Cannabis and Autism: a way of hope

Cannabis and Autism: a way of hope

Autism is not a disease and therefore, there is no drug that can cure it.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is usually diagnosed in very young children, between the ages of two and four, although it can sometimes be detected before 2 years of age. Autism has different degrees of severity. Autistic children see their social skills impaired, have communication problems, and develop repetitive behaviors. When they grow up, they may be limited in their abilities to function in social, school, and work environments.

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Autism is not a disease and therefore, there is no drug that can cure it. The medications taken by autistic children are designed to treat the different symptoms of ASD, although in the most severe cases the effects of the medications can last only a few hours. They are medications that are approved to treat depression, anxiety, or ADHD (Attention Deficit Hyperactivity Disorder). Sometimes these medications exacerbate their obsessive behaviors and insomnia.

Faced with this situation, several researchers have initiated clinical studies on the possible efficacy of the cannabinoids in marijuana to relieve the symptoms of the most severe autism. These clinical studies are mainly conducted in Israel by the teams of Dr. Adi Aran and Dr. Raphael Mechoulam, but in other countries, pediatric neurologists are also conducting studies in patients with severe autism, cases in which the medication does not work or does so very slightly.

What symptoms does autism have?

Autism is diagnosed when the child reaches the age that should begin to interact with the environment, approximately between the ages of two and four. Children affected by ASD have a limited ability to relate to people, as they have difficulty understanding and using nonverbal cues such as eye contact, facial expressions, gestures, and body language. This makes it impossible for them to understand the feelings of others and to express their own feelings properly.

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Autism also manifests itself with repetitive behaviors. Children may sway, even repeatedly bang their head against the wall, wave their hands, or repeat words or noises. They are very inflexible with respect to established routines and resist interruptions or modifications in their habits, such as a change of schedule, for example. They may also have difficulty tolerating sensory stimuli such as loud noises or bright lights that can trigger anger crises that manifest in tantrums in children. Many have difficulty sleeping.

While difficulties in social relationships and communication along with unusual behaviors define ASD, those affected may have a wide range of intellectual and language skills. Most have a mild or moderate disability, while others have above-average intelligence. The latter may have faculties that greatly exceed the population average in areas such as music, mathematics, or memory.

Some people with autism spectrum disorder don't speak at all, while others use the language fluently. In the latter cases, however, they may have problems associated with communication: they may have a monotonous voice, have unusual vocal gestures, or choose surprising topics of conversation.

Many autistics also have epileptic seizures (30%), gastrointestinal disorders, anxiety, or depression.

The case of Benjamin, a 4-year-old autistic boy

Ben and his mother Sharon live in a village in northern Israel. Before leaving to go to the supermarket, the child repeatedly hits his head against the wall. It circles at full speed screaming at full volume. As Sharon tries to calm him down, he pulls down his pants and defecates on the floor.

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As they leave the apartment, Benjamin escapes from his mother's hand and is about to be run over as he crosses to the other sidewalk. They go to the supermarket, but halfway through the purchase, they have to leave because Ben is screaming as he throws all the items on the shelf on the floor.

Sharon had moved from the United States when Ben was born. As a single mother, she believed that living in a small town in Israel would feel more supported by the community. When he was diagnosed with autism, Ben began taking the full spectrum of medications as usual. At that time I was taking Ritalin, a medication usually taken by those affected by ADHD. He had also tried antipsychotics and a mix of antidepressants and anti-anxiety medications. Not only did they not help him, but he became more hyperactive when the effects wore off.

One day, while requesting the prescription for Ritalin, Sharon told the pharmacist about the side effects of the drug and he suggested that she contact Dr. Adi Aran, a pediatric neurologist in Jerusalem who had begun experimenting with medical cannabis for children like Benjamin. Sharon resisted at first, but after learning about herself and watching videos that the parents themselves had made about the change that had occurred in their children after taking medical cannabis, she decided to contact Dr. Aran and went to visit him at Shaare Zedek Medical Center.

Dr. Aran, after seeing the severity of Ben's symptoms and the long list of medications he had tried unsuccessfully, decided to include him in the program he was conducting to administer medical cannabis to autistic children. Sharon went home with a prescription for an oil made from a cannabis strain with the proper formulation, and documentation to record the child's progress.

After two weeks of taking the new medication, Ben was calmer. He would respond when his mother spoke to him and he could sit still and maintain eye contact. If they were visiting some friends' houses, the child could be in another room playing quietly. Sharon was able to get the padding out of all the furniture and walls. Within months, teachers at the school with special needs told Sharon that Ben was prepared to move to a standard classroom.

This case, reported by Newsweek magazine in 2018, is illustrative of the serious situation experienced by families with children diagnosed with severe ASD. Cases such as ben or Charlotte Figi, the Colorado girl with refractory epilepsy for whom cannabis changed her life, give media visibility to the possibilities offered by cannabis to disorders that affect more and more children in the world. In Europe, epidemiological studies indicate that ASD affects 1% of births, while in the United States the percentage is higher, reaching 1 in 88 children.