CBD & THC alleviate behavioral and health problems associated with autism spectrum disorders.
Autism (Autism Spectrum Disorder, ASD) is a catch-all term for similar atypical behavioral traits such as restricted interests, repetitive behaviors, and difficulty interacting with others. It is actually somewhat more heterogeneous than we neurotypical people might imagine.
The term spectrum is used to describe the varying severity of autism - from high functioning at one end to nonverbal and severely mentally disabled at the other. However, this more linear definition of autism does not encompass the unique clusters of emotional, behavioral, and physical symptoms that many people with ASD experience.
The cannabis plant, which itself is complex in its composition, can not only improve many of the behavioral disorders associated with autism, but also alleviate some of the comorbid conditions that accompany it, such as inflammatory bowel disease, sleep disorders, and epilepsy.
WHAT IS AUTISM?
The term autism was originally used in the 1940s to describe children with behavioral characteristics that we now recognize as ASD.
Little is known about why ASD develops. Genetics may be a factor, as well as the age of the parents at the birth of the child. A possible link between exposure to heavy metals during pregnancy or through side effects of vaccinations could also play a role.
Whatever the cause, parents suddenly find themselves struggling to cope with a developing collection of behavioral and physical symptoms, often with little support or guidance from the health care system.
If your child is on the more severe end of the spectrum and exhibits self-injurious behavior or aggression toward themselves or others, doctors often prescribe a cocktail of prescription medications such as antipsychotics, antidepressants, or tranquilizers to prevent violent outbursts .
As understanding of ASD increases, clinicians are beginning to recognize that violent outbursts and self-injurious behaviors may themselves be manifestations of underlying or undiagnosed health conditions.
Comorbidities - the presence of multiple disorders in one person at the same time - are common in autism. Twenty percent of people with ASD also have epilepsy and other disorders, including gastrointestinal problems, anxiety, ADHD, sleep disorders, and eating problems.
Reducing sensory overload through the use of cannabis calms feelings of anxiety and allows for a more normal daily routine of life.
Some comorbidities are more obvious to observe than others. For a nonverbal child or adult in pain, a sudden violent outburst may simply be the way to express discomfort. Therefore, treating the underlying cause of pain can often lead to improvement in behavioral problems.
AUTISM & THE ENDOCANNABINOID SYSTEM
Scientists are beginning to suspect that an imbalance between excitatory glutamate and inhibitory GABA, both important neurotransmitters for neurodevelopment and general brain function, may explain many behavioral features of ASD as well as common comorbidities such as sleep disorders and anxiety.
Understanding the importance of the endocannabinoid system in the development of autism could lead to a more holistic therapeutic approach to the treatment of behavioral and health disorders.
In simple terms, the message to the sympathetic nervous system to return to a state of rest and relaxation just doesn't get through. A reduction in GABA tone has also been observed in many other diseases, including epilepsy, Alzheimer's, schizophrenia, depression, and musculoskeletal disorders.
As the body's main homeostatic regulator, the endocannabinoid system ensures that neuronal activity remains in balance by releasing endocannabinoids (anandamide and 2-AG) retrogradely, where they bind postsynaptically to CB1 cannabinoid receptors.
While research into understanding autism tends to take a more reductionist approach by focusing on specific autism traits, a broader imbalance in the endocannabinoid system could explain why autism is not just emotional and behavioral disorders, but also gastrointestinal problems, epilepsy, and sleep disorders.
It is well documented that endocannabinoid alterations contribute to the development of various psychiatric and neurological disorders. Therefore, it is plausible that dysregulation of the endocannabinoid system could also be a determining factor in the onset of autism.
GENE EXPRESSION STUDY
An Gene Expression Study on postmortem brains of patients with autism revealed that they all had decreased CB1 receptor expression, which would certainly impair the ability of the endocannabinoid system to maintain neurological homeostasis.
Other changes in the endocannabinoid system are evident in autistic children, although it is not clear whether this has a causative effect in ASD. In one Study, which compared CB2 cannabiniod receptor expression in autistic children to a healthy control group, those with ASD showed significant CB2 upregulation. It is possible that this increased CB2 expression is simply a compensatory effect of the endocannabinoid system modulating the increased inflammatory state common in autism, and that targeting CB2 receptors may help alleviate some of the ASD symptoms and comorbidities caused by immune system dysregulation.
Anandamide, named after the Sanskrit word for bliss, is also being studied as a pharmacological target to improve the impairment in social functioning associated with ASD. Using a mouse model of autism, scientists found that the Blocking the production of fatty acid amide hydrolase (FAAH), the enzyme that breaks down anandamide in the body, reversed the rodents' marked social impairment.
Scientists have also shown how oxytocin, the feel-good neuropeptide that is produced during hugs, can increase the social reward by controlling anandamide-mediated signals to CB1 receptors. This observation led the researchers to speculate that, at least in ASD mice, impaired oxytocin-driven anandamide activity may play a role in the development of socially impaired behavior.
Understanding the importance of the endocannabinoid system in the development of autism seems to be able to lead to a more holistic therapeutic approach to the treatment of the complex clusters of behavioral and health disorders of ASD patients.
CBD AS A TREATMENT FOR AUTISM - THE PROOF
Given CBD's excellent safety record and the extensive research on pediatric epilepsy, it's not surprising that the first clinical trials investigating whether cannabis provides some relief to children with ASD favored CBD-rich cannabis oils.
In recent years, 3 studies have been conducted in Israel in which approximately 2500 children and adults with ASD have received cannabinoid treatment from the national medical cannabis program.
In the first trial investigated whether CBD oil would help alleviate the four comorbidities commonly associated with ASD: Hyperactivity symptoms, sleep disorders, self-harm, and anxiety.
53 children received CBD-rich cannabis oil for an average of 66 days. About two-thirds of the subjects showed improvements in self-injury and tantrums, hyperactivity, and sleep disturbances. CBD administration improved anxiety in 47.1% of the children - although 23.5% noted that their anxiety had worsened. It should be noted that these results were largely dependent on parental reports and their subjectivity should not be underestimated.
Israeli scientists also conducted a retrospective Study which analyzed data from 188 children with ASD who were administered primarily cannabis oil (30% CBD to 1.5% THC) over a six-month period.
Using a self-reported questionnaire format that was answered by parents or caregivers when subjects were unable to do so, the results were again encouraging.
After six months of cannabis treatment, 30.1 percent of participants reported significant improvement in their condition, with another 53.7 percent reporting moderate benefits.
In addition, positive changes were also noted in quality of life markers, such as the ability to shower and dress independently. Remarkably, 84 percent of ASD patients with epilepsy reported "disappearance of symptoms" after six months.
That same year, Dr. Adi Aran published another retrospective study with a smaller cohort of 60 children with ASD. Subjects received a 20: 1 CBD: THC cannabis oil over a period of 7 to 13 months. Again, 61% of the subjects experienced significant improvement in behavioral problems, 39% experienced improvement in anxiety, and 47% experienced improvement in communication difficulties. Most children were taking other medications in addition to cannabis, with 33% taking a lower dosage and 24% discontinuing their medications by the end of the study.
The studies show promising results and especially in the case of autism, sufferers and relatives report that every small improvement that makes everyday life easier is a great help. We would like to see more studies on CBD and autism, as well as a broader understanding of the scope of a holistic approach in the treatment of ASD.