Cannabis and Autism: Can Weed Help Symptoms of Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a neurodevelopmental disorder classified by a spectrum of symptoms. For example, an autistic individual may struggle with sensory issues and executive functioning but have good communication skills or are good at reading social cues. But this isn’t the same for everyone diagnosed, as autistic people present their symptoms differently and all fall within different areas of the autism spectrum.

There is no cure for autism spectrum disorder, nor are there any approved medications for the treatment of autism. Treatment options for autism spectrum disorder can include a variety of therapies and accommodations. Abilify and Risperdal are two antipsychotics approved for treating some symptoms, such as irritability and aggression, and SSRIs may be prescribed for anxiety or depression.¹ However, there are no medications that treat the core characteristics of autism.

What Causes Autism?

There are several potential theories as to what may cause autism, but as of present, there is no single cause science has identified. However, the most significant contributing factor does seem to be genetics. 

According to research, the potential contributing factors to autism spectrum disorder include the following;

• Genetics. Over 100 different genes have been found to be related to the expression of autism.
• Environment and genetic interaction. If an individual is genetically predisposed to developing autism, certain environmental situations could trigger changes in gene expression.
• Brain connectivity differences.
• Immune system differences.

Signs & Symptoms of Autism

For an individual to meet the criteria for being diagnosed with Autism Spectrum Disorder, they must have “persistent deficits in each of three areas of social communication and interaction, plus at least two of four types of restricted, repetitive behaviors.”

The criteria for each domain of autism are as follows: 

Social Communication and Interaction. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history.

1. Deficits in social-emotional reciprocity, ranging from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests or emotions; to failure to initiate or respond to social interactions.
2. Deficits in nonverbal communicative behaviors used for social interaction, ranging from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships, ranging from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to the absence of interest in peers.

Restricted, Repetitive Behaviors. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text).

1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., lining up toys, echolalia, idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, rigid thinking patterns, eating the same food every day, etc.).
3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively perseverative interests).
4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Severity.

1. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).
2. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
3. These disturbances are not better explained by intellectual disability or global developmental delay.

The severity of an autism diagnosis can be broken down into three levels of support.

• Level 1 - requires support
• Level 2 - requires substantial support,
• Level 3 - requires very substantial support.

It is essential to note that these diagnostic criteria have not been updated in ten years, and much of the autism research has been primarily done on young males. Because of this, a significant portion of previous generations of girls went undiagnosed until their late 20s, 30s, or even 40s. 

Going undiagnosed can present a significant challenge for many women and lead to higher rates of concurrent diagnoses of depression, anxiety, and PTSD in adulthood. Not only can the symptoms of autism differ in their presentation in girls and women, but women are also socially conditioned at a younger age and learn to mask their symptoms early on. In a way, they can fly under the radar for a diagnosis.²

Individuals diagnosed with Autism Spectrum Disorder often have co-occurring diagnoses of ADHD, Anxiety, Bipolar Disorder, Depression, Epilepsy, Gastrointestinal disorders, or sleep disorders.³

How Cannabis May Help Alleviate Symptoms of Autism

Autism can not be cured or fixed. However, many individuals find that cannabis may alleviate certain symptoms of autism. Overall, the research on cannabis and autism is very unclear, and many patients find their specific cannabinoid dosage after some trial and error.

A 2018 study found that children diagnosed with autism spectrum disorder had lower levels of endogenous cannabinoid anandamide than neurotypical children.⁴ Another study in 2019 found that of 188 patients with Autism Spectrum Disorder who were utilizing a high CBD, low THC product, 95 patients reported experiencing moderate to significant improvement in their symptoms after one month. The most reported side effects were sleepiness and disliking the smell and taste of the cannabis oil.⁵

A small study of 15 children with autism spectrum disorder published in December of 2021 aimed to identify cannabis-responsive biomarkers in children with autism. A biomarker is “a defining characteristic that is measured as an indicator of normal biological processes, pathogenic processes, or responses to an exposure or intervention, including therapeutic interventions, which can be categorized by subtype such as diagnostic, monitoring, pharmacodynamic/response, and predictive.” The researchers of this 2021 study reported that patients with autism had improvements in emotional and behavioral regulation, behaviors such as aggression, attention, and restricted or repetitive behaviors after taking their respective doses and ratios of THC and CBD. The researchers also noted that the cannabis-responsive biomarkers also returned to levels seen in the typically developing group after medical cannabis treatment in the autism group.⁶

In 2019, researchers began a clinical trial to assess the effectiveness of Cannabidivarin (CBDV) compared to a placebo in children diagnosed with autism, specifically regarding irritability in autistic individuals ages 5 to 18. The researchers are still recruiting participants; you can find more information here. 

More research is needed to determine what cannabinoids may be best for treating certain symptoms that can be present in individuals with autism. 

Legality and Doctor’s Recommendation

To determine if autism is a qualifying condition in your state, you can head to our Laws & Regulations section for the medical cannabis rules for your state. In addition, many doctors may consider some of the symptoms of autism to fit the definition of anxiety if the patient does not already have a dual diagnosis, which is common in those diagnosed with autism spectrum disorder.

If you find that your state recognizes autism or comorbid conditions, such as anxiety and PTSD, as qualifying medical conditions. In that case, you can seek a doctor’s recommendation to register for your state’s medical marijuana program.

How NuggMD Can Help

NuggMD is the nation's leading medical marijuana technology platform, serving patients in over half of the United States and growing. We’ve connected over 1,300,000 patients with their new medical marijuana doctors face-to-face via our state-of-the-art telemedicine platform. 

We believe that every human being has the right to explore the benefits of medical cannabis and are fully committed to helping each patient explore all of their options in their journey to wellness. For further information on whether you qualify for medical cannabis, select your state.

Frequently Asked Questions About Cannabis & Autism

Can cannabis help with symptoms of autism?

Cannabis may help with core symptoms of autism, such as attention, repetitive/restricted behaviors, and aggression. Along with possibly helping alleviate symptoms of common comorbid disorders such as anxiety or PTSD.

What terpenes might help relieve symptoms of autism spectrum disorder?

While terpenes have been present in cannabis products used in some clinical trials, no terpenes have been singled out for having effectiveness toward symptoms of Autism Spectrum Disorder.

Is CBD or THC better for autism?

Depending on the individual's age, tolerance, and physiology, CBD or THC could relieve some symptoms that come with being autistic. Each person has a unique endocannabinoid system, so not every autistic person will have the same response.

References

1. Aishworiya, R., Valica, T., Hagerman, R. et al. An Update on Psychopharmacological Treatment of Autism Spectrum Disorder. Neurotherapeutics. 2022;19: 248–262. https://doi.org/10.1007/s13311-022-01183-1
2. Schuck RK, Flores RE, Fung LK. Brief Report: Sex/Gender Differences in Symptomology and Camouflaging in Adults with Autism Spectrum Disorder. J Autism Dev Disord. 2019;49(6):2597-2604. doi:10.1007/s10803-019-03998-y
3. Fusar-Poli, L., Brondino, N., Politi, P. et al. Missed diagnoses and misdiagnoses of adults with autism spectrum disorder. Eur Arch Psychiatry Clin Neurosci. 2022;272: 187–198. https://doi.org/10.1007/s00406-020-01189-w
4. Karhson DS, Krasinska KM, Dallaire JA, et al. Plasma anandamide concentrations are lower in children with autism spectrum disorder. Mol Autism. 2018;9:18. Published 2018 Mar 12. doi:10.1186/s13229-018-0203-y
5. Bar-Lev Schleider, L., Mechoulam, R., Saban, N., Meiri, G., & Novack, V. Real life Experience of Medical Cannabis Treatment in Autism: Analysis of Safety and Efficacy. Scientific Reports. 2019;9(1): 200. https://doi.org/10.1038/s41598-018-37570-y
6. Siani-Rose M, Cox S, Goldstein B, Abrams D, Taylor M, Kurek I. Cannabis-Responsive Biomarkers: A Pharmacometabolomics-Based Application to Evaluate the Impact of Medical Cannabis Treatment on Children with Autism Spectrum Disorder. Cannabis Cannabinoid Res. 2023;8(1):126-137. doi:10.1089/can.2021.0129

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.