Through 2019 the hype around cannabidiol (CBD) hit an all-time high, and an increasing volume of anecdotal reports have been part of the media frenzy about the compound.
While CBD oil is sold over the counter (and isn’t regulated by the Food and Drug Administration), it’s usually sold for use by people over age 18.
For parents, this new wave of using cannabis for autism is another junction on the road to exploring solutions to help their child improve the quality of their life
What is Autism?
Autism spectrum disorder (ASD) is a complicated lifelong neurodevelopmental disability that typically begins in childhood and encompasses a broad range (spectrum) of symptoms and disabilities.
It is usually associated with altered behavioral characteristics including fits of rage, restricted or repetitive motor movements, and signs of slower cognitive development.
Current data suggests that 25% of children diagnosed with treatment-resistant epilepsy also have ASD.
The inherent variability in the severity of autism symptoms can often pose problems in defining an approach to help manage the condition. As a result, there is no explicitly defined single treatment of autism.
Additionally, as autism is a lifelong disability, the primary focus is on improving the quality of life for both the individual and often the parent(s), consisting of various therapies teaching life and behavioural skills to improve independence.
While most of are all familiar with cannabis as an illegal substance in most jurisdictions, the use of CBD oil is relatively new so you might have a clarifying question on your mind:
What is CBD?
CBD is a non-intoxicating cannabinoid (cannabis compound), found in the buds of the cannabis and hemp plants.
Street cannabis usually contains very little if any CBD, due to growers breeding strains to maximise yields of tetrahydrocannabinol (THC) found in the cannabis buds – the compound in cannabis which gets you high.
Cannabis as a whole contains over 100 cannabinoids, of which 2 are CBD and THC. However, the rest are thought to have their own (non-intoxicating) benefits and effects which are under investigation via research studies.
CBD is more commonly found in hemp – a species of the cannabis genus which naturally has the opposite ratios of THC : CBD than street weed. As a result, the hemp plant contains high levels of CBD while only containing trace elements of THC.
While it’s still early, the benefits of CBD oil are currently the focus of multiple clinical studies. Medicinally, only one product manufactured by GW pharmaceuticals based on a highly concentrated pharmaceutical-grade CBD isolate solution is licensed in the UK called Epidyolex (also known as Epidiolex in the USA) for the treatment of severe forms of treatment-resistant epilepsy in children.
So now you have a snapshot about CBD, you might be wondering how does it work within our body?
The answer lies in the Endocannabinoid System (or ECS for short):
CBD like all other cannabinoids interacts with a system built solely for communicating with cannabinoids (impressive right?) This is called the Endocannabinoid System, otherwise known as the ECS.
The ECS is a network of receptors which manage the absorption of cannabis-based compounds across the body, affecting a wide range of physiological and neurological functions.
This system responds directly to cannabinoids from both cannabis (phytocannabinoids) and those produced naturally by our bodies called endocannabinoids.
The ECS has been regarded as one of the most critical systems involved in human health.
Due to the nature of autism, children diagnosed with ASD are at increased odds to develop social anxiety disorder (SAD), and multiple studies have reported the ECS assists with the regulation of emotional responses, contextual behaviour changes and social interactions.
Early research has reported the ECS can play a role in regulating some of the processes which are disrupted in a child with ASD. Naturally leading to an increased interest about the mechanics of the endocannabinoid system from the carers of those with ASD.
CBD Oil and ASD
Changes in cannabinoid receptors present in autistic children have been outlined in recent research, suggesting potential deficiencies in the production and signalling of endocannabinoids.
This hypothesis was demonstrated via another preliminary study. While this is not strong enough to be conclusive on its own, researchers believe this is a strongly suggestive indicator that there may be reduced levels of the endocannabinoid anandamide in children with ASD.
Other research has reported that CBD can enhance anandamide signalling, boosting the ECS into function.
Additionally, children with ASD are more likely to suffer from anxiety, hyperactivity and issues with sleep. Given research suggests CBD is anxiolytic, helping with sleep, and antipsychotic, it is no wonder CBD is of high interest for individuals with ASD.
Still, it’s important to talk about a significant caveat: children who have been prescribed medicinal CBD oil for autism are often using a full-spectrum CBD oil which contains a more substantial amount of THC than would be legal in an oil available as a supplement.
These type of higher THC cannabis oil is a medicine, often not derived from hemp and is only available on private prescription in the UK.
In the states, the use of medical marijuana along (including cannabis oil with THC) is widely available in states where medicinal cannabis is legal.
CBD Oil for Autism Studies
Anecdotal evidence of the successful use of cannabis and CBD to manage ASD symptoms is accumulating, but a formal and large backlog of clinical studies is currently absent.
Nonetheless, a small number of studies have examined the use of medical marijuana and CBD oil for autism:
A study in 2019 based out of Israel observed the use of CBD oil in the treatment of ASD, with an average duration of 66 days across a sample of 53 children.
The study reported that after several weeks of 1:20 CBD oil use, over 70% had improved sleep and hyperactivity reduced in over 68% of the children.
Another recent study, also in Israel, including Raphael Maechoum (the first scientist to isolate THC), reviewed the use of CBD and THC across a sample of 188 individuals with ASD.
Using primarily (94%+) cannabis oil, derived of 30% CBD and 1.5% THC (1:20 THC:CBD ratio), administered on average 79.5mg CBD (+/- 61.5mg) and 4mg THC (+/- 4mg) in individualized, titrating concentrations.
After one month of use, over 48% of the individuals outlined, they reported significant improvements in symptoms, and after six months of use, 30% mentioned they felt a significant overall improvement.
A 2019 observational study published in Frontiers in Neurology gave 18 participants CBD-enriched cannabis sativa extract (75 : 1 CBD/THC) for a period of up to 9 months.
Of which 15 people completed the study, and only one reported an absence of improvement in the symptoms of autism. With 9 participants reporting improvements in 30% in at least 1 symptom (mostly more) after completing the study.
There is a need for further clinical research to understand further how CBD affects the brain and interacts with ASD. The neurological basis for ASD is not yet understood either.
No doubt, the next few years will bring exciting results to the centre screen with the results of multiple studies in this space expected to close for review.
Nonetheless, some people will likely use CBD will they wait for results outside of anecdotal reports and if that’s you remember to talk to your doctor before using CBD.