Medical Marijuana in Autism Spectrum Disorder: A Systematic Review

The Potential of Cannabis in ASD Treatment

As an integrative psychiatry practice, Alpine Psychiatry is deeply committed to exploring safe and effective treatment options for individuals and families navigating Autism Spectrum Disorder (ASD). A recent systematic review, Cannabis and cannabinoid use in autism spectrum disorder: a systematic review (PubMed link), sheds light on the potential role of medical marijuana (MJ) in alleviating ASD symptoms.

The review highlights improvements across a range of symptoms, including:

• Hyperactivity and impulsivity

• Self-injurious behaviors

• Anger and irritability

• Sleep disturbances

• Anxiety and depression

In addition, some patients showed progress in cognition, sensory sensitivity, attention, language, and social interaction. These findings suggest that cannabis and cannabinoids may serve as therapeutic alternatives for certain individuals with ASD.

Safety and Tolerability

While the results are encouraging, safety and tolerability remain central considerations. Reported side effects included:

• Sleep disturbances

• Restlessness

• Nervousness

• Appetite changes

Most side effects were mild to moderate and often temporary. However, careful monitoring and individualized dosing are essential when considering cannabis as part of a treatment plan.

Understanding the Components of Cannabis

Medical marijuana contains a variety of compounds that influence its effects:

• THC (tetrahydrocannabinol): Responsible for psychoactive effects, but may also reduce agitation.

• CBD (cannabidiol): Non-intoxicating, with evidence for calming and anti-anxiety properties.

• Terpenes: Provide aroma and can influence relaxation or alertness.

• Flavonoids: Natural compounds with anti-inflammatory effects.

A balanced cannabinoid profile may offer therapeutic benefit, but too much THC can increase risks, especially in younger individuals or those with a family history of psychosis.

Some Risks to Consider

Like any treatment, medical marijuana is not without risks:

• Psychiatric effects: In rare cases, THC may trigger psychosis in vulnerable individuals.

• Motivation and mood: Long-term THC use may reduce motivation, which often reverses with dose reduction or cessation.

• Physical effects: High use may contribute to reflux, nausea, or in rare cases, Cannabinoid Hyperemesis Syndrome (CHS)—a condition marked by cycles of severe nausea and vomiting.

• Unclear cancer risks: Research is mixed, and factors such as age of onset, duration, and method of consumption likely influence outcomes.

The Need for Further Research

The systematic review emphasizes the need for randomized, double-blind, placebo-controlled clinical trials to determine the true efficacy and safety of cannabis in ASD. While existing findings are promising, more rigorous studies will help guide best practices and ensure families have evidence-based information.

Practical Guidance for Families Considering Medical Marijuana

If you are exploring medical marijuana (MJ) for a loved one with autism, here are some important do’s and don’ts to help guide safe decision-making:

✅ Do:

• Start with CBD-rich, Indica-dominant strains for calming effects.

• Use higher-CBD options in the morning to avoid daytime drowsiness or feeling “high.”

• Consider hybrids (Indica + Sativa) that can be tailored for targeted relief.

• Introduce new strains slowly and monitor for both benefits and side effects.

• Work with a knowledgeable provider to adjust dosage and ensure safe integration with other treatments.

❌ Don’t:

• Start with pure Sativa strains—they tend to be more stimulating and may worsen hyperactivity.

• Increase THC too quickly; high doses raise risks of anxiety, paranoia, or psychosis in vulnerable individuals.

• Overlook long-term risks, including possible impacts on motivation, mood, or physical health.

• Ignore warning signs such as persistent nausea, vomiting, or reflux, which may indicate Cannabinoid Hyperemesis Syndrome (CHS).

Integrative Psychiatry Perspective

At Alpine Psychiatry, we emphasize individualized, holistic care. For families considering medical marijuana, our approach includes:

• Careful evaluation of risks and benefits

• Close monitoring of side effects

• Integration with other supports, such as therapy, functional testing, and biomedical interventions

• Ongoing collaboration with families to ensure safety and alignment with treatment goals

Helpful Resources

• PubMed Review Article

• Pennsylvania Medical Marijuana Program – Comprehensive details for caregivers and families

• Medical Cannabis: The Beginner’s Handbook – A resource for learning about medical marijuana strains and therapeutic use