When I first started writing about the claims made for medical marijuana and the cannabis oil derived from it, it didn’t take long for me to characterize medical claims for cannabis as the “new herbalism,” as opposed to pharmacognosy, the branch of pharmacology devoted to the study of natural products. The reason is simple. Although I support legalization of marijuana for recreational use, when I look at how medical marijuana has been promoted as a “foot-in-the-door” prelude to legalization, I see testimonials and flimsy evidence ruling over all. I see all the hallmarks of alternative medicine herbalism and none of the hallmarks of pharmacology. Here’s what I mean. Pharmacognosy examines an herb, plant, or other natural product and seeks to identify the chemicals within it that have pharmacological activity against a condition or a disease, the better to purify and isolate those chemicals and turn them into drugs. Herbalism, on the other hand, emphasizes the use of whole plants or extracts from plants, rather than the isolation of the most active compounds. Thus, herbal remedies often contain hundreds, or even thousands, of different compounds, of which only one or a few are active. Even extracts, such as cannabis oil, contain many compounds.

In contrast to pharmacognosy, herbalists often make the claim that whole herbs and plant components possess a a sort of magical synergy that is missing from the purified active constituents and/or that the mixture is somehow magically safer than the pure components because one compound can reduce the side effects of another without reducing therapeutic efficacy. When looked at closely neither claim stands up to scrutiny. Synergism between plant constituents is rare and very difficult to demonstrate, for example. In essence, herbalism turns back the clock 200 years to a time before scientists had developed the techniques and abilities to isolate active ingredients with pharmaceutical activity. Moreover, herbalism, in contrast to pharmacognosy, emphasizes anecdotes over scientific evidence.

Indeed, in my previous posts in this series on medical marijuana, one theme has emerged, which is that cannabis—specifically, a class of active chemicals in marijuana known as cannabinoids—has potential for some diseases but is not the panacea claimed by its proponents. It does not cure cancer, for instance, contrary to glowing testimonials promoted by people like Rick Simpson. For other conditions, the evidence is either not particularly compelling or only mildly promising. The answer to the question of whether medical marijuana is good medicine is, as far as I’m concerned, mostly “no” and “we don’t know.”

So I reacted with considerable dismay last Friday night when I saw this news report on the 11 o’clock news, “Michigan panel recommends allowing marijuana for autism“:

And, indeed, there have been stories all over the local news in Michigan like the one above and this one:

Note all the hearty cheering from the audience when the vote tally was read.

Here’s what happened:

Michigan would become the first state to allow medical marijuana for children with severe autism if a senior official follows the recommendation made Friday by an advisory panel.

The state’s Medical Marijuana Review Panel voted 4-2 to recommend autism as a condition that qualifies for the drug.

Supporters say oil extracted from marijuana has been effective in controlling extreme physical behavior by kids with severe autism. Pot wouldn’t be smoked.

The panel was influenced by comments received earlier from some Detroit-area doctors, especially the head of pediatric neurology at Children’s Hospital of Michigan, and parents desperate for relief. Many of the three dozen spectators cheered and applauded after the vote.

This is an utterly horrible idea, but it looks as though our state is nonetheless about to take the plunge into the Brave New World of treating autism with cannabis oil. Indeed, Michael Komorn, the President of the Michigan Medical Marijuana Association and the attorney who brought the petition before the board, basically admitted in the first news clip above that there was no science behind the board’s recommendations when he said: “It’s a no-brainer. And you heard the testimony of these people. They just want a little hope. That’s all they’re asking for.” Notice the distinct lack of any mention of strong science as a rationale for adding autism to the list of qualifying conditions. Komorn even went so far as to tout how the parents “are responsible for growing the plants or acquiring the cannabis, and they are in charge of dosing, frequency of use, and method of ingestion.”

Think about this for a moment. Is there another regulated drug for which this is the case? The board didn’t even provide, along with its recommendation for approving autism as a qualifying condition for treatment with cannabis oil, anything resembling recommendations for dosing, method of ingestion, or frequency of use, very basic recommendations that, for example, the FDA includes in its approvals and even those evil drug companies provide for their poisons. (I do so love my sarcasm.) Yet, here, in the fantasy world of medical marijuana, apparently parents are as knowledgeable as physicians—more so, even, given that most physicians here have no idea how to prescribe medical marijuana—and no guidelines for use are needed. The lack of dosing recommendations is another powerful indication that there is no science behind this recommendation, because if there was science behind it we’d know the optimal dose and method of administration to use cannabis oil to treat autism. Clearly, emotion, not science, ruled the day on Friday. Indeed, how Dr. Harry T. Chugani, the head of pediatric neurology at an institution as respected as Children’s Hospital could testify in favor of this nonsense is beyond me, but apparently he did:

“It seems to work. … Wouldn’t that be better than giving them all these psychiatric drugs?” Chugani said. “Not every autistic kid would take this, but if your behavior is wild and you have to be institutionalized, I as a physician would prefer to try medical marijuana. I have at least 50 patients on multiple drugs and still their behaviors are not controlled.”

Notice that Dr. Chugani, too, didn’t cite anything other than anecdotal evidence. How, for instance, did he know that the child isn’t calmer because he’s high on cannabis? And if we’re going to drug autistic children to make them behave, why not use opioids or other sedatives as well?

In any event, if you want evidence that medical marijuana is far more akin to herbalism than pharmacology, we need look no further than my state’s dubious position of becoming a “pioneer” in something that no state should be a pioneer in. That’s why I’ll first examine how the Medical Marijuana Review Panel got to where it is now, then the general claim that cannabis is a useful treatment for autism. Finally, I’ll evaluate the existing scientific evidence, which is pretty thin.

Misguided activism advances cannabis herbalism

As has been the case with virtually all uses of medical marijuana sanctioned by states, the road to the Michigan Medical Marijuana Review Panel recommending approval of cannabis for autism began not with doctors and scientists clamoring for it based on evidence, but with parents becoming politically active to lobby for it based on emotional anecdotes. Such was the case in Michigan, and, if you’ve been paying attention to the “autism biomed” movement, this quote will sound very familiar:

The review panel voted 4-2 in favor of a petition submitted by Lisa Smith, a Michigan mother who has said cannabis oil has helped improve her severely autistic 6-year-old son’s behavior, sleep patterns and eating schedule.

“The parents I’ve talked to are passionate and adamant that this represents a dramatic improvement in the quality of life for them and their affected children,” said David Crocker, a medical marijuana doctor and member of the panel.

What other treatments for autism have we heard the same claims for? Let me think… Oh, yes. We’ve heard them for quite a few “autism biomed” treatments, with parents being just as passionate. Unfortunately, the vast majority of “autism biomed” is rank quackery. Examples include “Miracle Mineral Solution” (MMS, a.k.a a form of bleach fed to autistic children and administered as enemas for which miraculous results are claimed), chemical castration with Lupron, chelation therapy, GcMAF, and many, many other pseudoscientific “treatments” featured at quackfests like Autism One. I’ve even seen glowing testimonials touting homeopathy for autism and the IonCleanse® “foot detox” bath. As regular readers know, homeopathy is, as I like to say, The One Quackery To Rule Them All, and “foot detox” baths are a scam. Not surprisingly, segments of the autism biomed movement have embraced medical marijuana. For example, the “Thinking Moms’ Revolution” (TMR) has numerous posts on its blog extolling the alleged virtues of medical marijuana for treating autism and advocating “freedom of choice.” If you doubt the increasing embrace of medical marijuana by the autism biomed quackery movement, look no further than this ad for an Medical Marijuana for Children with Autism eConference, sponsored in part by TMR. Indeed, Jeff Bradstreet, the longtime antivaccine autism biomed quack who committed suicide a month and a half ago after the FDA raided his clinic was a speaker! So was a key supporter of medical marijuana for autism in Michigan, Lester Grinspoon.

Does this striking resemblance between autism biomed rhetoric and medical marijuana rhetoric mean that cannabis is useless for autism? Not necessarily, but it raises red flags. In any event, it would be more accurate to say that we don’t really know whether cannabis oil is efficacious for treating autism. I mention this similarity between the autism biomed movement and medical marijuana movement to emphasize how anecdotal evidence is incredibly unreliable, particularly for a complex condition like autism spectrum disorder (ASD). If you don’t believe me, consider this. Equally glowing testimonials for the rank quackery that is homeopathy to treat autism are not difficult to come by, which is one reason why testimonials are insufficient evidence upon which to base public policy; yet, that’s just what is happening in Michigan—and has been since medical marijuana was first approved. Remember, autism is a condition of developmental delay, not stasis, and autistic children frequently improve as they get older. Some even improve sufficiently to lose the ASD diagnosis.

I understand (at least as much as someone who hasn’t actually experienced having a child with special needs can) how parents would be desperate to do everything they can for their children, but personal experience and anecdotes, contrary to what is claimed, can be extremely misleading, as we’ve described here many times before. That’s why anecdotes are not enough, and carefully controlled randomized clinical trials are needed, which, contrary to the claims of advocates, don’t really exist. Indeed, the science cited in the petition, as we will see in the final section of this post, is inadequate to make such a major policy change, consisting as it does of mainly preclinical evidence and case reports.

How Michigan got to where it is today

With that in mind, it’s useful to note that the road to this “victory” began years ago and actually represents a rebound from a defeat two years ago. In 2013, the Michigan Medical Marihuana Review Panel voted against adding autism to the list of indications for medical marijuana by a 7-2 vote:

Jenny Allen, whose 6-year-old son was diagnosed with autism several years ago, has tried giving him “mind-bending” medications, signed him up for behavior therapy and changed his diet. But his problems, including self-destructive behavior and biting, continue.

Now the 32-year-old Lansing mom wants to try giving him part of a brownie — a pot brownie — but was brought to tears Tuesday when the Michigan Medical Marihuana Review Panel rejected a petition that would have given her the legal means to do so.

The panel, in a 7-2 vote, gave a final recommendation against adding autism to a list of debilitating conditions suitable for treatment under Michigan’s voter-approved medical marijuana law.

“I’m incredibly disappointed,” Allen told MLive after the hearing, going on to question whether all panelists had thoroughly researched the topic. “I’m pretty shocked, actually, that nobody even brought up what the base condition is. It’s rather appalling.”

The panel made this decision in 2013 based on a correct assessment of the state of the evidence, which is that there is “not much quality, peer-reviewed research exploring marijuana as a treatment for autism,” that the case for adding autism to the list of approved conditions for which medical marijuana can be prescribed consists almost entirely of anecdotes and testimonials, and that not enough is known about the effects of long term use of cannabis on the developing brain. This assessment was correct in 2013, and nothing has happened in terms of the existing science during the intervening two years to change that assessment. So what really happened to reopen the case?

Not surprisingly, it was litigation that forced the Department of Licensing and Regulatory Affairs to submit a new petition for autism to the Medical Marihuana Review Panel. It was submitted on behalf of a woman named Lisa Smith for her son Noah, who has severe autism:

Lisa Smith says her son’s behavior was dangerous: hair pulling, kicks, punches, all related to a severe form of autism. But it began to change more than a year ago when he was given daily oral doses of oil extracted from marijuana.

“That’s all stopped. He’s more focused, he’s calmer,” Smith said of 6-year-old Noah. “He sleeps better through the night. He has a better appetite. You can tell he’s growing, gaining weight.”

Another parent who features in several of the news stories about this issue is Dwight Zahringer:

Dwight and Ixchel Zahringer’s son Brunello is going on 4 but has yet to speak. Last fall, his parents heard the chilling diagnosis — autism.

“We’ve had a hard, fast education in this for the last nine months,” Dwight Zahringer said. “Think of it like always being at a rock concert — everything really loud — and then you’re trying to have conversations or focus on things but you can’t because everything is overwhelming,” he said.

The dealings with health professionals form a familiar tale — advice to use powerful prescription drugs that are costly and may have worrisome side effects, the failure to see that those drugs are helping and the decision to stop them.

The Zahringers have thus far been disappointed with the progress their son Brunello has made with conventional therapy, such as Applied Behavioral Analysis. Seeking faster progress, they found medical marijuana and latched on to it for hope:

“We’ve been watching a lot of videos, a lot of documentaries, and we’ve seen proof that it can help,” said Ixchel Zahringer.

“One family had a kid who was very severe” with autism symptoms, “and they started giving him some of that (cannabis) oil, and they saw the child calming down.”

Dwight Zahringer came to his belief that he needs medical marijuana for his Brunello the same way that many in the autism biomed movement come to the conclusion that their child needs, for example, MMS. He pored over Internet sites and marijuana-themed literature, which convinced him that he needed to try cannabis on his son ASAP. He started using hemp oil, which apparently gets around the state’s current ban on treating autism with marijuana, but really wants the real thing. Parents like the Zahringers and Lisa Smith are clearly loving parents who want the best for their children, just as most parents who fall for “autism biomed” quackery love their children and want the best for them. Unfortunately, as we have seen and will see, the pro-cannabis literature and websites that tout cannabis as a treatment for autism provide a very biased and cherry-picked view of the medical literature.

Cannabis for autism: The evidence (or, more correctly, the lack thereof)

Perusing the news reports on the vote of the Michigan Medical Marijuana Review Panel, one point I’ve seen is that the reason why this vote came down in favor of adding severe autism to the list of qualifying conditions and the vote in 2013 did not is because the science was so much better described in the petition this time around. Indeed, advocates tout having bolstered the petition with “over 75 peer reviewed articles with over 800 pages of research on the issue of cannabis as a viable option for the treatment of autism” in addition to the “nineteen families, as well as physicians from MI and around the country.” Apparently, two advocates had a major hand in picking these articles:

The individuals who navigated the deepest into the science behind Autism’s riddling labyrinth of theories are without doubt Joe Stone and Dr. Christian Bogner. They were able to provide peer reviewed evidence that cannabis not only has the potential to provide palliative relief of symptoms related to autism, but may also have the potential to target the underlying causes of autism itself.

Note that nowhere in this report is mentioned evidence from well-designed clinical trials. In any event, I could not find the exact petition text, but there is a MoveOn.org petition to add autism to the list of qualifying conditions for medical marijuana in Michigan posted by Joe Stone and signed by Dr. Christian Bogner, Chad Carr, Dr. Harry Chugani, M.D., Dr. Lester Grinspoon, Michael A. Komorn, and Joe Stone. At the end, it lists links to research, specifically a paper written by Stone and Bogner that, one notes, was published online on the Cannabis for Autism blog rather than in a peer-reviewed medical journal, entitled “The Endocannabinoid System as it Relates to Autism“. This paper is also available on Scribd, with a complete list of references. It is clear to me that this discussion, along with its references, was the basis of the science presented to the panel.

Before I address this paper, which appears to be the best evidence advocates can put forward, let me just refer you to a good solid analysis of the state of the evidence for cannabis for neurological disorders by Skeptical Raptor. You can read the whole thing if interested, but the point I want to emphasize is that there is weak evidence that cannabis could be useful for epilepsy, as I discussed in my first post on this topic, but that a Cochrane review concluded that high quality evidence was insufficient to recommend it. There is also some evidence for the use of medical marijuana for spasticity and pain. The reason that this is relevant is because advocates for using medical marijuana for autism frequently point to cases where cannabis is used to control seizures, which many autistic children suffer from. This is a separate issue than whether cannabis is specifically therapeutic in autism, but the two issues are often conflated.

Sadly, Stone and Bogner’s “paper” is one of the most blatant examples of cherry-picked research I’ve seen in a long time, and that’s saying something. Indeed, plowing through the list and looking up key papers was a tediously predictable endeavor. Basically, Stone and Bogner take papers that look at some aspect of cannabinoid function, whether it’s about autism or not, and extrapolate to autism. Let’s take a look at their most convincing piece of evidence first (to me, at least). In this case, by “most convincing,” I mean least unconvincing:

“Rare mutations in neuroligins and nerexins predispose to autism” (Földy 2013). Neuroligin-3 is the only known protein required for tonic secretion of endocannabinoids that include AEA and 2-AG (Földy 2013). Neuroligin-3 mutations have been shown to inhibit tonic endocannabinoid secretion (Földy 2013). These alterations in endocannabinoid signaling may contribute to autism pathophysiology (Földy 2013, Krueger 2013, Onaivi 2011, Siniscalco 2013). These finding have in part prompted researchers to apply to conduct research with nonhuman primates in order to further elucidate this link (Malcher-Lopes 2013).

Endocannabinoid system deficiencies are suggested to be involved in the pathophysiology of a growing number of diseases (Marco 2012, Russo 2003). Pacher and Pertwee both cover the endocannabinoid system in detail (Pacher 2006, Pertwee 2010). The number of functions that endocannabinoid signaling regulate in the human body is extensive and beyond the scope of this paper (Pertwee 2010). For sake of brevity only a few potentially relevant aspects will be listed:

So what are these elements? Basically, Stone and Bogner cite a whole bunch of papers supporting the conclusions that endocannabinoids:

  • Modulate synaptic function
  • Regulate GI functions
  • Suppress proliferation and cytokine release in the central nervous system (CNS)
  • Regulate stress responses
  • Increase cerebral blood flow
  • Modulate neural and glial cell function

…you get the idea. So, yes, cannabinoids are important molecules in the CNS and elsewhere. No one argues against that. It’s also true that it was recently shown that mutations in neuroligins and nerexins appear to predispose children to autism and that neuroligin-3 mutations inhibit endocannabinoid secretion, suggesting that bolstering endocannabinoid secretion might antagonize or reverse the abnormalities associated with such mutations. (A decent overview of this research suitable for a lay person can be found here, and the original paper is here.) Let’s just put it this way. This is a rodent model, and right there it’s a question of how relevant it is to real, human ASDs. This is very preclinical evidence, meaning that it might or might not turn out to be relevant to human ASDs. At best, it justifies further study. Moreover, the primate model referenced in Stone and Bogner’s paper appears to be merely a proposal presented to a conference in Qatar. This is thin gruel indeed, as a recent review article on medical marijuana published in the Journal of Developmental & Behavioral Pediatrics by Hadland et al. points out:

Many advocates cite scientific literature regarding benefits of cannabis for the treatment of pediatric behavioral conditions, but often, data cited are from animal model-based research that does not yet have translation to human subjects. For example, a 2013 study 80 from Stanford University showed that mice with a specific and rare gene mutation linked to autism showed altered endocannabinoid signaling in the central nervous system. These data were then cited by online and print media supporters of medical marijuana (e.g., the High Times 81) as evidence that cannabis could be used as a treatment for autism. As another example, when another recent study 72 based on a mouse model of Fragile X syndrome (described earlier in this review) showed alterations in endocannabinoid signaling pathways, these data were referenced (in this case, by more mainstream media outlets, such as the Huffington Post 8 and Fox News 82) as evidence for a promising role for cannabis as treatment. Although these and other high-impact studies share important insights into the pathogenesis of autism spectrum disorders (ASD) and Fragile X syndrome, based on their results alone, it is erroneous and potentially harmful to conclude that cannabis should be used as treatment for either of these disorders at this time.

Indeed. Not surprisingly, Stone and Bogner’s article references that very same study on Fragile X syndrome as well. Much of the rest of their article boils down to the list I enumerated above plus other correlations, their arguments reduced to, in essence, this:

  1. The endocannabinoid system is important in [insert important CNS function or signaling pathway here] in preclinical cell culture and animal models.
  2. Autism and ASDs involve abnormalities of this important CNS function or signaling pathway.
  3. Ergo, cannabinoids can be used to treat autism and ASDs.
  4. Q.E.D.

In other words, there’s a whole lot of confusing correlation with causation and assuming pathogenesis when what is being observed might just be an epiphenomenon. There might be a direct role for these correlations in causing autism, and some of the signaling pathways might even represent promising targets, including the endocannabinoid pathway or a subset of it. Stone and Bogner go wrong by assuming all of these studies indicate a critical role for endocannabinoids in autism, such as elevated cytokine levels. For instance, take a look at this list of effects of cannabidiol (CBD):

  • CB1/CB2 agonist blocker (can inhibit overstimulation of CB1 by THC)
  • FAAH inhibition increases endocannabinoid levels (including AEA, 2-AG)
  • AEA reuptake inhibitor
  • 5-HT1a agonist
  • Suppressor of tryptophan degradation
  • PPAR alpha and gamma agonist Positive allosteric modulator at glycine receptors
  • TRPV1 and TRPV2 agonist
  • Adenosine uptake competitive inhibitor
  • Antagonist at abnormal-CBD receptor
  • Regulator of intracellular Ca 2+ T-type Ca 2+ channel inhibitor (Izzo 2009)

This is a wide range of effects, some of which could be relevant to autism/ASD. The problem, of course, is that we don’t know which ones are the most relevant and which ones actually involve promising therapeutic targets for intervention.

Extrapolate, extrapolate, extrapolate!

Whenever writing a research paper that is basic science that could potentially be translated into a treatment for a disease, it is generally considered mandatory to speculate at the end just how this could come about. For instance, when scientists write about cannabinoids in the context of models of neurodevelopmental disorders, after all the basic science, cell culture, and animal model work, naturally they try to describe how their results could be pursued so that they translate into a clinical treatment. It’s known as showing clinical relevance to your findings, no matter how basic science they are. Stone and Bogner quote several of these sorts of speculative statements in the discussion or introduction of papers as though they were Gospel truth, then conclude:

Given the known role of the endocannabinoid system in ASD it seems entirely possible, if not likely, that cannabinoid rich botanical extracts from cannabis can be utilized as useful agents targeting the pathophysiology of ASD, as well as the many debilitating symptoms and conditions associated with it. The wealth of options that cannabis has to offer those that suffer from ASD in MI is not currently legally permitted. We believe that needs to change.

As I said before, Q.E.D. (Yes, that’s sarcasm.)

Where’s the beef (i.e., the clinical evidence)?

What all these 75 references really mean is that there is some correlative evidence that the endocannabinoid system is abnormal in autism. However, it’s not at all clear whether these abnormalities are causative or downstream effects from the true cause or causes, whatever they might be. What this evidence means is that it’s probably worthwhile to study the endocannibinoid system in autism and whether modulating its activity can have an effect on autistic symptoms. What it most definitely isn’t is compelling evidence to authorize any doctor in the state who wants to do so to use cannabis oil to treat autism. Yes, because the law states two doctors have to sign off for use of medical marijuana in children, parents will have to find two doctors, but, really, does anyone think that will be very difficult?

To recommend a treatment for general use, we need high quality clinical evidence. Is there any such evidence for cannabis oil for autism? The answer is a resounding and unequivocal no. Indeed, an excellent indication of the paucity of evidence regarding cannabis oil and autism is the way Stone and Bogner dance around the issue by citing anecdotal reports about the use of cannabis oil and cannabinoids to treat epilepsy:

How can combinations of cannabinoids be put into practical use by individual families? For our purposes let’s review the anecdotal reports of cannabinoid based treatments currently being utilized in MI (and around the world) for pediatric epilepsy. I think this is a good comparison due to the range and complexity of both conditions. CBD continues to prove its effectiveness in treating many types of epilepsy, but not all (Porter 2013). Anecdotal reports provided in online groups with families that share dosing and other related information to cannabinoid based pediatric epilepsy treatments reveal that in many cases parents (and physicians) find that an increased ratio of THC is required to increase the efficacy of treatment. The range seems to vary significantly from 24:1 to 1:1 (CBD:THC). Some partial explanations for this might include the ability of THC to increase GABAergic transmissions via CB1 activation, its modulation of ion channels, and that it’s a PPAR gamma agonist which is neuroprotective in epilepsy (Stone 2014).

Due to the range of ASD it seems possible that, similar to cannabinoid based epilepsy treatments, varying ratios of cannabinoids (specifically CBD:THC) will prove to have a greater efficacy overall when compared to individual cannabinoid based treatments (like Dronobinal). This concept has been further supported by the research and clinical use of Sativex, a 1:1 (CBD:THC) botanical extract marketed for use in a range of treatments throughout the world (Hazekamp 2013, Russo 2006). The ability to specifically tailor cannabinoid ratios in botanical extracts from cannabis in a case specific manner may prove an even greater efficacy.

This is nothing more than handwaving, comparing two different conditions and assuming that what is observed in one condition will apply to another condition. Worse, as Skeptical Raptor reminds us, despite these anecdotal reports of benefit due to cannabinoids or cannabis oil in epilepsy, a recent Cochrane Review concludes that “no reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy.” In other words, there’s no high quality evidence that cannabinoids are efficacious in treating epilepsy. There’s even less evidence that cannabinoids can be used to treat autism. Indeed, as the aforementioned review by Hadland et al. notes:

Regarding human data on use of cannabis for developmental and behavioral conditions, to the best of our knowledge, the only available data are from small case series or single studies. For example, one 6-year-old boy with autism was treated with daily dronabinol for 6 months and was noted to have improvement in hyperactivity, irritability, lethargy, stereotyped behaviors, and speech, as measured by the Aberrant Behavior Checklist.83 This single case study was uncontrolled and unblinded. In another single case study 84 of a cannabis-using adult male with attention-deficit hyperactivity disorder (ADHD) off stimulants, the subject’s driving skills in a simulated test during a time of abstinence improved after smoking marijuana (What is unclear is whether this subject may have actually been experiencing cannabis withdrawal from his abstinence, with alleviation of his symptoms through subsequent use of marijuana.85). Another small case series 86 showed an improvement in self-injurious behaviors among adolescents after dronabinol therapy, but to date, the study has not been published, leaving protocol details scarce. In sum, none of these studies provides sufficient, high-quality data to suggest that cannabis should be recommended for treatment of ASD or ADHD at this time.

And neither does Stone and Bogner’s analysis, which was the basis of the evidence submitted with the petition to the Michigan Medical Marijuana Review Board to add autism as a qualifying condition for medical marijuana treatment. Their analysis is the very definition of cherry picking studies and extrapolating wildly from preclinical cell culture and animal studies and studies that address other conditions to conclude that cannabinoids are efficacious treating autism, while ignoring the dearth of evidence that counts: Actual clinical trial evidence. As the Cochrane review I cited pointed out, there were four randomized trials including a total of 48 patients using cannabinoids to treat autism. One report was just an abstract; another a letter to the editor. None of the trials provided randomization details, and there was no description of whether the control and treatment groups were equivalent. The studies were thus of incredibly low quality. All there are, are a handful of uninformative single patient case reports like this one.

Yet, when this this incredibly thin gruel was combined with emotional testimonials of distraught parents of severely autistic children, it was the emotional testimonials of distraught parents that won out. There isn’t another drug for which the FDA or a state would give doctors the go-ahead to use to treat humans for conditions like autism or cancer based on such slim to nonexistent evidence.

Approving the use of cannabis oil for autism: “Premature” doesn’t even begin to describe it

There is no doubt that the approval of medical marijuana for various medical conditions is driven far more by politics than science or clinical observations. For no condition is that more true than autism, for which even the anecdotal evidence is weaker than it is for other qualifying conditions such as chemotherapy-induced nausea, chronic pain, and epilepsy. Moreover, in this case, the Michigan Medical Marijuana Review Panel abdicated its responsibility to interpret existing science with respect to medical marijuana and autism. It is a travesty that the panel could take the cherry picked list of studies annotated with unjustified extrapolation of preclinical studies and conclude that there was a compelling case for adding autism to the list of qualifying conditions. The panel failed even to require that only relevant specialists, such as pediatric neurologists, be allowed to prescribe cannabis oil for autism and instead let any licensed physician (OK, two licensed physicians) do it. Worse, these physicians don’t even have to monitor how often or how much is given to an autistic child for whom they prescribe medical marijuana. They can leave it all up to the parents, the vast majority of whom have no medical training.

This lack of oversight is a big deal because, contrary to what medical marijuana advocates claim, science still doesn’t have a good understanding of what the long term effects of chronic daily cannabis use are on the developing brain. We do know that teenagers who were found to be dependent on marijuana before age 18 and continued using it into adulthood lose IQ points. One can argue that IQ is a poor surrogate for intelligence, but nonetheless such findings are worrisome. We do know that marijuana use is associated with abnormalities in the brain in young users in an exposure-dependent manner. There are other potential adverse health effects as well. In any decision to use a drug, there is a risk-benefit analysis, and thus far in autism there’s almost no evidence for benefit and troubling evidence of risk when cannabis is used long term in children.

Fortunately, the recommendation of the Michigan Medical Marijuana Review Board is not binding. That recommendation will now go to Mike Zimmer, director of the Michigan Department of Licensing and Regulatory Affairs. He will have the final say over whether autism is added to the list of qualifying conditions. We in Michigan can only hope he realizes what a massive mistake the review board made and overrules their recommendation. Although new evidence might change this in the future, at present, medical marijuana for autism is unscientific herbalism, not pharmacognosy, and has no place in science-based medicine or state policy.

Comments

  1. #1 Frank Collette
    August 10, 2015

    Alain
    ‘we features 23% more neurons’
    All of we? I thought everyone had 21% more.
    http://www.windeaters.co.nz/assets/articles/education/Heavy-Metal-Toxicity-and-ADHD.pdf
    Many more studies show autistics to have heavy metal toxicity too, just google!

    Herr Doktor
    ‘If removing amalgam gives you mercury poisoning then you are doing it wrong.’
    Completely wrong Doc. Ask any biological dentist before you comment.

    If one doesnt want an elephant in ones kitchen, dont make friends with an elephant trainer.

    Hey I’m off, too much unscientific and money grubbing bollocks here for me.
    Peace and happiness to you all.

    PS Please dont sue me Alain, I was not cursing, really I wasn’t. Just cussing….. it was my dyslexia.

  2. #2 Not a Troll
    August 10, 2015

    “…winning a gold star for the most voluminous post-scan urine sample ever in the PET lab..”

    That sounds painful (and gives me visions of Austin Powers).

    I hope they reimbursed you well.

  3. #3 zebra
    August 10, 2015

    Orac 185,

    And what would convince you “that it is safe for long term use in children“?

    This has nothing to do with whether any evidence exists for benefit– it’s about your claim of being scientific.

    Tell us what would constitute an ethical, valid, clinical trial, that would establish “safe for long term use in children”.

    You claim expertise in this area; it should be an easy exercise.

  4. #4 gaist
    August 10, 2015

    And what would convince you “that it is safe for long term use in children“?

    This has nothing to do with whether any evidence exists for benefit– it’s about your claim of being scientific.

    Tell us what would constitute an ethical, valid, clinical trial, that would establish “safe for long term use in children”.

    You claim expertise in this area; it should be an easy exercise.

    You want an ethical study on children for a substance without prior evidence of efficacy?

    It’s glad to know some things in life remain the same, even if it zebra’s lack of understanding.

  5. #5 Narad
    August 10, 2015

    zebra
    August 10, 2015

    Orac 185,

    ObInman.

    Keith Bell was the most recent exemplar, right?

  6. #6 Not a Troll
    August 10, 2015

    Ok, you all win. Running fMRIs are hella expensive, and those researchers with small sample sizes are acting like business people.

    http://neurochambers.blogspot.com/2014/01/tough-love-for-fmri-questions-and.html

  7. #7 herr doktor bimler
    August 10, 2015

    Completely wrong Doc. Ask any biological dentist before you comment.

    I deal only with robot dentists, which can be programmed not to talk.
    Reading the strange emissions from “biological dentists” puts me in mind of the mystical doctrines of the philosopher-dentist R. King Dri in Mathew’s novel “Tlooth”.

    Walter James Palmer, DDS […] specialized in cosmetic and mercury-free dentistry and amalgam removal.
    Ah, no wonder he has acquired so much money to travel around the world slaughtering megafauna. I did not realise that he he was aboard the mercury scamwagon.

  8. #8 herr doktor bimler
    August 10, 2015

    Running fMRIs are hella expensive, and those researchers with small sample sizes are acting like business people.

    I get the impression that the pressure to publish is even greater in neuroimaging than in other fields of research. Once the university have coughed up the money for a new 8-T scanner they want to see results right now.

    Does anyone compile comparative rankings of research fields, to see which ones produce the greatest proportion of publications that are never replicated and never formally retracted and just fade quietly into oblivion?

  9. #9 Lighthorse
    August 10, 2015

    Two other fMRI studies suggesting “diminished capacity for detecting errors” in cannabis users:

    http://www.ncbi.nlm.nih.gov/pubmed/19553917

    http://www.ncbi.nlm.nih.gov/pubmed/15795138

  10. #10 zebra
    August 10, 2015

    #208

    http://www.ncbi.nlm.nih.gov/pubmed/22592735

    Face it, your fearless leader is not such an expert as he claims. Good at repeating “but bleach” and “but woo”, though.

  11. #11 MI Dawn
    August 10, 2015

    @zebra 214: and this shows safety how? Given the adverse effects, I’m not convinced.

  12. #12 zebra
    August 10, 2015

    #215

    ????

    Where did I say this shows safety?

    I think you are not following the comments I was just making.

  13. #13 Esther Knight
    August 10, 2015

    Surely no one is seriously suggesting that aripiprozole is less harmful than Bedrocan? Or Bediol?

    Does Europe Exist?

  14. #14 Not a Troll
    August 10, 2015

    @ Lighthorse #191, #213.

    Thank you!

  15. #15 Mephistopheles O'Brien
    August 10, 2015

    It sounds like Zebra is asking for a study design which would determine whether a drug is safe for use in children, assuming efficacy is already established. Said design would need to be ethically acceptable, provide conclusive safety evidence, and deal with long term effects.

    As someone who has no experience with developing medical study designs, I’m going to leave it there.

  16. #16 Mephistopheles O'Brien
    August 10, 2015

    Does Europe Exist?

    Last time I looked it did. I don’t have direct evidence for the last several months, though.

  17. #17 Mephistopheles O'Brien
    August 10, 2015

    I’m guessing that #216 is meant to say “hey, look, evidence that cannabis helps autistic symptoms. Where are your mad pubmed and research skills now, monkey boy?”

  18. #18 Esther Knight
    August 10, 2015

    http://www.telegraph.co.uk/finance/newsbysector/pharmaceuticalsandchemicals/11333378/Cannabis-based-drug-makers-cancer-treatment-disappoints.html

    ‘Mr Gover said the company would start research programmes into further targets in the course of the year. He told the Telegraph last month that GW would investigate whether a cannabis-based medicine could be used to treat severe autism.’

  19. #19 Krebiozen
    August 10, 2015

    Mephistopheles O’Brien,

    Does Europe Exist?
    Last time I looked it did. I don’t have direct evidence for the last several months, though.

    Part of it is visible as I type this which may or may not be helpful depending on your philosophical bent.

    I’m guessing that #216 is meant to say “hey, look, evidence that cannabis helps autistic symptoms. Where are your mad pubmed and research skills now, monkey boy?”

    Your guess is as good as any. I have given up on trying to decipher zebra and his superior communication skills. He seems to think a succession of people failing to understand his blather while he accuses them of stupidity constitutes “a very interesting discussion all around”. I don’t.

  20. #20 Mephistopheles O'Brien
    August 10, 2015

    @Esther Knight – I look forward to the results of their trials.

  21. #21 Esther Knight
    August 10, 2015

    @Mephistopheles O’Brien – Yes, and while we wait can someone please explain what drove such a serious pharmaceutical company to make such an announcement?

    Was it the pseudo-science or was it the anecdotes that persuaded GW pharma to back cannabinoids for autism in the Telegraph?

  22. #22 Narad
    August 10, 2015

    Yes, and while we wait can someone please explain what drove such a serious pharmaceutical company [sic] to make such an announcement?

    The failure of their cannabis-based product for cancer pain in a Phase 3 trial?

  23. #23 Mephistopheles O'Brien
    August 10, 2015

    Was it the pseudo-science or was it the anecdotes that persuaded GW pharma to back cannabinoids for autism in the Telegraph?

    Presumably they think they have something. On the other hand, they thought they had something with their cancer pain drug as well, and this was not proved in their trial (though they remain hopeful and believe in their product). The company, GW Pharmaceuticals, seems dedicated to creating and selling drugs derived from cannabis. They currently have one product approved for use in 27 countries. I’m sure they want more, since one product is hardly enough for a company to be profitable with.

    Lots of companies start testing drugs they believe in strongly due to preliminary research (or folklore). Not all prove useful, at least not at first. See Resveratrol for an example.

  24. #24 herr doktor bimler
    August 10, 2015

    Was it the pseudo-science or was it the anecdotes that persuaded GW pharma to back cannabinoids for autism in the Telegraph?

    They have invested a lot of money in that solution so now they will work their way through the list of potential problems..

  25. #25 Esther Knight
    August 10, 2015

    I don’t think GW would risk huge amounts of shareholder’s money if the ‘pseudoscience and anecdotes’ route get laughed at on an important forum like this.
    They must know more, or have done more?
    Could they have given some cannabis to some autistic people already?
    How does it work in the UK? Does anyone know?

  26. #26 Lighthorse
    August 10, 2015

    @Esther Knight #225

    I would hardly say that GW is “backing” cannabis for severe autism; only that they plan to examine the potential for any possibility of its treatment with one or another of their products.

  27. #27 herr doktor bimler
    August 10, 2015

    I don’t think GW would risk huge amounts of shareholder’s money if the ‘pseudoscience and anecdotes’ route get laughed at on an important forum like this.
    They must know more, or have done more?

    Call me a hater, but I do not share this blithe faith in the altruistic motivations of the pharmaceutical industry.

  28. #28 Chris
    August 10, 2015

    If there is one thing this thread has done, it has revealed how cannabis affects thought processes.

  29. #29 Esther Knight
    August 10, 2015

    Chris that is a very unscientific thing to say (#232)
    There is no evidence that anyone here has been using cannabis.
    Stick to your own rules or don’t complain when others break them.

  30. #30 Mephistopheles O'Brien
    August 10, 2015

    @Esther Knight – you said above “Adults with autism who use cannabis: There are xillions* of us”. Common usage would mean that you include yourself in the group of adults with autism who use cannabis. That’s not science, but it is at odds with your statement that “There is no evidence that anyone here has been using cannabis.”

  31. #31 Chris
    August 10, 2015

    Poor Ms. Knight, she now knows how seriously I take her incoherent statements. Also my observation was about more than one person.

  32. #32 Esther Knight
    August 10, 2015

    OK so my self-reported anecdote is a start.
    How about those thought processes? How are they affected?

    Am I autistic? What if I was misdiagnosed? What if I have an undiagnosed thought disorder?

    Basically, let’s stick to one set of standards and point out the hypocrisy along the way?

  33. #33 Esther Knight
    August 10, 2015

    Sorry Chris but as far as I can tell, Zebra has been taking something I’ve never heard of and Frank is on something a bit stronger than weed.
    That only leaves me. I don’t know what those others are doing here, I really don’t.

  34. #34 herr doktor bimler
    August 10, 2015

    Frank is on something a bit stronger than weed.

    Crank magnetism is one helluva drug.

  35. #35 Mephistopheles O'Brien
    August 10, 2015

    I had a stoner roommate in college for a month. He got pretty incomprehensible at times, though so far as I know he was doing OK in his classes (but then, the first two semesters were all pass/no credit).

  36. #36 Chris
    August 10, 2015

    I have a friend who grew up in the sixties/seventies. Her parents were “cool” and had parties where they smoked pot. They would talk and talk, and they would think themselves quite brilliant, especially how they would make the world better.

    Even when she was very young she thought they were talking nonsense. So she decided to stay away from marijuana.

  37. #37 Esther Knight
    August 10, 2015

    Ok but the friends we have growing up or in college are not completely selected at random. Birds of a feather…

  38. #38 herr doktor bimler
    August 10, 2015

    Even when she was very young she thought they were talking nonsense. So she decided to stay away from marijuana.

    A similar reason lies behind the Doktorling Sonja’s decision to abstain from beer.

  39. #39 Chris
    August 10, 2015

    hdb: “A similar reason lies behind the Doktorling Sonja’s decision to abstain from beer.”

    Were you providing the example? Youngest child has also made the decision to abstain from alcohol, similar reasons. She has also decided to never have children, as she sees what happens to people when they become parents.

  40. #40 Not a Troll
    August 10, 2015

    Well, to share in the manner of the crazy/drug (ab)use boards, SWIM takes modafinil and 5-htp as needed.

    Modafinil, yes, the “smart” drug. Except (n=1) if you really need it, it doesn’t make you smart; it barely gets you passing as a functioning human being while also keeping you from falling asleep at the wheel.

    But SWIM tells me that taking it as needed is always a gamble since you need to take it in the morning before you know how bad your day is going to be. In addition, it has an inexplicable half life that allows sleep 4 hours after taking it on some days and other days it is more like 17 hours. One never knows how long one will be awake after taking. Also, it causes bruxism on some days but not on others. [And, it costs around $400/month, probably because the military is competing with you for the same drug, but who knows.]

    The 5-htp is for deep sleep and provides vivid (but luckily, most often comical dreams). How? I have no idea. SWIM generally keeps that on the low-down because it sounds crazy.

    Note: Both are legal for SWIM to use. Do not try this at home without a Rx and/or consult with your doctor.

  41. #41 herr doktor bimler
    August 10, 2015

    Were you providing the example?

    “If you can’t be a good role model, aim to be a bad example.”

  42. #42 Roger Kulp
    August 10, 2015

    Esther Knight

    Would you care to elaborate what you believe the risks of ABA are?I know there are a lot of parents who swear by it,and say it helped their child greatly,but I have seen just as many stories of parents who say ABA did nothing for their child one way or another.So what are the risks you see?But please,spare me the usual neurodiverse BS about how treating the autism would take away your individuality,and erase who you are as a person.

  43. #43 JP
    August 10, 2015

    The 5-htp is for deep sleep and provides vivid (but luckily, most often comical dreams). How? I have no idea. SWIM generally keeps that on the low-down because it sounds crazy.

    It’s a serotonin thing. I’m on 150 mg of Zoloft right now, up from 100 mg a week ago and on the way to 200 in a week. I’ve started having the long, involved, vivid and memorable dreams again that I remember from the last time I was on an SSRI. Last night I had a dream about diving for treasure, except when I got to where the treasure was, it was a purple dragon plushie with comically small wings. The great thing is that I was not disappointed, as this dragon was very important and meaningful for reasons I cannot explain in a waking state.

    I know about the 5-htp because I once bought some as a sleep aid, and found out serendipitously just before taking it that it shouldn’t be taken if you are taking an SSRI, as it can cause serotonin syndrome.

    The Zoloft actually is causing some bruxism as well, but them’s the shakes, I guess. With any luck it’ll pass.

  44. #44 JP
    August 10, 2015

    A similar reason lies behind the Doktorling Sonja’s decision to abstain from beer.

    I haven’t had a drink in days, so now I am having two, because I’ve decided that’s how it works.

  45. #45 Denice Walter
    August 10, 2015

    @ JP:

    I had rater disappointing results with 5-htp and melatonin
    ( separately) for sleep.

    Treasure and a plushie purple dragon? Did he sound like Mr Cumberbatch?

  46. #46 Denice Walter
    August 10, 2015

    RATHER disappointing

  47. #47 JP
    August 10, 2015

    Treasure and a plushie purple dragon? Did he sound like Mr Cumberbatch?

    Nope, it was mute; literally a toy stuffed animal. Search me.

  48. #48 Not a Troll
    August 10, 2015

    JP,

    I’m happy to hear that you’re having enjoyable dreams, and good advice on the 5-htp interaction with SSRIs.

    Btw, you made my night. You’re the first person to ever know what I’m talking about with the dreams. All I have ever read about (or heard about from my friends) have been the nightmares.

    On that note, it’s past time for bed on this coast. Perhaps I will run across your purple dragon plushie tonight.

    Pleasant dreams….

    (Note: Earlier I meant to write ‘”on the down-low” not “on the low-down”. I do know the difference. Grrr.)

  49. #49 JP
    August 11, 2015

    I’m happy to hear that you’re having enjoyable dreams, and good advice on the 5-htp interaction with SSRIs.

    Btw, you made my night. You’re the first person to ever know what I’m talking about with the dreams. All I have ever read about (or heard about from my friends) have been the nightmares.

    Oh, I’ve had some of the nightmares too, and they were truly awful. I only had them was when I was on Lexapro, if memory serves. Just really, really f*cked up dreams. There’s one in particular that’s seared into my consciousness forever, but I am not going to relate what happened here.

    So far so good with the sertraline, though.

  50. #50 Esther Knight
    August 11, 2015

    Roger I would love to oblige but why reinvent the wheel? TGPA on facebook seem to have it covered already – https://www.facebook.com/thinkingpersonsguidetoautism/posts/367470526627614

    Let’s talk about the risks of the neurodiversity movement!

  51. #51 Harobed
    Australia
    August 11, 2015

    I often wonder about the rights of all children. Whether it is bleach enemas or the effects of marijuana on young brains, the rights of these children are being abused. Using untried woo does not help children who have autism. It is a bit like saying that “my child is not learning quick enough at school, maybe I should try marijuana so he can know everything at six years of age”. Use of standard applied behavioural analysis may not work instantly, but it can have long lasting good effects. Marijauna can have terrible effects on the adult brain, never mind on the brains of children aged three or four.
    at 6 years of age”

  52. #52 Esther Knight
    August 11, 2015

    Here in the UK we have somehow managed to approve riperidone for autistic children, despite the risks.

    Is anyone here seriously suggesting that it’s safer to give a child risperidone over cannabinoids?

    http://sfari.org/news-and-opinion/news/2014/risperidone-use-in-children-with-autism-carries-heavy-risks

  53. #53 Garou
    Québec, Canada
    August 11, 2015

    @esther knight

    From your article: ”More worrisome, however, are the side effects, the most significant of which is weight gain from an increased appetite.”

    Because that doesn’t happen with marijuana, right?

  54. #54 Esther Knight
    August 11, 2015

    @Garou you’d think so but paradoxically no.
    Long term cannabis users are less likely to be obese.
    These are, however, self-selecting recreational users.
    We might see a different effect in a clinical population?
    We won’t know until we allow it as long term medicine for a large enough population to study.

  55. #55 Cruz
    August 12, 2015

    http://www.icsdp.org/cannabis_claims

    Seems like you could really use some real science. The link above will help you see that your points on MJ impairing IQ or damaging the brain in general are based on very bad science.

  56. #56 Oughtism
    Melbourne, Australia
    August 13, 2015

    What the writer of this article fails to understand is that the marijuana will not be used to treat the core symptoms of autism, but to help alleviate some of the severe co-occurring challenging behaviours that cause pain and great suffering to both the child who is seriously impaired by autism and his or her family or care givers.

    • #57 Orac
      August 13, 2015

      Oh, I understand that quite well. I argue that there’s no good evidence that cannabis can do that either, because there isn’t.

  57. #58 Esther Knight
    August 15, 2015

    @Oughtism you fail to understand that some of us have autism with no co-morbidities and we are using cannabis to reduce symptoms of autism.

  58. #59 Esther Knight
    August 15, 2015

    Orac if you were to design a trial of cannabinoid treatment for autism, which co-morbidities (if any) would you exclude?

  59. #60 Festus
    August 16, 2015

    #263
    ‘some of us have autism with no co-morbidities’

    Impossible!

  60. #61 DdC
    CA
    August 16, 2015

    Access to drug comes at high price
    http://nzh.tw/11379959
    Jade Guest’s life has changed since she has been able to access medical marijuana in Colorado to treat her severe epilepsy, but it meant her family just spent their first Christmas separated.

    Marijuana Stops Child’s Severe Seizures
    http://endingcannabisprohibition.yuku.com/sreply/667

    New York Nine Year Old Girl With Dravet Syndrome
    Dies Without Medical Marijuana
    http://endingcannabisprohibition.yuku.com/sreply/881
    Some things you should know about seizures
    http://endingcannabisprohibition.yuku.com/sreply/891

    Cannabis For Autism & Seizures.
    http://endingcannabisprohibition.yuku.com/sreply/855

  61. #62 Not a Troll
    August 17, 2015
  62. #63 Not a Troll
    August 17, 2015

    ^ Follow-up to my link above.

    It looks like the Medical Innovations Bill (Saatchi Bill) has been revised to be the Access to Medical Treatments (Innovation) Bill. that is claimed to disallow the use of ‘quackology’.

  63. #64 Esther Knight
    August 19, 2015

    There appears to be a war, on Facebook.
    The cannabis for autism page and some anti-vaxxers appear to be at war.

    facebook.com/CFourA/reviews

  64. #65 Roger Kulp
    August 19, 2015

    @ Esther Knight

    you fail to understand that some of us have autism with no co-morbidities

    Seriously I do not believe you.

  65. #66 Roger Kulp
    August 19, 2015

    Meanwhile measles is merrily spreading its way across Queensland.

  66. #67 Esther Knight
    August 19, 2015

    Orac, a glaring inaccuracy!
    That Stone & Bognor essay was self-published on Scribe first then, tellingly without comment, simply reproduced on the ‘cannabis for autism’ blog.
    One gets the distinct impression that the blog owner isn’t particularly keen on pseudoscience, albeit possibly vulnerable to it?

  67. #68 Narad
    August 19, 2015

    One gets the distinct impression that the blog owner isn’t particularly keen on pseudoscience, albeit possibly vulnerable to it?

    Julian Pursell is somewhere around the level of Philip Hills.

  68. #69 Esther Knight
    August 19, 2015

    Has Philip Hills not worked for the last five years either?
    Struggling to see any similarity. Help.

  69. #70 Esther Knight
    August 20, 2015

    Got it!
    Julian is a patient who uses exercise as therapy.
    Philiip is a ‘therapist’ who sells woo.

    Level-wise, which is lower?

  70. #71 Garou
    Québec, Canada
    August 20, 2015

    to Cruz #260
    From your study “state of evidence cannabis use and regulation”
    “There are concerns that cannabis use, especially when initiated in adolescence, may lead to various forms of cognitive impairment. For example, a recent Health Canada advertisement flashed “loss of memory” and “learning problems” on the screen (Health Canada, 2014). The U.S. National Institute on Drug Abuse has warned parents that cannabis use “has negative effects on attention, motivation,
    memory, and learning that can persist after the drug’s immediate effects wear off – especially in regular users” (NIDA, 2014). While there is moderate evidence to support a general claim that early-onset and sustained cannabis use is associated with certain cognitive deficits,
    there remain important gaps in our knowledge regarding the full range of effects and their reversibility.”

    So they basically admit that marijuana consumption impairs cognitive function (which is kind of obvious), but hey, it might be reversible! We don’t know exactly to which extent you’re impaired!
    I’d tend to agree that the effects are reversible, having seen people fully recover myself, but we’re talking about children of school age that would be “treated” with marijuana on a regular basis here. Pretty safe bet that it’s not ideal for their success. Not to mention the whole “giving a psychoactive drug to non verbal children that can induce badtrips and other unpleasant experiences.

  71. #72 Esther Knight
    August 21, 2015

    @Garou,Cruz
    If aspects of autism can be described in terms of ‘over-memorising’ and ‘over learning’ then perhaps cannabis is reducing these?

  72. #73 Kaila
    August 23, 2015

    Having a child with autism is truly nothing you can understand unless your child has autism. The whole point of medical marijuana for autistic children is not just calm them down so that they are easier to manage, but to calm them down and center them so that they have the ability to focus and learn that they wouldn’t have otherwise. There are very few “regulated medicines” offered to children with autism and even less that have been proven to work or have any long term benefit. It is absolutely heartbreaking to see your child change from one thing to another almost over night. You do feel alone and hopeless and don’t have any answer to your a million burning questions. While I do think that there should be regulation in doses and frequency, you have to remember that not one autism is the same as any other. A standard dosage and frequency level would not work for every kid, defeating the purpose of legalization. As long as parents are safe, responsible and doing something legal it should not matter to anyone else, especially not someone who has no personal experience and probably watches youtube as a reference.

  73. #74 Mephistopheles O'Brien
    August 23, 2015

    Kaila

    The whole point of medical marijuana for autistic children is not just calm them down so that they are easier to manage, but to calm them down and center them so that they have the ability to focus and learn that they wouldn’t have otherwise.

    Does it work for that? What’s the evidence for that? Thanks.

  74. #75 Garou
    Québec, Canada
    August 23, 2015

    @Kaila #278

    So, are you implying that Orac is watching youtube videos for reference? Maybe you should look up who he is before making these kinds of claims.

    Although nobody doubts that your situation is not an esay one to be in and that you really love your child / children, that doesn’t give you any kind of credentials when it comes to treating them for their autism.

    Having been an extensive user of marijuana a couple years ago, I can tell you it doesn’t rhyme with “focus and learn” as you say. In fact, quite the opposite. The claims on marijuana “curing” or helping with autism are not just unsupported by any kind of evidence or study, they don’t even make sense in the perspective of what the drug does to the user.

  75. #76 Garou
    Québec, Canada
    August 23, 2015

    @Esther knight #277

    Is there such a thing as “over learning”?

  76. #77 Esther Knight
    August 23, 2015

    @Garou

    Yes, the ‘restricted interests’ leads to learning a lot.
    The ‘inappropriate speech’ is when that info gets dumped.

    Whether we fail to learn a lot or avoid infodumping, the goal is not to infodump. What’s the point of learning a lot if you have autism? It’s not like anyone will listen?

    P.S Orac may not be using youtube for evidence but he is using facebook in a cherry-picked way,.

  77. #78 Garou
    Québec, Canada
    August 23, 2015

    @Esther Knight

    By infodump, do you mean speaking with great detail to someone about something you are very knowledgeable about, but the person is not interested in hearing it?

    Even if your “restricted interests” lead you to a lot of knowledge about something that you might not be able to share with many people, that doesn’t mean that knowledge has no value. You can always find people with whom you share interests, especially with internet today.

  78. #79 Esther Knight
    August 24, 2015

    @Garou you’re very kind and I’m sure that happens to some of us but we can’t rely on that for all of us.
    Even now that the beauty of my youth gives way to the wisdom of my old age, not even the guys listen to my dumps.

  79. #80 Alain
    August 24, 2015

    @Garou,Cruz
    If aspects of autism can be described in terms of ‘over-memorising’ and ‘over learning’ then perhaps cannabis is reducing these?

    Esther,

    The only situation where there’s no need for overlearning is in case of PTSD. Now would you please support overlearning for everything else?

    The use-case is when I used to read a book three time in the same amount of days would I remember the text of the entire book _and_ the picture of ALL the pages in said book (and in my case, I used to remember over 1000 books in THAT details before 2004).

    Only reason I no longer remember these books is because I met a few psychopath and ended up with a complex PTSD.

    That kind of memory is incredibly useful in creating a good life for all the number of autistics in the world and I just absolutely can’t figure out why you’d want to deprive them of this ability. And yes, I’m dead serious.

    Alain

  80. #81 Esther Knight
    August 25, 2015

    Alain you are right.

    Being unable to learn the hard stuff I concentrated on the soft stuff instead. So when I met a few psychopaths I didn’t end up with a complex PTSD.

    Essie

  81. […] medical literature suggests that the hype far exceeds any realistic promise. Three weeks ago, I wrote a post likening the use of “medical marijuana” for autism to a form of quackery that I have written […]

  82. #83 Alain
    August 31, 2015

    Esther,

    Please accept my excuses regarding your motives. I failed to consider that your comment did not suggest using cannabis to treat overlearning in all cases.

    That was a reading comprehension failure which is unusual for me because, I usually assume that I’m not understanding what is written unless I worked out all the possibilities of the meaning of your (or anyone else’s written or verbal) statement.

    You can see why I ended up with the complex PTSD; I work out all the implications of what’s being said to me or at me.

    Today, what’s different is that I know what I’m worth and thus, keep the same method of deducting whatever is said to me or about me without it affecting me in any emotional manner.

    Thanks you very much and please have my best regards,

    Alain

  83. #84 Nicoli
    September 30, 2015

    Science, “the systematic knowledge of the physical or material world gained through observation and experimentation.”
    Thousands of people have observed the effects of medical cannabis on medical problems specific to them or their loved ones. Thousands of experimented. Let the voices be heard. Science is not exclusive to scientists who have to wait for funding, grants, approval and pretentious pious politicians and their self-serving agendas.

  84. #85 Bill Price
    October 1, 2015

    Nicoli, science is a bit more than random observations and random “experimentation”. It requires care in determining just what you are observing. “[M]edical problems specific to them or their loved ones” shows a total absence of care in determining just what is being observed.

    “Thousands [have] experimented” with exactly what, under what conditions: what have they actually observed? GFunding and approval embodies the criteria that allows the answers to be medically useful, rather than just random grabs at a sandpile.

  85. #86 Dangerous Bacon
    October 1, 2015

    “Science is not exclusive to scientists”

    Surgery is not exclusive to surgeons.
    Designing buildings and bridges is not exclusive to architects and engineers.
    Police work is not exclusive to police.
    Fighting wars is not exclusive to the military.

    Things tend to turn out better when amateurs recognize their limitations and professionals are allowed to do their jobs

  86. […] Medical Marijuana For Autism And Autism Biomed Quackery (scienceblogs.com) […]

  87. #88 Justin
    Portland
    October 26, 2015

    As a person who has seen DIRECT and IMMEDIATE improvement of severe autistic symptoms, with medical cannabis compounds. I have to say, you’re absolutely wrong. Your arguments do not add up. You cite, “cherry-picked arguments.” All the while, you constantly employ that tactic yourself. Do you care for any autistic children or interact with them daily? Would you care to explain to them, that trying a plant, (not big pharma, which reportedly has you in their pocket,) to treat their soul crushing symptoms, is “premature?” The first search hit for your name describes you as, “The ultimate quack of all time, ORAC from National Geographic funded “ScienceBlogs.com”

    I am very glad that even the weak minded will have a hard time buying into your nonsense.

  88. #89 Chris
    October 26, 2015

    Justin: “As a person who has seen DIRECT and IMMEDIATE improvement of severe autistic symptoms, with medical cannabis compounds.”

    Please get your robust study of the “DIRECT and IMMEDIATE improvement of severe autistic symptoms” with the astounding study size of N=1 published in a PubMed indexed journal, and then come back to astound us with your brilliance.

  89. #90 MI Dawn
    October 26, 2015

    I don’t know what Justin used for search terms, but *I* certainly didn’t come across The first search hit for your name describes you as, “The ultimate quack of all time, ORAC from National Geographic funded “ScienceBlogs.com” as MY first Google hit. Under Orac, there are several references to the Original, a Wikipedia entry about the Hadron Collider, and some references to posts on RI. Nothing on the first page had what Justin found (unless he used quack as one of the search items).

    Under the NSSON, an AOA post does come up on the first page. Even there, however, I am not finding Justin’s search results.

  90. #91 MI Dawn
    October 26, 2015

    Oh, found it. It’s the extremely important Farce*book* page “exposing” Orac with a few words dropped. Justin, didn’t anyone ever tell you that when you quote something, if you drop words you are supposed to use an ellipsis (aka …) to indicate missing words? You fail grammar today.

  91. #92 Alain
    October 26, 2015

    Justin,

    Just what the f*ck are you smoking??

    Which symptoms, care to name any?

    Did you f*ck!ng know that some autistics used cannab!s a few decades ago and left them seriously numb; which trigger a lot of anxiety??

    Yeah, they feel numb and that cause anxiety. Is that what you want?? But hey, they’re numb so you don’t have to take care of the _ONE_ which you just submitted to the treatment…

    Now, do tell me a$$hole, do you care enough about their anxiety to conclude that cannabis is not the answer you’re looking for? If not, shame on you. You should never care for autistics.

    Alain

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