Autism-related Self-injury is Treatable with Medical Marijuana
Since Pennsylvania enacted the Safe-Harbor letter, I’ve had success treating a few patients with autism spectrum disorder (ASD). Most notable of those are the patients who cause self-injury and harm themselves during emotional outbursts. These patients, in particular, are worth considering for medical marijuana as an abortive therapy for such emotional outbursts. Traditional medications serve either to prevent such problems in the first place – having their effect all day – or, they are more invasive and have significant short and long-term side-effects.
Inhaled PRN self-injury
In medicine, we write “as needed” as “PRN”. If I had to write a prescription for medical marijuana for a child with autism spectrum disorder and self-injurious behavior, I would write it like this:
medical marijuana vape-pen 2-4 breaths inhaled Q1-2h PRN severe agitation
That means 2-4 hits as needed every 1-2 hours for episodes of severe agitation.
There are a few reasons why I recommend inhalation as the route of administration. Firstly, it is fast-acting for squelching aggression or self-injury before it’s too difficult to manage. It can be used at home safely for this purpose. Second, it is titratable. Notice how I wrote 2-4 inhalations? That’s because the dose can be titrated to the necessary amount. The patient themself can use it until they feel there is enough to calm the behavior. No one has overdosed from marijuana and with careful caretaking the drug is safely administered this way.
Of course, the patient does have to be willing to use the medicine. So far, patients have not been averse to using marijuana this way. This is why close counseling is important for therapy to be successful.
Call to Action
I recommend considering this for physicians treating patients with self-injurious behavior related to ASD. While my experience is only one anecdotal data point, it is one of few out there and thus it can be used comparatively. There is nothing out there related to medical marijuana as an abortive therapy for self-injury in patients of any age with ASD. However, each individual case is unique in severity and when other medications have failed, the risks of using medical marijuana (which are primarily sociopolitical and legal) should be weighed with the benefits of stopping self-injury. Discuss this with your patients and their families and consider using it as part of our Hippocratic Oath.
You too can support the use of medical marijuana for autism by joining organizations like MAMMA (Mothers Advocating Medical Marijuana for Autism). Check out their facebook page for more details. Let us know your own experiences and do your part by sharing this on your facebook page or other social media site! It all makes a difference.