When the Georgia Legislature voted last month to expand its medical marijuana program, it wasn't to legalize growing operations or streamline the application process. Instead, they added to a list of qualifying conditions; going forward, patients with AIDS, Alzheimer's or Tourette's syndrome will be eligible to buy cannabis oil with very low amounts of THC, the psychoactive compound in weed.
Of these newly approved conditions, one in particular stood out. State Sen. Matt Brass told Reuters that while he doesn't approve of recreational marijuana use, "he wanted those with autism to be allowed to be use cannabis oil after obtaining a doctor's approval." Georgia's revised law allows for exactly that: cannabis as autism treatment. The only problem? We don't really know if it works.
The parents fighting to get their kids medical marijuana
Inspired by stories of epileptic children whose lives were dramatically improved by medical marijuana, parents of autistic kids took the initiative and began to experiment with similar treatments — despite a lack of research.
You can find these parents everywhere online, in various grassroots and support groups with names like Mothers Advocating Medical Marijuana for Autism, or MAMMA, using hashtags like #cannabis4autism to spread the word about their cause. There are personal stories of autistic kids who wouldn't eat suddenly finding their appetite with the help of weed brownies, those whose self-destructive rage could only be soothed with cannabis cookies and others whose violent aggression seemed to melt away thanks to pot grown by mom in the backyard. Anecdotally speaking: Pot looks promising.
But then you have a kid like Alex Echols, who made headlines at age 11 in 2013 because his parents used marijuana to curb his autism-related bouts of extreme self-harm, which included "slamming his head into walls and slapping his face" until it bled. Three years later, Alex's dad, Jeremy Echols, shut down his blog about Alex, writing that although he was heartened by "amazing stories" of autistic children benefiting from marijuana, this was but "one side" of the truth. In a final post, he explained that cannabis no longer worked for Alex:
We've stopped with the cannabis tinctures despite having a wonderful donor (TJ's Organic Gardens), because we just couldn't figure out what [Alex] needs. We've found that while our initial struggles were lack of knowledge and supply, our struggle now is figuring out how it's actually affecting Alex. His inability to communicate has always made medications difficult, but in the case of cannabis, this country's bullshit paranoia has made research so spotty that it's 100% up to the parents to guess at dosage, strain, etc.
Clearly, the Echols family came up against the limits of what had seemed like a potential miracle cure — and sadly, some of those limits are manmade.
What we know about autism and marijuana
Autism spectrum disorder encompasses a variety of developmental disorders with no known single cause. There's disagreement as to whether we should even think of it as a disease. These circumstances make autism very difficult to treat — or even talk about without oversimplifying. Then you have the many pernicious myths about it, compounded by a mysterious spike in cases.
Still, the handful of studies about marijuana and autistic disorders have delivered tantalizing results. A 2013 experiment discussed in Neuron highlighted the discovery that an autism-linked mutation of neuroligin-3, a membrane protein that appears to create and remodel our central nervous synapses, also affects endocannabinoid signaling. The endocannabinoid system is a series of receptors throughout the body that influence everything from appetite to immune response to sleep to hormone balance; these receptors respond to both the cannabinoids from marijuana — hence the name — and the body's own cannaboid-like compounds, or endocannabinoids. When the authors of the Neuron study raise "the possibility that alterations in endocannabinoid signaling may contribute to autism pathophysiology," they also hint at a potential therapeutic application for marijuana in autism patients.
Scientists have continued to pursue the endocannabinoid-autism connection. Another 2013 study, published in the Journal of Autism and Developmental Disorders, revealed that one receptor in particular — CB2, or cannabinoid receptor type 2 — is overexpressed in children with autistic disorders. While another type of receptor, CB1, is known to be what accounts for the "high" of THC, since the compound binds to them, CB2 is thought to be crucial for marijuana's anti-inflammatory and pain-relieving properties. "Our data indicate CB2 receptor as potential therapeutic target for the pharmacological management of the autism care," wrote the authors of the study.
If autism is partly understood through endocannabinoid dysfunction, and marijuana directly modulates the endocannabinoid system, couldn't it be a solution for some kids? We've barely scratched the surface of the question.
Finally, a clinical trial
Because the U.S. continues to prohibit marijuana at the federal level, research on its implications for autism disorder therapy is advancing faster overseas. Israel, for example, has been a leader in the field of weed science since the 1960s. Israel legalized medical marijuana in 1992 and now stands to capitalize on decades of progressive pot policy by taking their expertise global.
In January, Shaare Zedek Medical Center in Jerusalem began the world's first medical trial to assess the effects of cannabinoids on young people with autism disorders. Led by Dr. Adi Aran, the director of the hospital's neuropediatric unit, 120 autistic individuals ages 5 to 29 are taking part — and many more parents are hoping their children can take part in future trials. "Our waiting lists are full," Aran told the Times of Israel. Many, many families want to participate and they come from all over Israel. They hope and they heard from their friends and other families that it might help."
Aran's patients aren't using marijuana. Instead, a pharmaceutical company called Breath of Life is breaking weed down into cannabis extracts that isolate and amplify certain compounds — particularly CBD, or cannabidiol, a non-psychoactive cannabinoid that has shown great medical promise.
In Israel, as in the U.S., stories of marijuana's miraculous effects on some autistic children have circulated among hopeful and desperate parents. This has led some parents to step outside the law to try it: "We have a lot of information from television and news," one father told the Times of Israel. "Everyone who spoke, either it didn't improve them or it was amazing. No one talked about a decline." It's easy to see why he and others are willing to consider cannabis as an alternative to traditional antipsychotic pharmaceuticals, which carry heavy risks for patients.
Yet these scattered successes are not enough to paint a pattern, especially in such complicated disorders as autism. And while Aran's study may have far-reaching implications for autistic individuals and their families around the world, we will have to see many more of its kind before we understand what cannabis can accomplish in this realm of medicine. A good start for U.S. research, if we want to make that a priority, would be removing all the legal obstacles that stand in the way of what could potentially be a major breakthrough.