Cannabinoid Treatment of Autism Spectrum Disorder in Children and Adolescents
According to the Autism Society of America, no single cause has been identified for autism spectrum disorder (hereinafter alternatively “autism”) to date, but a growing body of research confirms that the disorder is characterized by several developmental disabilities that typically begin during early childhood that adversely affect the ability to interact with others appropriately including most especially severe deficits in communication (Autism overview, 2018). Furthermore, there are currently no pharmacological regimens available that can cure autism or even treat its symptoms with proven efficacy (Treatment of autism, 2018). Despite these challenges, studies have shown that early interventions that help children learn how to walk, talk and interact with others during the first 3 years can significant improve childhood development (Treatment of autism, 2018). In addition, some novel experiments using cannabinoids derived from medical marijuana have shown significant promise in treating autistic children to the point where some researchers have referred to these compounds as “miracle drugs” that can treat the disorder in unique ways that are not possible otherwise (Schwartz, 2017). This paper provides a brief overview of autism and the current conventional interventions that are used to treat the disorder, followed by a discussion concerning the use of cannabinoids to treat the condition in a population of 21 children and adolescents. Finally, a summary of the research and important findings concerning the use of cannabinoids to treat autism in children and adolescents and directions for future research are presented in the conclusion.
Review and Discussion
There have been increasing anecdotal and empirical observations from researchers around the world concerning the potential efficacy of using various cannabinoids to treat autism (Schwartz, 2017). In some cases, however, medical marijuana remains illegal in the jurisdictions that are involved and this intervention is unavailable. Medical marijuana research has been formally legalized in several countries in recent years, though, including government-sponsored research projects using cannabinoids to treat autism in Israel, the Netherlands and Canada (Schwartz, 2017).
In the United States, the state of Minnesota’s Department of Health recently included autism to the list of approved conditions qualifying for treatment using medical cannabis products (Medical cannabis now used to treat autism, sleep apnea in Minnesota, 2017). In contrast to the regulatory framework that is in place in the three aforementioned countries, though, the formal process required to obtain approval for testing the efficacy of cannabinoid compounds on autistic patients in the United States is more complex and time-consuming (Schwartz, 2017). For example, the Minnesota Department of Health was required to conduct public forums that were intended to solicit public feedback concerning the most appropriate conditions that should qualify for medical cannabis treatment. During the hearing process, the Minnesota Department of Health received sufficient scientific and anecdotal evidence concerning the benefits of medical cannabis for treating autism to warrant additional research (Medical cannabis now used to treat autism, sleep apnea in Minnesota, 2017).
These types of research initiatives have increased in importance and relevance in recent years because autism is among the most rapidly growing developmental disorders in the United States today, affecting approximately 1 out of every 68 children based on studies by the Centers for Disease Control and Prevention (Schwartz, 2017), an increase from 1 in 166 in 2000 as shown in Figure 1 below.
Although this increased prevalence rate may be attributable, at least in part, to heightened awareness of the disorder among primary care clinicians, the current prevalence rate clearly indicates that the problem is severe and growing worse and therefore warrants additional research to identify potentially efficacious interventions. These efforts are especially important because, as noted above, the symptoms of autism are highly debilitating in many cases, causing serious communication and social skill deficits together with various obsessive-compulsive behaviors that are difficult to control (Schwartz, 2017).
Given the paucity of treatments for autism, there is clearly a need for further research to identify evidence-based interventions for this disorder. A candidate in this regard that holds significant promise for treating autism in young children and adolescents is the use of various commercially available cannabinoid compounds such as Ruby Red THC. While the randomized clinical trials that are needed to provide the scientific...
In addition, researchers have demonstrated that cannabinoids can block the release of neuron-generated norepinephrines which provide regulation of both heart rate and blood pressure (Lawrence, 2010).In addition, Lawrence (2010, p. 37) reports that, “Cannabinoids, particularly those taken from external sources, have complex actions in the brain, causing a wide range of effects on memory, cognition, spatial perception, and coordination.”
Here again, although additional research in this area is needed for more conclusive evidence, the studies to date indicate that one of the most frequently occurring modulatory receptors (i.e., those receptors that do not directly result in neuron firing excitation or inhibition) in the human brain are the cannabinoid receptors (Lawrence, 2010). The suspected pathways that are implicated in the brain receptors may play a role in mitigating the symptoms of autism in young sufferers. In this regard, Lawrence (2010, p. 38) adds that, “When neurons are firing, it seems the receiving cells may produce the endocannabinoids in response to overstimulation. The endocannabinoids then diffuse back to the nerve terminals where the excitatory (or perhaps inhibitory) signal was originally sent.” In those cases where the
When the endocannabinoids bind to the CB1 receptors (these are G-protein that are coupled receptors) in the human brain, the production of secondary messenger cyclic adenosine monophosphate is inhibited in the nerve terminal in ways that are comparable to the function of epinephrine at alpha-2 receptors (Lawrence, 2010). Researchers speculate that the overarching purpose of these processes is to restore stasis when the brain is overactive. For instance, Lawrence (2010, p. 38) concludes that when endocannabinoids bind to the CB1 receptors, ‘this will affect the movement of ions in and out of the nerve terminal, resulting in less release of neurotransmitter [because] the neurons probably produce the endocannabinoids only when there is too much activity, trying to restore a balance to brain activity.”
The results of cannabinoid treatment of 21 patients ranging in age from 4 to 18 years showed overall positive results; however, one 6-year-old male patient experienced a negative reaction to the original dosing regimen of THCA Double OG with Purple Urkle Terpenes 25mg per ml 7.5 mg to be dosed three times a day; THC Blood Diamond, with Purple Urkle Terpenes with Week 1- 2mg per dose three to four times per day during week one. This young patient was also allowed to receive up to 4mg for the dose before bed. Subsequent adjustments to dosing THC were based on the patient’s sensitivity to Blood Diamond THC with terpenes during week two. Empirical reports from the mother of the negative reaction included the following observations:
Huge spike in behaviors both aggressive and SIB, meltdowns, tantrums as well as some new.
His eczema is flaring also and he broke out in a rash on his torso last night.
This seems like [a] die off from my previous experience.
By contrast, other young patients experienced significant improvements in autistic symptoms as evinced by the following representative clinical observations and notes set forth at Appendix A. Selected updates/progress notes highlighting especially significant improvements are set forth in
Conclusion
The research showed that autism spectrum disorder is a complex developmental disorder that typically emerges during early childhood and for which no known cure is available. As a result, the interventions that are currently used for autism are targeted at controlling symptoms only rather than effecting a cure for the disorder. Unfortunately, there remains a dearth of interventions with proven efficacy in treating the symptoms of autism, and many young people and their families continue to suffer from the debilitating effects of this mysterious disorder. One avenue of study that may provide these patients with the efficacious treatments they need is the use of cannabinoids in age- and weight-specific dosages. In the final analysis, the brief clinical notes outlined above in Table 1 and shown at Appendix A suggest that cannabinoids hold significant promise for the treatment of the symptoms of autism spectrum disorder in young children and adolescents.
