Is there research on the use of cannabis products with children with autism?
Gregory Barnes, M.D., Ph.D., is the permanent director of the University of Louisville Autism Center and the Spafford Ackerly Chair for Child and Adolescent Psychiatry. He also has served as a reviewer for the Autism Speaks special grant program for preclinical translational research and the Autism Speaks translational postdoctoral fellowship grant program.
Q: Is there research on the use of cannabis products with children with autism?
Cannabis products have been receiving a lot of attention since medical and recreational marijuana use has been legislated around the U.S. Media reports about parents seeing improvements in their children with autism are encouraging. Yet there is still a lot we don’t know about these products.
Typically, the types of products touted are one of two kinds. First, there are THC-containing products, which are the kind that have a “high” effect and are only legal in certain states for medical usage in adults. The presence of high THC may be harmful to the developing brain and is known to increase risk for psychosis in children. The second type, CBD products, do not produce a high and are usually available over-the-counter.
There have been rigorous studies of THC and CBD use in general and for certain conditions. But autism does not have that evidence. There are no published results of scientifically rigorous randomized controlled studies about these products and autism for either adults or children. We don’t know if these products are effective in autism, or what autism symptoms they might treat. We also have no idea if they are safe in the short-term or long-term for children with autism.
In general, American Academy of Pediatrics (AAP) guidelines for complementary health approaches (like cannabis) say providers should monitor their patients’ use of any unproven complementary health practice but discourage treatments that are clearly risky.
In February, the AAP published an ethics discussion about using cannabis for children with autism with severe self-harm behaviors. The authors suggest that individuals with autism or their caregivers work together with providers to make decisions about therapies. This process can open up discussions about safety for each individual, what laws might apply, and risks of non-standard preparations. Providers should be thoroughly knowledgeable about the use of these products to engage in these discussions.
THC or CBD in cannabis products might have adverse effects on your child’s other health conditions or overall health. Sometimes, the balance of risk and benefit may weigh in favor of trying a relatively safe but unproven method.
So, are these products safe? Studies found CBD products are generally safe for adults and have shown some benefits for anxiety, pain and some seizure disorders. But none of the studies included children or adolescents. We know that regular use of THC-dominant cannabis in adolescents increases their risk for long-term developmental changes, addiction and chronic psychosis disorder. In children, some purified cannabis medications may irritate the liver. We learn more about these products as we monitor exposures in children during carefully conducted clinical trials.
Autism Speaks held a consensus conference in 2018 to encourage discussion about the state of the research on cannabis and autism. Our working group expects to make our consensus available later this year. Until then, we encourage you to discuss cannabis products with your child’s health provider before trying them.