Use of Medical Marijuana in Children and Adolescents with Autism Spectrum Disorder for Core Autism Symptoms or Co-Occurring Emotional or Behavioral Problems

Approved by Council May 2019

Background

Amid changing legislation and attitudes related to marijuana and cannabinoids, such as cannabidiol (CBD) and tetrahydrocannabinol (THC), some physicians are issuing medical marijuana permits for children and adolescents with Autism Spectrum Disorder, targeting core autism symptoms or co-occurring emotional and behavioral problems. However, there is no scientific evidence showing efficacy for these indications nor is there reliable information regarding potency, quantity, frequency, route of administration, duration, or age safe for use. Caregivers, understandably seeking to help their child with Autism Spectrum Disorder, may turn to marijuana or cannabinoids in the context of unsubstantiated or distorted claims of efficacy and safety.

There are clear risks of harm for children and adolescents using marijuana and cannabinoids. Consistent marijuana use at an earlier age poses greater risk of long-lasting impairment on cognition, brain structure, and brain function, associated with a potentially irreversible decline in intelligence quotient. Long-term use of marijuana during adolescence is also associated with increased incidence and worsened course of psychotic, mood, anxiety, and substance use disorders. Short-term use can impair working and short-term memory, learning, attention, coordination, perception, and judgment, and can cause paranoia, anxiety, and irritability. Furthermore, the concentration of THC in marijuana has significantly increased in recent years, posing higher risks of marijuana use. Additionally, the products being sold in dispensaries currently are not subject to Food and Drug Administration standards and are not purely isolated cannabinoids; they are therefore not reliable in their potency/concentration of CBD or THC, or the inclusion of other ingredients.

Exposing children and adolescents with developmental disorders such as Autism Spectrum Disorder to marijuana or cannabinoids could further increase the prevalence or severity of psychiatric disorders and intellectual disability in this highly-vulnerable population.

Recommendations

The American Academy of Child and Adolescent Psychiatry recommends:

  • Against the use of medical marijuana or isolated cannabinoids for core symptoms or co-occurring emotional or behavioral problems in children and adolescents with Autism Spectrum Disorder.
  • That families should be educated about risks and discouraged from using marijuana and cannabinoids for Autism Spectrum Disorder.
  • That State and Federal legislators refrain from approving the use of marijuana and cannabinoids in children with Autism Spectrum Disorder in the absence of scientific evidence in the peer-reviewed medical literature.

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The American Academy of Child and Adolescent Psychiatry promotes the healthy development of children, adolescents, and families through advocacy, education, and research. Child and adolescent psychiatrists are the leading physician authority on children’s mental health.