Is Medical Cannabis an Effective Treatment for Autism? A Recent US DHHS Recommendation Renews Hope for Much Needed Research

In today’s episode, we’re bringing you an entry from our Law Meets Science blog on the potential for medical cannabis to be used in the treatment of Autism Spectrum Disorders.

Read the full article.

About the author:
Sharon Salcedo, RN, BSN*

Transcript

Welcome to Womble Perspectives, where we explore a wide range of topics, from the latest legal updates to industry trends to the business of law. Our team of lawyers, professionals and occasional outside guests will take you through the most pressing issues facing businesses today and provide practical and actionable advice to help you navigate the ever changing legal landscape.

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In today’s episode, we’re bringing you an entry from our Law Meets Science blog on the potential for medical cannabis to be used in the treatment of Autism Spectrum Disorders. A link to the full episode can be found in the show notes.

Autism Spectrum Disorders are lifelong neurodevelopmental conditions that usually appear in infancy or early childhood, and for which no single cause has been identified. Core symptoms include restricted or repetitive behaviors, limited interests, and difficulty with language, learning, and social interactions. The incidence of Autism Spectrum Disorders is increasing dramatically. In 1992, the incidence was 1 in 10,000 kids. In 2020, the CDC estimated that 1 in 36 kids had ASD. Because there are no medical tests available, diagnosis is based on behavioral and developmental assessments.  

Autism is often accompanied by attention deficit hyperactivity, gastrointestinal, obsessive compulsive, seizure, sensory processing, and sleep disorders. Behavioral manifestations may include aggressiveness, rage, self-injury, and sensory impairments.

Treatment consists of behavioral interventions that yield varied results. Only two pharmaceutical medications have been approved by the FDA for use in Autism Spectrum Disorders, but they do not treat the core symptoms and are only intended for management of irritability and aggression. These two medications have many potential side effects, including metabolic disorders and tardive dyskinesia, a condition characterized by involuntary repetitive movements that can become permanent. Many other medications not intended for treatment of Autism Spectrum Disorders are used with varied results.

Research is ongoing for the treatment of the disorder with medical cannabis, defined as the use of cannabis sativa plant derivatives for medical purposes. The cannabis sativa plant contains compounds called cannabinoids, the two main ones being the non-psychoactive compound cannabidiol, or CBD, and the psychoactive compound delta-9-tetrahydrocannabinol, THC. CBD extracted from hemp, a different variety of the cannabis sativa plant, has 0.3 percent or less THC. 

Medical cannabis targets the endocannabinoid system, a unique cell signaling network composed of cannabinoids like the ones in the cannabis plant. The endocannabinoid system plays a critical role in regulating sleep, temperature, pain, immune function, inflammation, learning, memory, and emotions. Recent studies have revealed that the endocannabinoid system is dysfunctional in individuals with Autism Spectrum Disorders, creating interest in studying the use of medical cannabis for treatment.

Research has demonstrated that after treatment with medical cannabis, individuals with Autism Spectrum Disorders had reduced episodes of self-injury and rage, and improvements in hyperactivity, sleep, and anxiety. Adverse effects included mild somnolence and appetite changes. A 2021 study identified 65 potential cannabis-responsive biomarkers that trended toward normal physiological levels after cannabis treatment. The authors of the study proposed further research of metabolic profiles likely to respond to medical cannabis. Study conclusion challenges have included the varied level of disabilities among study subjects, lack of objective measuring tools, and the variety of products used, whether CBD-dominant or THC-dominant, or a combination of CBD and THC.

Though one particular CBD extract has been approved by the FDA for treatment of specific seizure disorders, the FDA has not approved any cannabis-derived products for treatment of Autism Spectrum Disorder. There are, however, reasons to be hopeful. 

It is currently legal in 15 states to prescribe medical cannabis for autism. Plus, on August 30, 2023, the US Department of Health and Human Services issued a recommendation to reschedule cannabis from a Schedule I controlled substance to a Schedule III controlled substance. The US Drug Enforcement Administration is reviewing the recommendation and has final authority over rescheduling cannabis. If the recommendation is adopted, cannabis would remain federally prohibited, but researchers would have greater flexibility in conducting studies of the drug and its effects on human health. While the recommendation does not call for descheduling cannabis completely, it is a move in the right direction.

Research on medical cannabis and Autism Spectrum Disorders is still in its early stages. Continued well-controlled clinical trials are needed to establish treatment guidelines and long-term safety of cannabinoid products.

Thank you for listening to Womble Perspectives. If you want to learn more about the topics discussed in this episode, please visit The Show Notes, where you can find links to related resources mentioned today. The Show Notes also have more information about our attorneys who provided today's insights, including ways to reach out to them.

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