Earlier this month, Michigan’s Medical Marijuana Program (called MI Medical Marihuana* Program or MMMP) Review Panel recommended the approval of eleven additional conditions for the MMMP. One of those conditions approved is autism. Many advocates attended the public forum with the Review Panel; some included parents of children whose behaviors or medical concerns tied to their autism diagnosis included seizures, chronic nausea, extreme aggression and behavioral issues.
Autism Spectrum Disorder (ASD), according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) is an assorted, but connected, group of neurological conditions characterized by “persistent deficits in social communication and social interaction across multiple contexts”.
Autism and cannabis have been studied by researchers in Israel, but most other information sources are anecdotal, rather than empirical. It is easier to study medical cannabis in other countries where it is fully legal. According to the Israeli Society of Children and Adults with Autism, 1 in 100 births are diagnosed with autism. In April 2018, the Centers for Disease Control and Prevention (CDC) provided new prevalence data for the United States and found that 1 in 59 children have been diagnosed with ASD. The Autism Society has published that about 1 percent of the population in the world has ASD.
With these numbers, looking for solutions to families and patients to mitigate the symptoms is a high stakes endeavor. It has been suggested to use cannabidiol (CBD) which is a cannabinoid from the plant Cannabis but does not produce the more widely associated “high” that an individual usually gets from smoking the dried plant or flowers. That “high” is due to a different cannabinoid, the most famous one, called tetrahydrocannabinol (THC). In one study done in Israel, parents of children with ASD were instructed on how to administer oral drops of CBD oil for the course of 2 months. Many of the challenging behavioral symptoms associated with ASD improved, including: a nearly 68% change in self-injury and rage attacks, hyperactivity improvement in 70% of cases, disruptions in sleep patterns improved in 71%, anxiety and mood improved in 47%, and social communication skills improved in nearly 88% of patients evaluated. The study outcomes were observed and recorded based on parental observation and reporting and was not a clinical trial so there is still a lot yet to investigate and validate.
Another study, believed to be the first clinical trial to evaluate the effects of medical marijuana on ASD is currently underway in Israel and aims to assess the safety, tolerability, and efficacy of cannabinoids mix for behavioral problems in children and youth with ASD. It is a Phase 2 double blind, randomized, placebo controlled trial (NCT02956226) with patients receiving a 20:1 cannabis extract mix (CBD:THC extract, a placebo, or pure CBD and THC in a 20:1 ratio mix. The study has an estimated enrollment of 150 participants and is estimated to be completed a year from now.
With more states in the US, and countries across the globe, looking to expand their medical cannabis access (or all uses of cannabis) there may be more opportunities to develop and execute empirical studies like the clinical trial being done in Israel. There may also be more opportunities to collaborate on research, which is more common in other fields of medicine and science. The ultimate goal being to increased ability to provide solutions for patients and families with loved ones diagnosed with ASD.
*Of note, Michigan spells marijuana with an “h” instead of a “j”; this is done to avoid putting forward an act of the MI Legislature to change the spelling since historical law in MI spelled marijuana with an “h” (marihuana). Both spellings are acceptable in the mainstream but the form using “j” has become more common.