Cannabis Can ‘Significantly Improve The Quality Of Life’ For Youth With Autism, Epilepsy And Other Conditions, Scientific Review Says

A new scientific review finds that high-CBD, low-THC cannabis products have potential to “significantly improve the quality of life” for children with autism and epilepsy, additionally showing “promising results in reducing key symptoms” of other conditions experienced by young people, such as cancer—all with mostly “mild, manageable side effects.”

The report, published this week in the journal Medical Cannabis and Cannabinoids, assessed the findings of 10 studies since 2019 that looked at the use of medical cannabis to treat patients under 21 with various health conditions, including autism spectrum disorder (ASD), cancer, treatment-resistant epilepsy and Sturge–Weber syndrome, a neurological and skin disorder.

Authors of the report, from Leafwell—a telehealth company that connects patients with doctors who recommend medical marijuana—and Duke University, said they “found generally positive effects across various disease states and populations.”

“In the pediatric population, emerging evidence, combined with existing literature, suggests medical cannabis may be beneficial for quality-of-life symptoms related to specific conditions, like cancer, [autism spectrum disorder], treatment-resistant epilepsy, and [Sturge-Weber syndrome].”

“While more research is necessary,” they concluded, “this review, together with other reviews of the literature, suggests that medical cannabis is potentially a viable treatment option alongside established medical treatment guidelines. This is especially true for pediatric ASD.”

Autism spectrum disorder was the subject of the studies with the strongest methodological designs, the new review says, which “found improvement in some primary outcomes related to medical cannabis treatment.” Two other studies found no significant differences, it adds, “suggesting that medical cannabis treatment did not worsen ASD-related health outcomes.”

One study in particular, the report notes, found that 3.9 percent of patients with ASD “experienced worsening primary outcomes, while 74.5% reported improvement.”

“Taken together, the strength of study designs, consistent findings, and relatively low adverse effect rates suggest that cannabis may contribute positively to patient treatment,” authors wrote, although they noted that there’s considerable variation within the pediatric ASD population in general.

“Newer research,” they continued, “ought to investigate whether there are specific ASD subtypes for whom medical cannabis may be more effective or less safe and which routes of administration are most effective.”

The researchers excluded studies about pharmaceuticals such as the CBD drug Epidiolex—a cannabis-derived drug approved by the Food and Drug Administration (FDA)—instead focusing on “cannabis-based medical products.”

“We made this decision because an increasing number of medical cannabis patients are using non-FDA-approved flower-based products for their conditions,” the report says. “It is more probable, especially in the USA and Canada, that a pediatric patient uses cannabis-based medical products purchased at a dispensary due to the product’s ubiquity rather than a government-approved drug product.”

Typically products were oral solutions or dried flower with relatively high concentrations of CBD and low amounts of the psychoactive cannabinoid THC. Only one of the studies looked at THC only.

“Individuals using medical cannabis through state-run programs in the USA or Canada may not have consistent access to similar high-CBD, low-THC products,” authors noted, adding: “Although the types of products available to medical cannabis patients vary by state, there is a need for physicians to educate patients on the current literature.”

The review also acknowledges a need for further investigation around matters including the safety of long-term cannabis use and the potential for cannabinoids to interact with other drugs. “Little is known about the long-term safety profile of medical cannabis formulations in the general population and specifically in the pediatric population,” it says.

Findings of the review align with “similar positive effects” observed in past reviews of available evidence, authors of the report said. At the same time, both the current and past reviews also “noted that most published studies lacked a control group, were limited by small sample sizes, and varied in treatment dosages,” indicating a need for more targeted study.

Past reviews also found the strongest evidence supporting medical marijuana for treatment of chemotherapy-induced nausea and vomiting, authors pointed out, while their own review found the most robust evidence around autism.

Leafwell said in a post about the new report that the company’s research demonstrates the “tremendous promise” of cannabis to help treat common pediatric conditions while also indicating the plant’s relative safety.

“Overall, findings within these studies support previous evidence that medical cannabis can be an effective alternative to commonly prescribed pharmaceuticals such as opioids and sedatives, and with fewer risks of side effects,” it said. “In addition to successfully alleviating patient symptoms, studies indicated generally mild and minimal side effects following cannabis use, with drowsiness and appetite changes among the most commonly reported.”

The company said its work is important because findings can promote better access to cannabis products among pediatric patients, reduce social stigma around cannabinoid medicine and help keep families informed.

“Research findings over the last five years continue to show the usefulness of medical cannabis in the treatment of numerous pediatric conditions,” the company said. “At the same time, medical cannabis may be a safer alternative to commonly prescribed drugs, as side effects in minors appear to be minimal and mild.”

“The review illustrates a need for more research into medical cannabis use among young patients,” it continued. “Despite an increase in studies over recent years, there’s still a lot to learn, and knowledge gaps when it comes to dosing, the efficacy of specific product types, and more.”

The new report comes on the heels of another Leafwell study authored by researchers from DePaul University in Chicago. That research used Leafwell data to examine what conditions qualify minors for state-legal medical cannabis programs, concluding that younger people enroll in the programs for many of the same reasons that older adults do, including anxiety, PTSD and chronic pain. Other common conditions included insomnia and depression.

Among minor patients—those under 18—cancer and epilepsy were more common reasons for obtaining a medical marijuana recommendation than they were among young adults, ages 18 to 20. Patients in the older age group, meanwhile, were comparatively more likely to cite depression, chronic pain or insomnia as their primary qualifying condition.

While the data for that study was self-reported—coming from the patient database at Leafwell—authors wrote that the research “represents the largest cohort of pediatric medical cannabis users in the world.” Leafwell operates in 34 states, they said, helping patients obtain marijuana cards. As part of that service, clients fill out a baseline questionnaire, which goes into the company’s patient database.

The majority of academic research around youth cannabis use focuses not on medical benefits but instead on youth consumption patterns in the wake of cannabis legalization. Many critics have worried that legalization would lead to a sharp rise in teen use of marijuana, but so far that hasn’t materialized.

For example, a recent federal report published by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that past-year marijuana use among minors—defined as people 12 to 20 years of age—had generally fallen in the years since states started legalizing marijuana for adults.

Notably, the percentage of young people aged 12 to 17 who’ve ever tried marijuana dropped 18 percent from 2014, when the first legal recreational cannabis sales in the U.S. launched, to 2023. Past-year and past-month rates among young people also declined during that time period.

Multiple other studies have debunked the idea that cannabis reform broadly increases youth use, with most finding that consumption trends are either stable or decrease after the reform is implemented. Use by heavy users may increase, however.

For example, a research letter published by the Journal of the American Medical Association (JAMA) in April said there’s no evidence that states’ adoption of laws to legalize and regulate marijuana for adults have led to an increase in youth use of cannabis.

Another JAMA-published study earlier that month that similarly found that neither legalization nor the opening of retail stores led to increases in youth cannabis use.

Data from a recent Washington State survey of adolescent and teenage students found overall declines in both lifetime and past-30-day marijuana use since legalizations, with striking drops in recent years that held steady through 2023. The results also indicate that perceived ease of access to cannabis among underage students has generally fallen since the state enacted legalization for adults in 2012.

Rates of youth marijuana use in Colorado, meanwhile, declined slightly in 2023—remaining significantly lower than before legalization. That’s according to results of the biannual Healthy Kids Colorado Survey released this month that found that past-30-day use of cannabis among high schoolers was at 12.8 percent in 2023, a dip from the 13.3 percent reported in 2021.

A separate study late last year also found that Canadian high-school students reported it was more difficult to access marijuana since the government legalized the drug nationwide in 2019. The prevalence of current cannabis use also fell during the study period, from 12.7 percent in 2018–19 to 7.5 percent in 2020–21, even as retail sales of marijuana expanded across the country.

In December of last year, meanwhile, a U.S. health official said that teen marijuana use had not increased “even as state legalization has proliferated across the country.”

“There have been no substantial increases at all,” said Marsha Lopez, chief of the National Institute on Drug Abuse’s (NIDA) epidemiological research branch. “In fact, they have not reported an increase in perceived availability either, which is kind of interesting.”

Another earlier analysis from CDC found that rates of current and lifetime cannabis use among high school students have continued to drop amid the legalization movement.

A study of high school students in Massachusetts published last year found that youth in that state were no more likely to use marijuana after legalization, though more students perceived their parents as cannabis consumers after the policy change.

A separate NIDA-funded study published in the American Journal of Preventive Medicine in 2022 also found that state-level cannabis legalization was not associated with increased youth use. The study demonstrated that “youth who spent more of their adolescence under legalization were no more or less likely to have used cannabis at age 15 years than adolescents who spent little or no time under legalization.”

Yet another 2022 study from Michigan State University researchers, published in the journal PLOS One, found that “cannabis retail sales might be followed by the increased occurrence of cannabis onsets for older adults” in legal states, “but not for underage persons who cannot buy cannabis products in a retail outlet.”

The trends were observed despite adult use of marijuana and certain psychedelics reaching “historic highs” in 2022, according to separate data released last year.

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Photo courtesy of Chris Wallis // Side Pocket Images.