A group of Israeli researchers have been exploring the use of CBD to reduce problem behaviors in children on the autism spectrum. A feasibility study involving 60 children found substantial improvement in behavioral outbreaks, anxiety and communication problems, as well as stress levels reported by parents.
Though CBD — full name cannabidiol — is extracted from marijuana or hemp, it doesn’t contain THC, the chemical in marijuana that has psychoactive effects, so it doesn’t make you feel high.
Because CBD is so new, there also aren’t a lot of rules about what can and cannot be included in CBD products. So, there’s a huge variety in the quality of products. You may even find different amounts of CBD in different packages of the same product.
CBD is still pretty new, so there’s very little research about its safety or how well it works, especially for children. So far, there’s only one marijuana-derived medication that has been approved by the Food and Drug Administration. It’s called Epidiolex, and it’s used to treat a rare form of epilepsy in patients who are at least two years old.
CBD and autism
The researchers, led by Adi Aran, MD, director of the pediatric neurology unit at Shaare Tzedek Medical Center, went on to do a double-blind, randomized, placebo-controlled trial with 150 participants with autism. In this trial, just completed but not yet analyzed, patients were treated CBD for three months.
CBD is everywhere. From corner stores and bars to medical marijuana dispensaries, it’s being offered for its reputed ability to relieve pain and make people feel better.
While anecdotal evidence of the benefits of CBD is common, there are risks associated with using these products, especially in children. Some of the concerns:
Concerns about CBD
Last year the World Health Organization, acknowledging the explosion in “unsanctioned” medical uses of CBD, reviewed the evidence for its safety and effectiveness. The WHO report concluded that “CBD is generally well tolerated with a good safety profile.” Any adverse effects could be a result of interactions between CBD and a patient’s existing medications, the WHO noted.
“The biggest problem is there’s a lot that we still need to know, especially in kids,” says Paul Mitrani, MD, a clinical psychiatrist at the Child Mind Institute. “In regards to treating mental health disorders in children and adolescents, there’s a lack of evidence to support its use.”
“When you’re desperate, you want options,” said John Mitchell, clinician at Duke ADHD Clinic in Durham, N.C. “I’m a parent myself. I get it.” But, he cautioned, for now the enthusiasm is running ahead of the science. “I’m very hesitant to say anything promising about it. It’s an open question.”
“I’m trying to be very cautious about it,” said Meiri with regards to CBD and autism. “We still don’t have enough research about safety and efficacy.”
Hints of help
Most such studies are based on parents’ perceptions, rather than measured changes in comparison to placebo groups. The placebo effect can be strong, since parents typically want to see improvements. A placebo-controlled trial of CBD for autistic children has been completed at the Shaare Zedek Medical Center in Israel, but the results aren’t yet published. Another is underway at the University of California, San Diego.
No silver bullets
The medical community considers pure CBD relatively safe: The World Health Organization, for example, has said there’s no evidence of anyone abusing CBD recreationally, or of any public health problems. But there are still some risks, especially for kids.