July 2, 2011

Autism and Medical Marijuana

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Q. Medical Marijuana and Autism: Is it Worth Trying?

A. Yes, but with extreme caution. And I’ll tell you why.

Medical marijuana (MMJ) isn’t completely safe. It has some risks. Case in point: some people who ingest certain MMJ strains DEVELOP ticks, twitches or are thrown into a full blown seizure. Yep, you won’t hear people talk about that. Medical marijuana smokers on websites, however, call this “kibbying.” Here’s an example of an anecdotal report from someone on a marijuana board on net: “It's 9:30pm, I have 4 pages left to go on a paper that’s due in 12 hours. FUN! So what do I do, I get higher than I've been in a long time! Bad idea...I know, but the point is that right now I’m twitching. I always twitch when I get REALLY stoned…”

Here’s another post on same website from ANOTHER person who got twitches from MMJ. “I got twitching for the first time a while back (after getting very, very high), and it kinda scared me. Really quite bad in my legs and arms, for about 15 minutes. Uncontrollable. Strange. Can't say much more besides I've been there before, but if anyone has an explanation for that, I'm all ears...” Source: http://www.marijuana.com/medicinal-marijuana/2612-ahh-twitching-horrendus-twitching.html

Interestingly, there’s a real LACK of research regarding MMJ triggering seizure activity. If MMJ advocates want to be taken seriously, they should provide public with better research. Imagine the consequences of an autistic person using MMJ to help rid migraines and instead, they end up having a tonic clonic seizure? I would think one way to prevent this would be to study which strains are MOST likely to cause or trigger seizure activity and slap these strains with warning labels. What are strains?

Medical marijuana (MMJ) comes in 3 strains: Indica, Sativa and Hybrids. Hybrids are a mix of both and are either “indica dominant” or “sativa dominant.” Example: A Hybrid could be 70% Indica/Sativa 30%  or 70% Sativa/Indica 30%

MMJ users report sativa strains have anti-depressant affect, treat chronic pain, increase focus and enhance creativity. That’s if you’re not hallucinating, paranoid or having a psychotic episode, I suppose. Most sativas are higher in THC. MMJ users report sativas good for low grade pain, anxiety, nausea, energy and body buzz. Apparently, a body buzz feels good. Unclear if “body buzz” would scare or comfort an autistic person. I noticed users describe MMJ sativas as having side effect of “clear head” or “fuzzy.” Good information, as I would not want to use a MMJ strain for my autistic son that caused fuzzy thoughts. We’re aiming for clear thoughts here.

Indica strains: Reported to be more sedating, used for acute pain, muscle relaxing, insomnia, nausea and anorexia. Some indica strains stronger than others. Marijuana users describe stronger strains causing “couch lock.” This means you are so high you apparently sit on a couch and can’t move. Not my idea of a good time. And certainly not what I would want for my autistic son, unless he was in a self-injurious behavioral mode unresponsive to conventional treatments and causing bodily harm.

Research shows human brain has Cannabinoid receptors. CB1 receptors target hippocampus, limbic system and basal ganglia and have anti-convulsive effect. CB2 receptors are found in immune system and have an anti-inflammatory effect. As per research, it appears strains HIGH in Cannabidiol (CBD) would be the more medically sound strains. Strains high in THC increase social anxiety and isolation, clearly not what you want for severe autism. Cannabidiols also act on 5HT1a receptor, which is a receptor targeted by antidepressant drugs and leads to the uplifting, pain modulating effect.

So: Cannabis sativa is higher in THC. Cannabis Indica is higher in CBDs.  Again, I would NOT suggest giving strains high in THC to an autistic person with epilepsy. THC causes hyperexcitability in brain. NOT good for epileptics.  For a good video that talks about strains high in CBDs, I found this: www.youtube.com/watch?v=qroKHwQEVl8

Also this website has info: http://projectcbd.org/
The truth is, HALDOL, Risperdal, Zyprexa and other powerful anti-psychotics, have done more harm than good to the autistic population. Surely, it would behoove autistic patients with serious behavioral and medical issues to have access to medical cannabis with high levels of CBD’s.
Medical marijuana is also used to as an appetite stimulation for autistics and other challenged individuals who are HIGH RISK for suffering serious medical problems and might need a G-tube (gastrostomy tube) because they won't eat. If medical cannabis helps PREVENT a G-tube, that is a good thing.

HOW does MMJ interact with frequently prescribed medications, such as Prozac? Nobody really knows. Yet, IF sativa strains target serotonin receptors, for example, might ingesting pure sativa or sativa dominant strains risk triggering “serotonin syndrome”? And, if INDICA strains are thought to elevate dopamine, might someone on a dopamine elevating pharmaceutical be at risk? Too much dopamine can trigger psychosis.

Consider one study that showed Schizophrenics given cannabis strains high in SATIVA (the strains most likely to raise serotonin levels) had LESS schizophrenic symptoms. WHY? Drugs that increase serotonin decrease dopamine. By reducing dopamine in the schizophrenic brain, you could, theoretically, lessen symptoms. Recall, too much dopamine linked to schizophrenic behaviors. TOO LITTLE dopamine linked to Parkinson’s disease.

In a study by Pamela DeRosse at Long Island’s Feinstein Institute for Medical Research, schizophrenics who smoked cannabis “had faster brain processing speed, greater verbal ability and better memory than patients who didn't smoke”. However, the study fails to show which marijuana strains smoked, which is important information, since different strains target different brain receptors.

Caution when using marijuana with autistic people: THC (9-tetrahydrocannabinol), an active ingredient in marijuana, can cause hallucinations, paranoia and psychotic episodes. Yet, there’s something called cannabidiol (CBD) in select strains that reduces psychosis. Strains high in Cannabidiol (CBD) supposedly have anxiolytic and antipsychotic effects. It would seem logical then to consider marijuana strains HIGH in CBDs and LOWER in THC for an autistic patient. Of course the entire idea of medical marijuana for my autistic son is a bit odd, as I’ve always hated pot. The idea of smoking something that makes you hungry and slows your cognition never appealed to me, but I can see how people who are in pain or suffering could benefit from it. Also, when you’ve witnessed Haldol causing your child to go into retrocollis and have a olygiric crisis, you start to look more at things like medical marijuana.

Still, I’m concerned about how MMJ could trigger seizure activity. Nobody knows why. This is my theory: when the CB 1 receptor is activated by marijuana, it may inhibit GABA release. GABA is what helps quell seizure activity, so if GABA is inhibited, couldn’t that lower seizure threshold? And the more smoked or eaten, the more GABA it would inhibit, thus this explains people reporting they get twitches when “really high.”

Interestingly, some people mix smoking marijuana with taking valium, as if they are self-medicating. Valium increases GABA in the brain.
Here’s what one person said on another marijuana site on net: “get this when I smoke and even when I'm sober, I get random twitches which I never had before.”

Don't know why, but when I pop a xanax before smoking, the twitches don't come. Actually, they don't come at all when I'm on pills.” Source
: http://www.bluelight.ru/vb/archive/index.php/t-103795-p-4.html.   (Xanax elevates GABA in the brain)

To smoke or eat it? Most severely-autistic persons can’t or won’t smoke marijuana, so the mechanism of delivery becomes eating marijuana, which can have a different effect on the brain. For one, when eaten, the onset, peak and duration of marijuana is a lot longer than if smoked.  Secondly, cooking with marijuana can deliver unequal and more powerful doses if not done correctly. There seems to be a lot of studying involved before choosing medical marijuana.

Evidence showing the mechanism of action of specific marijuana strains is LACKING. Not good. If indeed certain cannabinoid receptors are targeted and do DIFFERENT things, than it’s critical to KNOW which strains act accordingly on receptors in order to prescribe that strain for medicinal purposes! Perhaps there is no big push in MMJ community to do this, because too many people don’t give a rat about the medicinal purposes and are only there to get high, as seen in the long lines of perfectly healthy 20 yr olds entering marijuana dispensaries. Oh well, maybe they have a headache and advil just doesn’t quite do the job. It’s none of my concern, I’m just concerned about if it can help my autistic son not smash his fists into his head. And how it can help those who truly need this medicine for medicinal purposes. 

Other things you may not know about medical marijuana:

1.              Synthesized THC is known as dronabinol  or Marinol and sold as a schedule 3, prescription drug
2.              Synthesized THC is not very effective
3.              SATIVEX is a drug derived from cannabis plants
4.              Sativex more effective since it has higher CBD
5.              Mechanism of delivery for sativex is oromucosal (sprayed in mouth), which could serve as a great rescue medication, if it works, for self-injurious behavioral meltdowns
6.              Pharmaceutical companies have already entered into exclusive marketing agreements for Sativex
7.              Sativex is marketed in Canada by GW Pharmaceuticals
8.              There are female and male cannabis plants. Females are supposedly higher in the good CBDs that help epilepsy, dystonia, etc…
9.              Endocannabinoid system in brain is responsible for maintaining homeostasis. MMJ targets these receptors
10.       Prior and current law enforcement officials are rumored to be involved in the medical marijuana business. I guess law enforcement retirement packages aren't too good these days.

All in all, it seems medical marijuana is a loosely controlled social experiment that I’m not convinced can help autistic persons with serious medical issues like seizures or self-injurious behaviors. I hope it can, as current drugs for autism and SIB aren’t very promising. And MMJ does seem safer than typical anti-psychotics. So, I will continue researching medical marijuana.  It may—if I can pinpoint strains most likely to help my son-- become a good rescue med. Of course that would entail a spray form, as you can’t expect an autistic person slamming their fists into their head to pause, sit down, and eat a marijuana brownie.  Lots to think about here.


Claire said...

Excellent post. I did not know about MMJ and seizures. A few years back, good old fashioned pot would have been good for my daughter (I hate the stuff too...never smoked it in my life). She is prone to anxiety and at the time was often nauseated and had poor appetite. It looked like a good thing to ease all of those symptoms. The medical stuff, typically, lacks balance...for lack of a better word...and there is no way in hell I could get it off the street...so we passed, and I still wonder.

MattW said...

I appreciate the summary and the questions it raised!

Cannabis4Autism said...

Hi Kim,

This is excellent thank you. Have you seen "Cannabis for Autism" on Facebook?

I'm a 39 year old asperger, I use cannabis as medicine and I've been using it for over 20 years.

I've been studying the science full-time for about a year now, I can answer all of your questions but I cannot type that much. Would you be happy to talk on skype sometime?

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