Autism spectrum disorder (ASD) is a multifactorial, pervasive neurodevelopmental disorder defined by the core symptoms of significant impairment in social interaction and communication as well as restricted, repetitive patterns of behavior. In addition to these core behaviors, persons with ASD frequently have associated noncore behavioral disturbance (ie, self-injury, aggression), as well as several medical comorbidities. Currently, no effective treatment exists for the core symptoms of ASD. This review reports the available preclinical and clinical data regarding the use of cannabis and cannabidiol in the treatment of core symptoms, noncore symptoms and comorbidities associated with ASD. Additionally, we describe our clinical experience working with children and young adults with ASD who have used cannabis or cannabidiol. At present, preclinical and clinical data suggest a potential for therapeutic benefit among some persons with ASD and that it is overall well tolerated. Further research is required to better identify patients who may benefit from treatment without adverse effects.

Autism spectrum disorder (ASD) is a multifactorial, pervasive neurodevelopmental disorder affecting 1 in 54 children in the United States, based on surveillance data obtained from a cohort born in 2016.1 Consistently, such studies have demonstrated clear gender predominance in the condition, with males 4 times more likely to be affected than females. Data obtained from the California Department of Developmental Services, widely considered one of the most reliable long-term records of ASD prevalence trends in the United States, has demonstrated an increase in prevalence by a factor of 25 from birth year 1970 to 2012 and by as much as a factor of 1000 from birth year 1931 to 2012.2 In the United States, the total cost per year for children (birth to 17 years of age) with ASD has been estimated between $11.5 billion and $60.9 billion (US dollars in 2011) due to a variety of direct and in-direct costs, including but not limited to medical care, special education, intensive behavioral intervention, loss of parental productivity, and out-of-home placement.3,4 Given the rising prevalence and significant economic and social costs associated with ASD, it is critical that continued efforts be made toward better understanding the underlying etiologies and finding improved therapies for the condition.
This review reports the available preclinical and clinical data regarding the use of cannabis and cannabidiol (CBD) in the treatment of core symptoms, noncore symptoms and comorbidities associated with ASD.