Can CBD or THC help autism? Maybe, but there are many unanswered questions.

cbd hemp oil, doctor hand hold and offer to patient medical marijuana and oil., legal light drugs prescribe, alternative remedy or medication,medicine conceptCannabis products have been receiving a lot of attention since medical and recreational marijuana use and hemp-derived cannabidiol (CBD) have been legalized in various states.

Media reports about parents seeing improvements in their children with autism after using either CBD or marijuana are encouraging, so you may be thinking about trying it for your child. Before you do, however, it is essential that you educate yourself about various types of cannabis products and what science has shown – and not shown – about their safety and effectiveness.

Cannabidiol products are derived from industrial hemp, a variety of the cannabis sativa plant that does not contain significant amounts of tetrahydrocannabinol (THC), the component that causes a “high.” CBD is legal in Kentucky and Indiana and CBD products are available over the counter in the form of oils, lotions and creams, as well as in edible items.

Marijuana, a slightly different plant that does contain THC, is legal in some states for medical or even recreational use in adults, but not in Kentucky or Indiana.

So, are these products safe? Studies have found CBD products are generally safe for adults and there have been rigorous studies of THC and CBD use in general and for certain conditions. These substances have shown some benefits for anxiety, pain and seizure disorders and the FDA has approved a drug containing CBD for the treatment of some types of seizures.

However, there are no published results of scientifically rigorous randomized controlled studies about either CBD or THC-containing products in autism for either adults or children. We don’t know if these products are effective in autism, or what autism symptoms they might treat. We also have no idea if they are safe in the short-term or long-term for children with autism.

There are some concerns related to these products in children:

• CBD products may interact with other medications when taken internally.
• The presence of high THC may be harmful to the developing brain and is known to increase risk for psychosis in children.
• Regular use of THC-dominant cannabis in adolescents increases their risk for long-term developmental changes, addiction and chronic psychosis disorder.
• In children, some purified cannabis medications may irritate the liver.

We learn more about these products as we monitor exposures in children during carefully conducted clinical trials.

The American Academy of Pediatrics’ (AAP) guidelines for complementary health approaches (such as cannabis) say providers should monitor their patients’ use of any unproven complementary health practice but discourage treatments that are clearly risky.

In February, the AAP published an ethics discussion about using cannabis for children with autism with severe self-harm behaviors. The authors suggest that individuals with autism or their caregivers work together with providers to make decisions about therapies. This process can open up discussions about safety for each individual, what laws might apply, and risks of non-standard preparations. Providers should be thoroughly knowledgeable about the use of these products to engage in these discussions.

I would encourage anyone considering use of these products to do so cautiously and consult with your or your child’s physician. While the products are derived from plants, good science from carefully conducted clinical trials suggests that these compounds can affect several organ systems. If you are considering CBD- or THC-containing products, it is essential you talk with your doctor and conduct a careful evaluation of the risks versus benefits, consider the lack of rigorous scientific evidence, and carefully monitor for any negative effects including liver irritation.

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Gregory Barnes, M.D.

Gregory Barnes, M.D., Ph.D., is the director of the University of Louisville Autism Center and the Spafford Ackerly Chair for Child and Adolescent Psychiatry. He also serves as the co-director of the Pediatric Epilepsy program at Norton Children’s Hospital and is a neurologist with UofL Physicians – Child Neurology.

All posts by Gregory Barnes, M.D.
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