When Jim Carrey co-opted the image of a distressed boy with tuberous sclerosis complex (TSC) in an effort to reinforce the actor’s views about vaccines, he inadvertently brought attention to TSC, which is, unlike vaccines, associated with autism. In using the image of Alex Echols, for which he later apologized, Carrey may also have brought attention to another topic of discussion in autism circles: the use of marijuana as a therapeutic.
Alex’s parents have a blog where they’ve written about Alex and his needs for many years. Among those needs, they argue, is therapeutic marijuana, which they say helps Alex with his self-injurious behaviors. They have published their clear agenda for accomplishing this for their son, who currently lives in a group home.
The Echols are not alone in their belief in and urgency about marijuana as an intervention for neurological conditions. Many other parents and some clinicians also have suggested that the plant—and its active compounds—might offer an effective treatment for some of the intense behaviors related to autism and for schizophrenia, as well. But what do we really know about marijuana and its therapeutic possibilities?
Like so many sources of neuroactive compounds, pot has dual potential to be beneficial or damaging, depending on which ingredient is the focus. One of its active compounds, delta-9-tetrahydrocannabinol, or THC, acts through a signaling system that involves some of the same components associated with atypical signaling in schizophrenia. According to Tori Rodriguez, writing at Psychiatry Advisor, studies have shown interesting parallels between altered brain function measures in people with schizophrenia and people who were marijuana intoxicated.
Thus, THC, it seems, is ‘pro-psychotic’ (although that’s controversial), and there’s a chicken–egg question about whether or not it contributes to the development or onset of psychosis-related conditions like schizophrenia or if people with such conditions might be more prone to reach out for it as self-medication. The age at which one reaches for it might also be a factor, but studies show a “consistent” association between pot use during the teens and risk for developing a psychotic disorder.
The only US Food and Drug Administration–approved marijuana-related drug currently available is a synthetic version of THC, for treating nausea and vomiting related to cancer chemotherapy and weight loss associated with AIDS. Not much on the approved drug table for people with schizophrenia.
But marijuana is one of those two-faced offerings from nature that can help or hinder. Now that pot has become legal in various parts of the US, these issues of help or hinder become more critical and will start to settle into some form of commonly accepted wisdom that likely belies the complexities.
As an example of that complexity, another physiologically active compound in marijuana (there are dozens) is cannabidiol, which might act as an antipsychotic, in contrast to its pot-plant partner THC. Plants, you see, are complex organisms just like we are, and banning the entire plant ends up banning every possibility each of its hundreds of active compounds might hold.
So far, the studies of cannabidiol in schizophrenic populations are small, but at least one suggests head-to-head effectiveness against one atypical antipsychotic with less in the way of negative side effects compared to the approved drug. Cannabidiol is one of the target substances that the Echols want to be able to give to their son to reduce his distress and distressing episodes of self-injurious behaviors. Parents of children with epilepsy and other neurological conditions also would like cannabidiol oil to be available as a treatment for their sons and daughters.
In good news for these families desperate to find some therapeutic relief for their children, in late June, the Obama administration removed a bureaucratic obstacle to research into these compounds. Also on tap with some promise of bipartisan support is the proposed CARERS Act, which has 11 co-sponsors and would open up all kinds of legal avenues to applying marijuana medically.
And what about marijuana for autism? Compared to the studies done for schizophrenia, which number more than 1000, autism and marijuana has gotten almost no research attention. That hasn’t stopped a grassroots movement from growing up around using pot as an autism therapeutic, with a Facebook group, MAMMAS (Mothers Advocating Medical Marijuana for Autism), boasting almost 5000 followers, or one writer and autism parent from advocating for its use from a public pulpit.
But as the authors of a recent review note—and PubMed searches bear out—no studies exist suggesting clinical benefit for autism. Indeed, in a news release publicizing the review, the first author, Scott Hadland of Boston Children’s Hospital, is quoted as saying:
in using medicinal marijuana (parents) may be trading away their child’s future for short-term symptom control.
These authors also call for more research into cannibidiol’s effects and more emphasis on developing high-cannabidiol/low-THC products. Perhaps these compounds, rather than the plant, should be what we mention when we talk about these neurological therapeutics. After all, no one brings up using willow trees for pain or blood thinners, even though they originated the active compound in aspirin, and no one says they take ’foxglove’ as a heart medication–they take digoxin instead.