Can autism be treated with medical cannabis?
Michelle Walker was at her wit’s end when she moved from Texas to Colorado last year. Her 9-year-old son, Vincent, has autism, and as a last ditch effort, her family made the trek so that they could get their hands on medicinal cannabis for him, since it’s legal in Colorado and not in Texas.
Walker, director of state chapters for the non-profit organization Mothers Advocating Medical Marijuana for Autism, says Vincent had a very limited vocabulary and would attack she and her husband every day prior to taking cannabis. “We were prisoners of our home,” she says. “We were scared he’d run away or drown.”
Incredibly, Vincent experienced an almost instantaneous transformation, says Walker. “I remember the first time I gave it [medical cannabis] to him,” she says. “He was diagnosed as being non-verbal, and he was able to speak.” Since then, Walker says he doesn’t attack them anymore and he’s learned how to read.
As it turns out, the Walker’s story is not unusual. “Most of my patients turn to medical cannabis after having exhausted both pharmaceutical options and other forms of treatment, including specialized diets and behavioral therapy,” says Dr. Junella Chin, an integrative cannabis physician based in New York state..
Currently, there are two types of drugs that are FDA-approved for autism: risperidone, an anti-psychotic, and aripiprazole, an antidepressant. According to a study published in the journal Pharmacy and Therapeutics, both types of drugs are only approved to treat irritability associated with autism.
The Challenge in Treating Autism
Irritability is only small slice of the pie. “Autism is a type of developmental disorder characterized by mild to severely impaired function of brain,” explains Jagdish Khubchandani, Ph.D., associate professor of community health in the department of nutrition and health science at Ball State University.
Hallmarks of autism include impaired communication and social interactions, as well as repetitive behaviors. It can’t be diagnosed by a simple blood test, though. Diagnosis is based solely on presented symptoms, says David Berger, M.D., a board-certified pediatrician and assistant professor at University of South Florida’s College of Nursing.
And a diagnosis doesn’t always happen as early as it should. Per research from the National Institute of Mental Health, less than one in five kids are diagnosed by age two, which is a problem, because the earlier autism is diagnosed, the better chances children have to make developmental and learning progress as they get older.
The thing is, doctors aren’t 100 percent sure what causes autism and how it manifests itself, which adds to the difficulty in devising a treatment plan that works. “This has contributed to lack of effective treatment and management strategies,” says Khubchandani.
What Research (and Doctors) Say
Research on medical cannabis as an autism treatment is in the very early stages, and right now evidence is mostly anecdotal. There’s currently an ongoing U.S. clinical trial looking at how a mix of CBD and THC (in a 20:1 ratio of CBD to THC) affects the behavior of children with autism — but it won’t be completed until 2019.
“There is some discussion about marijuana use in alleviating symptoms that may occur with autism,” says Khubchandani. “However we need to be cautious.” Khubchandani says the long-term risks and level of benefits of CBD are not yet documented. “CBD has the potential to act on brain receptors for neurotransmitter that act in reducing anxiety, depression, and seizures,” he says. “However, all evidence to date is of low quality.” Dr. Chin cautions that cannabis can affect the developing brains of children and teens. “Adding cannabis to the functioning (normal) endocannabinoid system may actually interfere with developing brains,” she says.
There is a 2017 study published in the Proceedings of the National Academy of Sciences of the United States of America which shows that CBD reduced the number of seizures and improved social interaction of mice that have Dravet syndrome (a childhood epilepsy disorder) and exhibit symptoms similar to those with autism. But the key word here is “mice” — this hasn’t been scientifically proven yet in humans.
Because of the frustration that many parents, like Mchelle Walker, experience when managing their children’s autism, there is still a lot of excitement around cannabis even though the research isn’t there yet. “Medical cannabis can be a game changer for kids who do not respond to traditional medications,” says Dr. Chin. A 2010 article published in O’Shaugnessy’s, the Journal of Cannabis in Clinical Practice, highlights anecdotal evidence from parents who said medical cannabis is more effective at alleviating behavioral symptoms than pharmaceutical drugs.
Where Does the Law Stand?
As far as access to cannabis for autism goes, every state is different, says Berger. There are currently 29 states where medical marijuana is legal (plus Washington, D.C.), and each state has different rules on what it can be used for, says Berger.
In Florida, where Berger practices, there are nine approved conditions for medicinal cannabis use, including cancer, epilepsy, and PTSD. It can also be prescribed to those with other debilitating conditions that have similar symptoms to the nine approved conditions, as long as your doctor thinks the benefits outweigh the risks. Because autism often shares symptoms, such as seizures and anxiety, with the nine approved conditions, it’s possible for doctors to prescribe it if they feel comfortable doing so, says Berger.
The same flexibility isn’t the case quite yet in Colorado, where the Walkers live. They are able to get Vincent medical cannabis because he also has epilepsy, which is one of the approved conditions for use in that state. A bill was introduced this March that would add autism and acute pain to the list.
Using Cannabis for Autism
In places where parents can get medical cannabis for their children, treatment is pretty individualized. Berger says that for those who need round-the-clock treatment, a starting point might be a dose of five mg of CBD (for smaller children) or 10 mg of CBD (for older kids or adults) three times a day, with an increase in dosage gradually depending on the response. “You have to give yourself enough time to assess how it’s working,” he says. There are now even nasal spray and patch forms of medical cannabis available in Florida.
Above all, Michelle Walker wants other parents to know that this treatment is not about getting kids high. CBD, which is the cannabis compound primarily used in the treatment of autism, is non-psychoactive. “The goal is for these children to live their best lives and to be the best they can be,” she says.
Story by Christina Heiser