Autism spectrum disorder (ASD) is a developmental brain condition that is now the ninth leading cause of neurological disability worldwide. It is primarily recognised by differences in social communication and by restricted, repetitive behaviours. These behaviours can include “stimming” and intense sensory reactions, such as sound or touch sensitivity.
The goal of therapy in ASD is not to alter the core features of ASD, but rather to help an individual address troubling symptoms or comorbid psychiatric conditions. These may arise as an autistic person tries to adapt to neurotypical environments at work, school, at home, or in their social lives.
The Complexities of Medical Management in ASD
ASD is often found alongside other conditions (co-occurring conditions), which can complicate diagnosis and treatment. Around 40-50% of autistic individuals are diagnosed with four or more co-occurring conditions. Common examples include:
- Anxiety
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Obsessive-Compulsive Disorder (OCD)
Most autistic individuals are prescribed more than three different medications to manage their symptoms and/or the symptoms of co-occurring conditions. In the US, only two medications, aripiprazole and risperidone, are approved by the FDA (US) to address certain features of ASD. However, these medications have known undesirable side effects, such as weight gain and metabolic changes, and may show poor long-term effectiveness.
The limitations of these conventional options underscore the importance of exploring alternative approaches for symptom management.
Cannabis and the Autistic Community
Interest in medical cannabis as an alternative option for managing distressing symptoms in ASD has been growing among caregivers and the autistic community. Some research suggests that disruptions in the body’s own cannabinoid system (endocannabinoid signalling) may play a role in the pathophysiology of ASD, which further highlights the need to understand the effects of cannabinoids in this population.
While formal, placebo-controlled clinical trials are ongoing, data from adults currently using cannabis for symptom management can offer valuable insights. A recent study examined self-reported changes in core and co-occurring features of ASD immediately before and shortly after using cannabis in a large sample of self-identified autistic adults.
Overview of the Study
The study analysed anonymous, patient-reported data from the Strainprint® app, a medical cannabis journaling platform used by individuals in Canada.
Who Took Part?
Total Sample: 111 self-identified autistic adults (aged 19–70).
Usage Data: The group tracked their symptoms across 5,932 cannabis use sessions over 74 months.
Inclusion Criteria: Only sessions where cannabis was inhaled (e.g., smoking, vaping), symptoms were re-rated within four hours, and the cannabinoid content was lab-verified were included in the main analysis.
What Symptoms Were Tracked?
The researchers grouped the tracked symptoms into four main clusters:
- Sensitivity: Skin sensitivity, touch sensitivity, sound sensitivity, and sensory overload.
- Repetitive Behaviours: Limb flapping, stimming, repetitive behaviour, and compulsive behaviour.
- Mental Control: Challenges concentrating and intrusive thoughts.
- Negative Affect: Anxiety and irritability.
Symptom severity was rated by users on a scale of 1 (least severe) to 10 (most severe) before and after using cannabis.
Key Findings of the Analysis
This was the first empirical study to look at the perceived acute (short-term) effects of cannabis on ASD-associated symptoms in adults.
Short-Term Changes in Symptom Ratings
The overall findings indicated that symptom severity ratings were reported as being reduced in the vast majority (98.33%) of all tracked sessions after cannabis use.
When broken down by cluster, the self-reported mean reductions in severity were:
- Negative Affect: Reduced from 7.02 to 1.70.
- Repetitive Behaviours: Reduced from 6.86 to 2.03.
- Mental Control: Reduced from 6.75 to 2.12.
- Sensitivity: Reduced from 7.27 to 2.32.
Factors Affecting Symptom Changes
The study also looked at whether factors like age, dose, and cannabinoid content predicted the level of perceived change in symptoms:
- Dose: Higher doses (number of puffs) were associated with greater changes in repetitive behaviours, mental control, and negative affect. Interestingly, individuals tended to use stable doses over time, suggesting that tolerance to the short-term effects on these symptom clusters may not have developed.
- Age: Older individuals reported a greater change in sensitivity symptoms than younger individuals.
- Cannabinoid Content (THC and CBD): The percentage concentration of tetrahydrocannabinol (THC) and cannabidiol (CBD) in the products used did not appear to be significant predictors of changes in any of the four symptom clusters.
- Repeated Use Over Time: For the Sensitivity cluster, the effects seemed to lessen over repeated use sessions.
Changes in Baseline Symptoms Over Time
A key finding related to the long-term view of self-medication:
- The baseline severity ratings (the rating before using cannabis) for repetitive behaviours and negative affect significantly increased over the course of the tracked cannabis use sessions.
This suggests that while the acute effect of using cannabis may provide a temporary reduction in these symptoms, regular, long-term use may lead to these symptoms intensifying over time. However, as the authors note, it is also possible this change reflects a shift in people’s willingness to use cannabis, meaning they only began a session when their symptoms were already at a higher level.
Final Thoughts
This pioneering study on patient-reported experiences suggests that self-identified autistic adults who use inhaled cannabis for symptom management perceive a significant short-term chage in ASD-associated symptoms like anxiety, irritability, and sensory issues. The data indicates that this temporary effect appears to be strongest for those with the highest initial symptom severity.
However, the findings also highlight the need for caution. The potential for an increase in the baseline severity of repetitive behaviours and negative affect with repeated use over time is a significant finding that requires further, controlled investigation.
The study’s findings ultimately reinforce the need for further research, including well-powered, placebo-controlled clinical trials to fully understand the effects of various cannabinoids and to determine long-term safety and effectiveness in the ASD community.
Need to Know: Next Steps
We aim to keep our patients informed with the latest data and research.
- Discuss with Your Specialist: If you are considering medical cannabis for symptoms associated with ASD, you should always discuss this research and all treatment options with your prescribing specialist or healthcare team.
- Stay Informed: Follow us for further updates and analysis of the latest research
Disclaimer: This blog post is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It is important to understand that the research presented in this blog post is unable to determine the safety, effectiveness, or cure of any condition through the use of medical cannabis as further research is necessary.
