A new review of scientific research on the use of marijuana’s components to treat autism spectrum disorder (ASD) finds that “preliminary evidence suggests potential benefits,” including improvements around anxiety, sleep and behavior. But more work—especially randomized controlled trials—are needed “to confirm these results and establish clear treatment guidelines,” authors said.
“Preliminary findings suggest that CBD-rich formulations may provide modest benefits for sleep and social interaction, with a reduction in anxiety symptoms,” says the peer-reviewed study, published in the journal Cureus. “Regarding core ASD symptoms and behavioral outcomes, cannabinoids demonstrated greater efficacy compared to placebo in some studies.”
Researchers also acknowledged that “adverse events varied” among patients, and “response to treatment was inconsistent across individuals,” underscoring the need for further study.
“While cannabinoids, particularly CBD-rich formulations, appear to be relatively safe and potentially beneficial,” the new paper says, “further large-scale, controlled trials comparing CBD to established ASD treatments are essential to clarify its role and long-term impact in ASD management.”
The 13-person team behind the new study includes researchers from various hospitals and universities in Brazil.
Overall, they wrote, “While preliminary evidence suggests potential benefits, particularly for anxiety, sleep, and behavior, the findings remain inconclusive due to study heterogeneity and methodological limitations.”
For the analysis, authors looked at seven studies involving 494 patients, focusing on “key clinical outcomes, such as sleep, autistic core symptoms, anxiety, behavior, social effects, and adverse events.”
“Improvements were noted in anxiety, sleep quality, social effects, and behavior, although these findings varied across studies,” they concluded. “Importantly, adverse events were generally mild and occurred at similar rates in cannabinoid and placebo groups, supporting the intervention’s safety profile.”
Studies also indicated “a slight improvement” in sleep quality, while “autistic core symptoms showed positive responses” the report says. “Some studies also reported reductions in hyperactivity, agitation, self-injurious behavior, and epilepsy, along with improvements in communication skills, attention, and eye contact.”
Drowsiness was the most common side effect, followed by decreased appetite, weight loss, anxiety and restlessness.
“Despite these occurrences, cannabinoids are often considered well-tolerated compared to traditional pharmacological interventions,” authors wrote. “Nonetheless, careful monitoring and individualized dosing are essential to minimize potential risks, and further research is necessary to fully elucidate the long-term safety of cannabinoid use in ASD treatment.”
As for the mechanism behind cannabis’s influence on ASD, the study notes that “CBD interacts with the ECS [endocannabinoid system], a critical signaling network involved in neurodevelopment, social behavior, and homeostasis.”
“Emerging evidence also suggests its role in gut-brain communication, further linking it to ASD pathophysiology,” the report continues. There’s also some evidence from mouse models that CBD may reduce “repetitive behaviors and anxiety related symptoms in ASD” as well as signs that ” low doses of THC in specific formulations appear beneficial for social behaviors, though their long-term effects remain uncertain.”
Some of the obstacles to the research, authors acknowledged, are that intervention types, dosing regimens and outcome metrics varied from study to study. Other research omitted basic statistical data “such as means, standard deviations, and interquartile ranges,” they said.
“Variation in cannabinoid formulations across studies makes it difficult to assess their true efficacy and safety,” the paper adds, also noting the low number of randomized controlled trials (RCTs) and in some cases “methodological biases, particularly in patient selection and randomization.”
“More rigorous, well-designed RCTs are necessary to confirm these results and establish clear treatment guidelines for cannabinoid use in ASD,” the report concludes.
The new review from researchers in Brazil comes on the heels of separate research finding that high-CBD, low-THC cannabis products have potential to “significantly improve the quality of life” for children with autism and epilepsy disorders.
“While more research is necessary,” authors of that study concluded, “this review, together with other reviews of the literature, suggests that medical cannabis is potentially a viable treatment option alongside established medical treatment guidelines. This is especially true for pediatric ASD.”
Another, federally funded report published last year in the Journal of the American Medical Association found that cannabis use during early pregnancy was not associated with child autism.
That analysis included data from 178,948 pregnancies born to 146,296 unique individuals between 2011 and 2019. Children were screened at various points on autism and developmental measures.
“In this study, maternal prenatal cannabis use was not associated with childhood ASD after adjusting for potential cofounders,” the research found, “including sociodemographic characteristics, other noncannabis substance use and maternal comorbidities.”
Last month, meanwhile, officials in Ohio agreed to advance autism spectrum disorder as a possible qualifying condition for medical marijuana. The proposal next proceeds to an open public comment period and expert review.
Connecticut added ASD as a qualifying condition for medical cannabis late last year. Other states that already recognize the disorder as a specific eligible condition include Colorado, Delaware, Georgia, Louisiana, Michigan, Minnesota, Pennsylvania and Utah.
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