of particular clinical importance. Medically, THC is used to typically relieve pain, insomnia, nausea, and poor appetite. As THC happens to be a partial agonist of both the CB1 and CB2 receptors, it is responsible for producing the “typical marijuana high feeling” that is associated with the consumption of recreational marijuana.
CBD is generally less controversial than THC as it does not produce either mind-altering or euphoric effects like THC. This is because it has a markedly low affinity for CB1/CB2, as it acts as an antagonist. The receptor systems it affects in the body are TRPV1, GPR55, PPAR as well as its agonism on the serotonin (5HT1A) receptor in high concentrations which helps with anxiety, pain perception, sleep, and nausea. CBD also likely has a partial dopamine receptor agonist, which may help to relieve psychotic symptoms.
The role of the cannabinoid receptor system in the body is very complex and includes maintenance of homeostasis, regulation of cell function, motor coordination (basal ganglia), stress response, brain reward system, memory function (hippocampus), modulation of pain, appetite, and reduction of inflammation.
One of the causes of autism spectrum disorder has been pointed out to be an imbalance in the GABA (glutamate and gamma-aminobutyric) and glutamate system. The effect of CBD on endocannabinoids such as anandamide which can cause the inhibition of the release of GABA and other neurotransmitters makes it effective in the treatment of some autism cases.
Autism Treatment for Children
If you’ve had your ear to the ground, no doubt you’ve come across the anecdotal miraculous effects of marijuana on children. The cases of Cash Hyde, Charlotte Figi and Alfie Dingley in particular have hit international headlines on several occasions. Indeed, due to these cases, pharmaceutical cannabis has been approved for the treatment of treatment-resistant epilepsy in children.
Increasingly, parents of children who have severe autism have turned to medical cannabis after getting frustrated by the lack of options. Anecdotal evidence and preliminary cannabis research have suggested the safety and efficacy of this form of treatment for autistic children as some have shown improved asd symptoms.
While using medical cannabis for children with autism, it is important to note that the goal here is not to get the children “high” but to use a holistic method for the management of autism symptoms and even treatment of the condition itself. Some of the outward symptoms of childhood autism spectrum disorder may include aggressive rages, self-injury, and even property destruction during blind rage incidences.
Cannabis treatment has been known to both improve internal balance as well as optimize the function of these symptoms leading to improve asd patient’s quality of life.
How do you know the right amount of marijuana to give your child?
Unfortunately, there is not a “one size fits all” solution as to how much medical cannabis treatment is suitable to manage and treat a particular child’s condition. This is both because of the broad spectrum of autism as well as the different terpenes found in cannabis that typically have different effects on different people. As well as the following, set out the dosage, the best way to find the right dosage for your child is by individualized microdosing while experimenting to determine the “sweet spot” titration. This will enable you to know what works best for your child and in which quantities.
Medical Cannabis and Autism
Medical marijuana aka medical cannabis, commonly refers to products derived from the cannabis plant which have been recommended for medical use by a doctor. These may include resins, dried flowers, tinctures, or cannabis oils. Consumption of medical cannabis may be direct or infused into candies, lozenges, or an array of foods.
Medical cannabis treatment for autism spectrum disorder is still in the infancy stage of testing but generally classified as ‘Schedule 1’ drugs which mean no “accepted” medical use and high abuse potential. Many states that have legalized marijuana have dispensaries that sell products whose active ingredients are verified as well as checking for contaminants. In most of these states, one is required to register for a special identity card when they are using medical marijuana for autism and any other condition.
As marijuana becomes more widely used to treat related symptoms of ASD patients such as calming aggression and prevention of seizures, more clinicians are taking an interest, which may lead to more prescribed marijuana for autism.
What are the Treatment Options for Autism?
Because of the wide spectrum of autism, treatment of it also tends to be very varied. Methods that are least controversial are behavioral and usually include social-skills training as well as parent-led therapy sessions carried out under a therapist’s supervision. Some early behavioral intervention methods that are backed by evidence-driven studies have been published.
Early behavioral interventions for autism
- The Lovaas Model based on Applied Behavior Analysis (ABA)
- The Early Start Denver Model
- Pivotal Response Therapy
- Verbal Behavior Therapy
Older children also benefit from extensive structured methods and therapeutic activities such as social development, motor skills development, daily living, and communication coaching.
Drugs approved for autism are astonishingly few with limited clinical trials to establish efficacy and dosing.
Drugs that have been approved for autism treatment
- Risperidone (brand name Risperdal)
- Aripiprazole (brand name Abilify)
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Stimulant medications like Adderall or Ritalin
- Naltrexone, an FDA-approved medication to treat alcohol and opioid addictions; has shown success in some patients by alleviating disabling repetitive and self-injurious behaviors.
It is of note that no medications exist that address the core symptoms of autism. Existing medications are mainly used to relieve symptoms such as anxiety, mood symptoms, behavioral problems, decreased appetite, and aggressive behavior. These overall do not tend to be very effective and many times cause a number of side effects, which limits their use.
Other commonly used methods used to improve ASD symptoms are natural herbs such as ashwagandha.
Also known as Indian ginseng or winter cherry, ashwagandha has been shown by multiple studies to have great anxiety-relieving properties in patients suffering from autism spectrum disorder. It also has great effects on mood and stress, which also positively affect autism symptoms. It does just about everything when it comes to improving health.
Other properties of ashwagandha that might benefit autism are:
- Promotion of sleep and enhancement of neurocognition resulting in deep and restful sleep.
- Enhancement of spatial memory, short-term memory, spatial memory, cognition, reaction time, as well as protection of the hippocampus (area of the brain critical to the formulation of short-term memory)
- Reduction of cortisol levels (Excessive levels of cortisol from chronic stress and disruption of the endocrine system due to man-made chemicals and products can interfere with sleep and neurological development and contribute to issues such as short-term memory impairment, anxiety, OCD, and depression.)
Can Cannabis be Used for Autism Anxiety?
Anxiety is a key hallmark of autism. This is often caused by hypersensitivity to stimuli and underdeveloped social as well as emotional capabilities. Anxiety can affect both children and adults with autism and causes great distress that further aggravates other symptoms. Though anxiety presents itself differently to different people, in autism it generally presents in different ways.
Types of Anxiety in Autism
- Generalised anxiety disorder
- Fear of social situations (social anxiety)
- Fear of crowds and open spaces (agoraphobia)
- Other specific fears (phobias)
As we will see later, the cannabinoids found in cannabis can have a soothing effect on anxiety and cause relaxation, therefore, aiding in the coping of autistic subjects.
What Research has Been Carried out on the Effects of Cannabis on Autism?
Cannabis autism research is still new though some studies do exist. A study conducted in 2018 at the Shaare Zedek Medical Center studied the safety and efficacy of whole-plant cannabis extract (20:1 CBD: THC ratio) on 60 children with autism that had severe behavioral problems. Out of these, 61% of the parents reported that behavioral symptoms in their children had either “much improved” or “very much improved,” 39% had improved anxiety levels, and in 47% of the population, communication had improved. In addition, 24% of children under study were able to cease medication, 30% adjusted to either lower dosages or fewer medications.
Adversely, 8% had to increase their medication while some experienced side effects such as hypervigilance which lead to sleeping difficulty (14%), loss of appetite (9%), irritability (9%), and restlessness (9%).
Another Israeli marijuana autism study was published in 2019 that had been carried out on 53 children given the same 20:1 ratio CBD to THC dose for an average period of 66 days. This survey found that there was a significant improvement in self-injury as well as rage attacks (67.6%), sleep problems (71.4%), hyperactivity symptoms (68.4%), and anxiety (47.1%). Improvement in ASD comorbidities overall was calculated at 74%. Common side effects experienced by the subjects included reduced appetite and somnolence.
On the other hand, a study carried out in 2018 by Stanford University found that anandamide levels (the bliss hormone) were relatively lower in children with autism. The research suggested that THC produced intense effects similar to anandamide, which is promising for autism.
Yet another study published in 2019 by the Journal of Nature found that cannabis can relieve autistic symptoms such as restlessness, seizures, fits of rage, restlessness, cognitive impairment, and speech impairment.
How Safe and Effective is Cannabis for Autism Spectrum Disorder?
The safety and efficacy of cannabis have been controversial subjects. As far as the safety of CBD goes, several studies have made the same confirmation; CBD is generally safe and well-tolerated by most people. It also causes minimal adverse effects. On the other hand, long-term use of THC has been associated with cognitive impairment especially in children.
Is it Ethical to Treat Children with Medical Cannabis?
The ethics surrounding cannabis utilization in children has been shrouded by controversy. The stand of most medical bodies was that there was insufficient evidence to support the safety and efficacy of cannabis. However, with the approval of Epidiolex (a cannabis-based drug that is used to treat childhood seizures) by the FDA, there has been less skepticism among the medical fraternity and inreturn, many in the medical fraternity have become less skeptical about medical cannabis use in children.
Ethically, cannabis strains that contain higher amounts of CBD than THC are often preferred for the treatment of autism in children. In cases where a THC high strain is more effective, careful administration should be observed while avoiding long-term use.
Cannabis Strains That are Best for the Treatment of Autism
A number of cannabis strains have been used to treat the symptoms of autism and its symptoms. However, some of the best strains both in offering relief and treatment are:
1. Green Crack
This is a Sativa dominant hybrid strain that has Skunk #1 genetics. Its great wake-and-bake qualities are effective in combating autism stress as well as aggression. This strain is also good for increasing concentration for people with autism.
Afghani is an Indica strain that has strong sedative properties. Its effects of blissful relaxation help in the relief of autistic aggression, depression, and anxiety.
3. LA Confidential
This is a high THC strain of up to 25 % and should thus be consumed moderately. As it is an Indica strain, it sets off total body relaxation as well as reduces social anxiety.
4. Sour Diesel
Sour Diesel is a Sativa dominant strain that is high in THC. It is known for its cerebral as well as energizing effects. This strain is used in medical cannabis for relieving symptoms related to stress, anxiety, depression, and pain. Sour diesel may additionally help autism patients in socializing.
5. Blue Dream
This strain is a Sativa dominant hybrid that originates from California. Labeled the “aspirin form of cannabis” it is helpful in managing autism pain and discomforts.
6. Charlotte’s Web
This is a strain that is high in CBD and lowers in THC. It has been considered the go-to strain in the treatment of childhood seizures, which makes it very suitable for autism. Due to its low THC content of below 0.3% THC, it is suitable for both children and adults with autism. It also has potent anxiety-relieving properties as well as strong calming properties. This makes it optimum for the alleviation of autism-related aggression.
Quite clearly, the biological endocannabinoid system plays a major role in the being as well as the proper balance between the body’s systems. In many autistic cases, the endocannabinoid system does not function correctly resulting in an imbalance in the central nervous system, immune, digestive or even the endocrine system. This often leads to the symptoms associated with autism.
The cannabinoids found in cannabis stimulate vital receptors found in the endocannabinoid system. This helps to regulate various processes like immune system function, body temperature, mood, heart activity, brain activity, metabolism, and others. Theoretically speaking, it is through such interactions that medical cannabis helps to improve symptoms in autism spectrum disorders.
Though research on the safety and efficacy of cannabis for the treatment of autism especially in children is still being carried out, the positive effects gleaned from anecdotal accounts may be reason enough for families grappling with the ill effects of autism to have hope. Before considering treatment initiation with cannabis, it is important to first consult with a qualified medical cannabis professional.
Properly combining the positive effects of cannabis with other behavioral and dietary forms of autism treatment could improve the quality of life of both autistic children as well as adults with autism. It is generally agreed that dosing cannabis for autism especially in children should be carried out in a cautious, systematic manner as inappropriate composition or misuse could lead to aggravated symptoms.
Here are some Safe and Tested CBD products for Autism:
- National Institute on Drug Abuse. Marijuana as a medicine. Drug Facts. Accessed May 21, 2021. https://www.drugsandalcohol.ie/18946/1/marijuanamedicinedrugfacts_july2019_.pdf
- Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol, and delta9-tetrahydrocannabivarin. Br J Pharmacol. 2008;153(2):199-215.
- Freeman TP, Hindocha C, Green SF, Bloomfield MAP. Medicinal use of cannabis-based products and cannabinoids. BMJ. 2019;365:1141.
- Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol. 2008;153(2):199-215.
- Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011;163(7):1411-1422.
- Hrdlicka M, Komarek V, Propper L, et al. Not EEG abnormalities but epilepsy is associated with autistic regression and mental functioning in childhood autism. Eur Child Adolesc Psychiatry. 2004;13:209-213.
- Agarwal R, Burke SL, Maddux M. Current state of evidence of cannabis utilization for treatment of autism spectrum disorders. BMC Psychiatry. 2019;19:328.
- Scherma M, Masia P, Satta V, et al. Brain activity of anandamide: a rewarding bliss? Acta Pharmacol Sin. 2019;40(3):309-323.
- Fišar Z. Cannabinoids and monoamine neurotransmission with a focus on monoamine oxidase. Prog Neuropsychopharmacol Biol Psychiatry. 2012;38(1):68-77.
- Centers for Disease Control and Prevention. Data & statistics on autism spectrum disorder. Accessed May 21, 2021. https://www.cdc.gov/ncbddd/autism/data.html
- Chaste P, Leboyer M. Autism risk factors: genes, environment, and gene-environment interactions. Dialogues Clin Neurosci. 2012;14(3):281-92.
- Durkin MS, Maenner MJ, Newschaffer CJ, et al. Advanced parental age and the risk of autism spectrum disorder. Am J Epidemiol. 2008;168(11):1268-1276.
- Buglione N. Marijuana madness. Autism Support Network. Accessed May 21, 2021. http://www.autismsupportnetwork.com/news/autism-treatment-marijuana-madness-8763721
- Karhson DS, Krasinska KM, Dallaire JA, et al. Plasma anandamide concentrations are lower in children with autism spectrum disorder. Mol Autism. 2018;9:18.
- Justinova Z, Solinas M, Tanda G, et al. The endogenous cannabinoid anandamide and its synthetic analog R(+)-methanandamide are intravenously self-administered by squirrel monkeys. J Neurosci. 2005 ;25(23) :5645-5650.
- Siniscalco D, Sapone A, Giordano C, et al. Cannabinoid receptor type 2, but not type 1, is up-regulated in peripheral blood mononuclear cells of children affected by autistic disorders. J Autism Dev Disord. 2013;43:2686-2695.
- Wei D, Lee D, Cox CD, et al. Endocannabinoid signaling mediates oxytocin-driven social reward. Proc Natl Acad Sci U S A. 2015;112(45):14084-14089.
- Russo EB. Taming THC: potential cannabis synergy and phytocannabinoid‐terpenoid entourage effects. Br J Pharmacol. 2011;163(7):1344-1364.
- Devinsky O, Patel AD, Cross JH, et al. Effect of cannabidiol on drop seizures in the Lennox-Gastaut syndrome. N Engl J Med. 2018;378(20):1888-1897.
- Thiele EA, Marsh ED, French JA, et al. Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomized, double-blind, placebo-controlled phase 3 trial. Lancet. 2018;391(10125):1085-1096.
- Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med. 2017;376(21):2011-2020.
- US Food and Drug Administration. FDA approves new indications for drugs containing an active ingredient derived from cannabis to treat seizures in rare genetic diseases. July 31, 2020. https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare#:~:text=Today%2C%20the%20U.S.%20Food%20and,year%20of%20age%20and%20older
- Meier MH, Caspi A, Ambler A, et al. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci U S A. 2012;109(40):E2657-64.