About Autism Spectrum Disorder
Autism Spectrum Disorder (ASD) is a complicated neurological developmental disability often diagnosed in childhood or early adolescence. Individuals with ASD typically have difficulty managing social interactions and often struggle with fundamental communication. Other characteristics of ASD may include anxiety, difficulty learning and maintaining attention, depression, and failure to meet developmental milestones such as speech and mobility (CDC, 2022). Because of its numerous symptoms, autism can sometimes be overlooked or misdiagnosed in children. Signs and symptoms of ASD can present as early as 12 months, but may not be recognized until early adolescence. Early intervention is essential as treatment options can vary from patient to patient. Treatment of ASD usually begins with various forms of therapy including behavioral therapy, speech and language therapy, and educational therapy. Should these interventions prove to be inadequate, medication and alternative treatments (such as cannabis) may be advised.
Because the cannabis plant produces many different psychoactive compounds, it can be utilized to treat a myriad of physical and psychiatric disorders. Cannabis was first documented as medicine in the US, in 1850, by the United States Pharmacopeia, a publication that sets the standard for medicine in the US. Cannabis has shown to be effective in treating anxiety, pain, Post Traumatic Stress Disorder, nausea, and –notably –seizure disorders (Bridgeman, 2017). In 2018, the Food and Drug Administration (FDA) approved a cannabis-based drug called Epidiolex to treat a rare and severe form of epilepsy (FDA Office of the Commissioner, 2018). Today, many medical practices in the US have begun to acknowledge cannabis as a safe and effective alternative to traditional therapeutic interventions. Dr. Stein, as well as other clinicians who are dedicated to the advancement of medical cannabis use, are an excellent resource for information about how cannabis may be a viable medical option to explore.
Research and rationale for the use of cannabis in ASD
Though new research around the use of cannabis in Autism Spectrum Disorder emerges regularly, current studies indicate that children affected by ASD experience positive results from the use of cannabis. Evidence suggests that cannabis can be useful to relieve some common symptoms of ASD including behavioral disturbances, hyperactivity, and anxiety (Parmar, 2021). A recent analysis of nine research studies suggest that cannabis use can help to relieve such ASD symptoms as anger outbursts, self-harm, hyperactivity, insomnia, anxiety, agitation, sensory sensitivity, attention issues, disturbances in social interactions, depression, and restlessness. It is important to also note that, along with other medications, there are risks associated with cannabis use. Possible side effects include sleep disorders, restlessness, diarrhea, increased appetite, redness in the eyes, fatigue, and agitation (Silva Junior et al, 2021). With proper monitoring and administration, cannabis has the potential to alleviate some of the symptoms from ASD. Dr. Stein and his team are the best resource with whom to discuss more about the benefits and risks of cannabis therapy, as well as how to mitigate any adverse reactions that may occur with cannabis use.
Dosing and common routes of administration for ASD patients
Common routes of administration for patients with ASD or epilepsy include sublingual tinctures, capsules or edibles. Inhalation therapy is typically not recommended for minors and may actually be prohibited in most states.
Each cannabis product will contain a specific ratio of THC and CBD. For example, a ratio of 9:1 CBD/THC would represent 9 parts CBD and 1 part THC. Specifically, a 10mg dose will contain 9 mg of CBD and 1 mg of THC.
Typically, Dr. Stein and his team will suggest an initial dose of a cannabis tincture consisting of either a 20:1 CBD/THC or 15:1 CBD/THC. Based on a study conducted in Israel, the 20:1 CBD/THC ratio is the optimal dose for patients with ASD (Parmar, 2021). If this ratio is not effective, the physician may have the patient try a ratio with more THC. In some cases, patients who also experience insomnia, may do well with a more potent ratio like a 1:1 CBD/THC product to be taken in the evening before bed. Oftentimes, a patient may need to experiment with multiple ratio products in order to find the product that works best.
At Neurology of Cannabis, one of our priorities is to carefully titrate the dose in order to achieve the best results while minimizing side effects. This usually entails sticking with the same dose for two to three days before slowly increasing the dose under the supervision of your physician. It may take 2-3 weeks or longer before the optimal dose is identified, and may need to be adjusted at any time during treatment.
What to expect in your first appointment with your provider
When meeting with Dr. Stein, you can expect the initial appointment to last approximately 30 minutes. Dr. Stein will review the patient’s symptoms and make the appropriate medical cannabis recommendations. Medical programs vary from state to state.
It is vital that you maintain an open dialogue with the patient’s recommending physician to ensure the most effective regimen is achieved. It’s often recommended that the patient and their caregiver keep a journal of their results as well as any side effects experienced.
Here are some common questions you may want to consider when consulting with your provider:
-Which route of administration should we try first?
– Which ratio product might be most effective?
– How often should I administer cannabis?
– What side effects should I be aware of?
After the appointment, you will complete your registration in your state’s Medical Cannabis program. If the patient is under 18 years old they will need a caregiver. This can be either a parent or guardian. Once the patient and caregiver application are approved, you will be directed on how to purchase medical cannabis from a licensed dispensary in your state.
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