In the past decade, there has been a steadily growing interest in autism spectrum disorders and medical cannabis treatments. The latest research is beginning to confirm what individuals with autism and their families have been increasingly reporting anecdotally about treating with medicinal cannabis, that cannabinoid medicines have great potential to moderate a number of autism-related symptoms and behavioural traits.
Autism Spectrum Disorder or ASD is a neurodevelopmental disorder that can cause complex social, emotional, behavioural and language challenges. It is classified as a spectrum disorder as there are seemingly endless ways it can present in different individuals.
Commonly encountered signs of ASD include social or communication difficulties, which can range from avoiding eye contact or engaging in groups, to diverse degrees of verbal abilities. Some individuals are entirely non-verbal, while for others language may be fluent, perhaps with a different cadence or tone.
Many people who are neurodiverse, another term many of those with autism resonate with, have a hard time comprehending non-verbal cues such as facial expression, body language and tone of voice. The range of symptoms, skills and impairments is vast in Autism Spectrum Disorder and can stretch beyond social and behavioural parameters.
In approximately 20% of autism cases, there are certain genetic disorders that occur concurrently, including but not limited to Fragile X syndrome, tuberous sclerosis complex. Additionally some 30-50% experience some kind of epilepsy. Each of these are rare in the wider population, yet it is clear ASD predisposes individuals to genetic polymorphisms that can further affect neurological processes and quality of life.
Other repetitive somatic behaviours are characteristic of autism spectrum disorder and can include flailing arms, rocking the body around and preoccupation with specific items or topics. Unfortunately in some cases these repetitive behaviours can include self-harm, such as hitting themselves or banging their head or body against furniture.
For those families and people with autism where behaviours or comorbid conditions result in harm to the individual, their carers or the environment, medication is essential in managing some of the symptoms, disruptive behaviours and to improve quality of life.
Medications for autism spectrum disorder are often a hodge-podge of anti-anxiety, antipsychotic and anti-epileptic drugs, and there are no medications specifically formulated for autism conditions. Many find alterations in diet and routine alongside medications to have the most positive benefits. Yet, Autism Spectrum Disorder presentations often evolve over time, especially during adolescence, making it difficult to successfully manage with current pharmaceutical medications which can often incur numerous medical, behavioural and nutritional side effects.
Given the breadth of autism disorder symptoms, many have wondered whether medical cannabis may be useful for autistic people with symptoms similar to other conditions, such as anxiety and epilepsy, that can be successfully managed with medical cannabis treatments.
Individuals with autism disorder often experience symptoms where there is evidence for the use of medicinal cannabis in other circumstances.
Anxiety and sleep disturbances are common in autism disorder, both of which can further contribute to behavioural and social challenges. There is strong evidence that medical cannabis can be helpful in reducing anxiety and anxious behaviours, as well as improve sleep.
In terms of ASD, medical cannabis formulations with high CBD and low THC are most commonly used. Although one study from Chile utilised a 1:1 ratio of CBD:THC in the majority of participants, which recorded 66% of children showing significant improvements in at least one core autism symptom.
A great deal of the research surrounding medical cannabis and Autism Spectrum Disorder is coming out of Israel. Recent research of 188 ASD patients showed after 6 months 155 were still continuing cannabis treatments, while only 60% responded to the final symptom questionnaire, some interesting data was still gathered.
Significant improvements were reported in 30% of individuals and another 53% showed moderate improvement. Quality of life scores markedly improved for many, with meaningful increases regarding concentration, positive mood and ability to dress or shower independently. 34% were also able to decrease some of their other pharmaceutical medications.
A smaller trial assessing medical cannabis for autism documented that 47% of caregivers reported improvements in anxious behaviours and as many as 71% with positive changes to sleep. This research only included 54 children nonetheless data showed CBD oil to have a 74% overall improvement in symptoms associated with ASD.
In one final piece of preliminary research worth mentioning, parents of children with ASD and associated severe behavioural problems reported behavioural outbursts were improved or very much improved in 61% of children.
Medical cannabis treatments do still sometimes come with side effects. Across all the studies with autism spectrum disorder participants side effects were observed in 5-25% of patients, most commonly restlessness, sleepiness and digestive or appetite changes. But generally speaking, less than 5% have withdrawn from medical cannabis studies due to unwanted side effects.
Understanding exactly how medical cannabis benefits autism symptoms, related pathology, as well as its efficacy and long-term safety is still in the early stages of research. Luckily there are some trailblazing families and researchers going the extra mile to investigate how medical cannabis may benefit autism manifestations.
Abigail Dar is a true warrior mum for medical cannabis and ASD. By the age of 16, Abigail’s son, Yuval who was on numerous antipsychotic medications for his severe behavioural problems associated with autism spectrum disorder, developed epilepsy. Adding antiepileptic drugs to his already extensive pharmaceutical treatments.
Yuval was prone to aggressive physical outbursts that made family life beyond a challenge. Having tried endless possible treatment combinations, the family decided to wean him off his antipsychotic medications under medical supervision. In Yuval’s case, the severity of some of his behaviours lessened, however he was still having violent outbursts and self-injurious actions one or twice per week.
After some difficulty in gaining access, Yuval was prescribed medical cannabis by a psychiatrist in his home country of Israel. The changes in him were profound. Yuval who is non-verbal, became calmer -even smiling with more regularity- much to the joy of his parents. But the change with the greatest impact was in his behavioural outbursts, which disappeared for 18 months while being treated with medical cannabis. Only returning when he was taken off the treatment for a reset period.
Nowadays, Yuval is in his mid-20s and Abigail continues to be an outspoken advocate for medical cannabis accessibility for people with autism, bolstering and contributing to research and data collection on families experiences with medical cannabis and autism.
Another mother whose heartfelt journey has touched the lives of many is Meiko Hester-Perez, who has been a tremendous advocate for medical cannabis treating autism symptoms in the USA since 2009. Her 10-year-old son Joey who was diagnosed with severe autism was given 6 months to live, due to his appetite and digestive problems that left him weighing a mere 20kg.
Having tried nearly every conventional and holistic option available Meiko decided to try medical cannabis treatment, which extended his life and provided a higher quality of living, reducing his self-harming and improving his wasting syndrome.
Unfortunately, Meiko’s son Joey passed away at the age of 19 after complications with an additional muscular disorder. Meiko remains advocating for safe and effective medical cannabis treatments, continuing her son’s legacy by contributing to the growth of the industry and helping other families through her work and story.
These mothers, along with many others such as those from MAMMA’s (Mothers Advocating Medical Marijuana for Autism) in the US, had exhausted pharmaceutical drug treatments and behavioural therapies and found improvements for their children and some sense of relief as a family when prescribed medical cannabis.
“… it does make everything more manageable. We are talking about our kids having less anxiety, restlessness and outbursts, a real game-changer for the quality of life of people with autism and their families and caregivers”
The government made an interim decision on 9 September this year to aim to bring low-dose CBD over-the-counter by mid 2021. Prime 7 described this as a potential “saving grace” for parents of children with autism.
Marianne’s 12 year old son Deakin, for example, suffers from a combination of Autism, ADHD, ODD, chronic anxiety and panic attacks. Before starting his medical cannabis treatments at CA Clinics, he was put on a mixture of groggy sleep medications, antidepressants, ADHD medications and anti-psychotics to no effect. Simple socialising terrified him, tantrums were recurrent and getting him to eat or take showers meant daily combat.
Marianne fought for three months with disapproving GPs before finally getting a referral to CA Clinics. Medicinal cannabis had immediate effects on Deakin with no reported side effects. He was smiling more and his progress astounded his therapist.
‘I have not seen him this happy in a long long time,’ Marianne said.
The Therapeutic Goods Administration’s (TGA) decision would mean people with some of Deakin’s medical conditions would have access to low-dose medicinal cannabis without the need for a prescription. While there are questions about how effective a low-dose CBD oil would be on certain symptoms and conditions, mothers like Marianne may have at least one option to not need to tackle hesitation from GPs for referrals. Something Marianne supports.
The endocannabinoid system may also provide insight into the presentation of autism with the innately produced cannabinoid, anandamide believed to be lower in persons with ASD. The endocannabinoid system offers potential treatment pathways, where modifying anandamide pathways may have positive implications for social interactions.
Although animal studies and clinical trials show promising results, there is currently insufficient data to support the widespread use of medical cannabis for autism disorder. In Australia, the option of treating autism symptoms and concurrent conditions with medical cannabis is determined by the GP or medical specialist. For further information on eligibility for medical cannabis treatments, book a free screening appointment with CA Clinics.
By Jessica Kindynis
Using a Telehealth model, our 15 minute screening appointments provide a quick and convenient way to assess the suitability of a patient’s condition for treatment prior to discussing options with their own doctor.