A wealth of anecdotal evidence suggests medical cannabis can be an effective treatment for autism spectrum disorder (ASD).
But what about clinical evidence?
A new study published in the Journal of Autism and Developmental Disorders represents the first attempt to explore the feasibility of using Cannabidiol (CBD) enriched cannabis to treat children with autism.
Why CBD Oil to Treat Autism?
You might wonder why would researchers choose cannabis to treat Autism Spectrum Disorder?”
We know from the research that CBD can be used to effectively treat anxiety. CBD is one of the main cannabinoid compounds in cannabis. Unlike THC (tetrahydrocannabinol), the other main cannabinoid in cannabis, CBD is not psychoactive and has anti-anxiety properties. However, when it comes to cannabis or CBD, there are no published studies looking at the effect on ASD and its associated symptoms.
Despite the lack of clinical data, several lines of evidence led researchers to take a look at CBD-rich cannabis as a possible treatment of autism.
In June 2018, the U.S. Food and Drug Administration (FDA) approved Epidiolex–the first cannabis-derived, CBD-based pharmaceutical for the treatment of rare and severe forms of epilepsy. Interestingly, about 10-30% of people living with ASD also suffer from epilepsy and researchers think that the two diseases may share similar biological pathways.
There is also an intriguing link between the endocannabinoid system — the neurotransmitter and receptor system in our bodies that is stimulated by cannabis-based cannabinoids like CBD and THC — and autism. According to a 2018 study published in Molecular Autism, children with ASD have lower concentrations of certain endocannabinoids in their blood. Administering CBD has also been effective at reducing the autistic-like social deficits in animal models of epilepsy and ASD.
Lastly, a large proportion of children living with ASD also have socially disruptive behavioral problems such as tantrums, violence, and self-injury. Children with these severe symptoms are difficult to care for and often do not respond well to standard medical treatments. This has led caregivers to consider alternative therapies including medical cannabis.
Putting CBD-Rich Cannabis to the Test
The new study published in the Journal of Autism and Developmental Disorders evaluates the feasibility of using CBD-rich cannabis as a medical treatment of children with autism.
60 children participated in the study and all of the participants had previously been diagnosed with both ASD and severe behavior problems. The researchers used whole plant extracts from strains with a 20:1 CBD to THC ratio.
Researchers gave the participants 2-3 daily doses of cannabis oil starting at 1mg/kg body weight/day and increased the dose slowly over 2-4 weeks depending on the patient’s response. Patients who did not show an initial response were given cannabis oil with a higher THC concentration.
29 of the participants experienced adverse side effects from the cannabis treatment. The most common were sleep disturbances (experienced by 14% of the participants), restlessness (9%), and loss of appetite (9%).
Will CBD Be Used to Treat Autism?
This matter will require many more studies, but the results of this study appear to validate the anecdotal evidence that CBD oil can help treat the symptoms of those living with Autism.
Overall, the researchers found positive changes in behavioral symptoms, communication problems, and levels of anxiety. 61% of the children’s caregivers reporting “much improved” or “very much improved” symptoms.
The participants continued taking other medications during the study, including antipsychotics and mood stabilizers. However, many were able to take fewer medications, lower their dosages, or stop taking additional medications completely.
It’s important to note that while the majority of the children who participated in the study showed improved behavior, 16 did not finish the study due to non-response, worsening symptoms, and in one case a psychotic episode.
Cannabis and Autism: What’s Next?
The overall impact of this study is significant. Not only is it the first study to scientifically evaluate the effect of cannabis on ASD, but the results were largely positive.
The results were so promising that the researchers are planning a larger follow-up study with 100 participants. The follow-up study will further explore the potential of cannabis to treat children living with severe, ASD-related behavior problems.
The researchers are careful to conclude that, while they are optimistic about their results, more controlled, clinical trials with higher numbers of participants are needed before physicians can begin prescribing cannabis or CBD for the treatment of ASD.
Another important point to make is that cannabis extracts with higher concentrations of THC, the main psychoactive compound in cannabis that can cause anxiety, can potentially make behavioral symptoms worse. This is why the follow-up studies will continue to use CBD-rich cannabis as well as Cannabidivarin (CBDV), a cannabis-based cannabinoid that is similar to CBD.
Given the historic FDA approval of CBD for the treatment of severe epilepsy, it’s possible we could see the approval of cannabis oil or CBD for the treatment of autism in the next several years.