A 2021 systematic review of nine published studies on cannabinoids and autism found that cannabis may have promising effects in the treatment of symptoms related to autism spectrum disorder (ASD), and may be used as a therapeutic alternative in the relief of those symptoms. In the nine studies, it was possible to observe that cannabis products used were able to improve symptoms related to ASD, including self-mutilation and anger bouts, hyperactivity, sleep problems, anxiety, psychomotor agitation, irritability, aggressiveness, sensory sensitivity, cognition, attention, social interaction, language change, depression, and restlessness.
When considering ASD, there are currently no defined drugs or psychotherapeutic approaches capable of extensively improving the quality of life, social skills, and cognitive functioning of the most severe cases. While the currently available drugs may mitigate certain symptoms, the effectiveness is, reportedly, limited and may have undesirable side effects. To understand the difference of cannabinoid therapy in comparison to the available, conventional treatments it is helpful to first gain an understanding of the Endocannabinoid System (ECS) these plant cannabinoids are interacting with.
The ECS and ASD
The ECS is the largest neurotransmitter system in the body, involved in regulating nearly every physiological process. It is composed of two receptors called CB1 and CB2 receptors, endocannabinoids, and metabolizing enzymes. Two key endocannabinoids have been identified as Anandamide (AEA) and 2-arachidonoylglycerol (2-AG). These endocannabinoids are responsible for activating the CB1 and CB2 receptors that are found throughout our bodies and brains. Once endocannabinoids activate these receptors, physiological actions take place.
Research has shown that one thing individuals with ASD have in common is observed reduced levels of endocannabinoids, such as AEA, palmitoylethanolamide (PEA) and oleoethanolamine (OEA). A 2019 published study showed these reduced levels in plasma samples from 93 children with ASD.
When experiencing a deficiency of endocannabinoids, research suggests the benefit of naturally increasing levels with the modulating cannabis compound, cannabidiol (CBD) or mimicking actions of cannabinoids with the cannabis compound delta-9-tetrahydrocannabinol (THC).
CBD and THC for ASD
CBD may modulate different aspects related to cognition, socioemotional responses, susceptibility to seizures, nociception and neuronal plasticity, which are often altered in autism. A 2019 study involving adults living with autism reported that CBD can change the levels of the metabolites glutamate, glutamine and gamma-aminobutyric acid (GABA). These metabolites contribute to the regulation of excitatory and inhibitory neurotransmission, both in typical development and in ASD. A 2018 study, looking at CBD-enriched cannabis on 60 children showed behavioral outbreaks were improved in 61%, communication problems in 47%, anxiety in 39%, stress in 33% and disruptive behavior in 33% of the patients.
Research is slowly collecting on the benefits of THC for ASD as well. Pure THC in studies is uncommon due to the potential euphoric effects of THC at increased amounts, however it is suggested that CBD and THC may be useful in combination, given the ability of CBD to negate intoxicating effects of THC. A 2010 study utilizing Dronabinol (synthetic THC) showed significant improvements for a 6-year old boy, diagnosed with autism, in hyperactivity, lethargy, irritability, stereotypy and inappropriate speech at a 6 month follow-up. The boy was not taking any other medications during the six months. As well, a 2006 published study showed improvement for patients in the management of treatment-resistant self-injurious behavior, following Dronabinol treatment.
More recently, data that was prospectively collected as part of the treatment program of 188 ASD patients treated with medical cannabis between 2015 and 2017 was analyzed. The majority of patients were treated with cannabis oil containing 30% CBD and 1.5% THC. After 6 months of treatment, 30% reported a significant improvement in symptoms, 53.7% were moderate, 6.4% were slight, and 8.6% had no change in their condition. The study concluded that cannabis for autism appears to be well tolerated, safe, and effective for relieving symptoms associated with ASD.
Cannabis as a Therapeutic Alternative
We may see cannabis more widely used in the future as an important therapeutic alternative to relieve symptoms of autism, especially bouts of self-mutilation and anger, hyperactivity, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, and aggressiveness; as well as improve sensory sensitivity, cognition, attention, social interaction, language, perseverance, and depression. However, to be more widely used, it must also be more widely researched for its’ benefits, therefore accepted.
Next Steps
Getting started with cannabinoid therapy can be overwhelming, especially when considering a neurodevelopmental disorder as complex as ASD. Although findings conclude that cannabis is safe and may provide relief for associated symptoms, there is plenty of room for further clinical research to explore the full therapeutic potential of CBD and THC, as well as the ability of other cannabinoids to offer benefit.
If you are seeking data-driven answers to your questions about cannabinoid therapy and ASD, the RoC Care Team is here to assist. They care a lot about helping you to find success. Reach them by calling (719) 347-5400, emailing info@realmofcaring.org, or by scheduling an appointment.
