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Tuesday, May 26, 2015

Autism and Marijuana in Michigan

At AP, Ed White writes of 6-year-old Noah Smith, whose autism symptoms seemed to improve after he took oral doses of an oil extracted from marijuana.
Noah is registered to use marijuana to control epileptic seizures; the effect on his autism was an unexpected benefit. Based on that success, Smith is asking the state of Michigan to add autism to the list of conditions that qualify for medical marijuana.

A public hearing is scheduled for Wednesday in Lansing. A committee mostly composed of health professionals will make a recommendation to the director of the Department of Licensing and Regulatory Affairs.

“I know parents who are desperate. They’re missing out on something that could enhance their child’s life,” Smith said. “A lot of children with autism don’t have another qualifying condition like Noah does with epilepsy.”

Since Michigan voters approved medical marijuana in 2008, it has been used to relieve the side effects of cancer, glaucoma, HIV, hepatitis C and a few other conditions. Post-traumatic stress disorder was the first addition a year ago. Nearly 200 people under age 18, a tiny fraction of the total, are approved to use marijuana.

In 2013, the state’s Medical Marijuana Review Panel voted against making autism eligible, 7-2. There was skepticism about the effectiveness and a concern about adding more children to the registry. But the new effort seems more organized with more doctors willing to speak in favor, including Noah’s doctor, Dr. Harry Chugani, chief of pediatric neurology at Children’s Hospital of Michigan in Detroit.
Earlier this year, Scott Hadland and colleagues looked at the research for an article titled "Medical Marijuana: Review of the Science and Implications for Developmental-Behavioral Pediatric Practice," in The Journal of Developmental & Behavioral Pediatrics.  Their conclusion:
Given the current scarcity of data, cannabis cannot be safely recommended for the treatment of developmental or behavioral disorders at this time. [emphasis added] At best, some might consider its use as a last-line therapy when all other conventional therapies have failed.90,91 As marijuana policy evolves and as the drug becomes more readily available, it is important that practicing clinicians recognize the long-term health and neuropsychiatric consequences of regular use. Although a decades-long public health campaign has showcased the harms of cigarette smoking, similar movements to illustrate the hazards of cannabis use have not been as rigorous or successful. As a result, accurate information on regular cannabis use remains poorly disseminated to patients, families, and physicians. Furthermore, there are especially few studies examining neurocognitive and psychiatric outcomes among children and adolescents with developmental or behavioral concerns who are exposed to cannabis, and this remains a critical area for future study. In coming to the decision to use marijuana for medicinal purposes, all parties should be fully aware of the long-term hazards of regular cannabis use, recognize the lack of evidence on its efficacy in developmental and behavioral conditions, and incorporate this information into a careful risk-benefit analysis.