Autism, Neurodevelopmental Disorders, and Medical Cannabis – How Attempting to Regulate the Medical Cannabis Market in Israel Only Creates More Barriers to Treating Children and Adults with Autism

World Autism Awareness Day is celebrated today worldwide under the theme of “From Survival to Flourishing” to increase the visibility of autism in society, the acceptance, and thriving able to live full  and meaningful lives of those diagnosed on the autism spectrum disorder (ASD).  Abigail Dar, a pioneer in promoting cannabis treatment for autism in Israel and worldwide, explains why every “reform” and new regulation coming from the Israeli Health Ministry and the authorized regulators distances treatment from those who need it most.

Treating children and adults with autism with cannabis is a legitimate therapeutic alternative. This is a clinical research fact, not opinion or anecdotal knowledge.

Until a few years ago, Israel was a pioneer in the field of cannabinoid treatment for children with neurodevelopmental disorders – starting from the observational study in 2014 conducted at Sheba Medical Center on treating children with drug-resistant epilepsy, to the world’s first RCT research conducted on children with autism at Shaare Zedek Medical Center in Jerusalem, and another clinical trial conducted at Assaf Harofeh Medical Center.

Accessibility to treatment and the ability to customize the product for each child provided many options for the specialist doctors to achieve therapeutic balance.

There is no medication for autism. Existing pharmacotherapy is for accompanying difficulties – from attention disorders, restlessness, anxiety, sleep disorders to outbursts and self-harm. The existing pharmacological tools for these symptoms are primarily antipsychotic drugs. These drugs were originally developed for other purposes (schizophrenia, major depression, anxiety, etc.), and their use is mostly unavoidable, in the absence of treatment tailored to the brain with deficits expressed in autism.

However, it seems that since 2015, when we started treating children and adults with autism in Israel with cannabis, with every new step of “regulation” or “reform,” access to treatment for children only goes further away.

The reform carried out in 2019 in the Israeli medical cannabis market led to an increase in the total number of patients from around 40,000 in 2018 to about 145,000 patients today. Quit impressive for a country with a population of 10,000,000, compared to the situation in other countries worldwide.

But when we look at what happened to the options and accessibility for treating children in Israel, we see an ongoing and worsening impairment – both in terms of the ability to legally treat under medical supervision, and in terms of treatment costs for parents.

It should be emphasized and reminded – we are talking about treatment with a beneficial medicinal plant, whereas the cheap and easy alternative offered today by the medical establishment is antipsychotic drugs, which have limited efficacy and long-term side effects that can be severe.

So where are the barriers?

Let’s start with the definitions of the qualifying conditions for cannabis for Autism written by professional committee of the Israeli Ministry of Health:

It  sets the age of 5 as the youngest age for treatment – while the therapeutic properties of the plant, in responsible and professional treatment, can benefit younger ages due to the anti-inflammatory and neuroprotective properties of some of the non-psychoactive cannabinoids.

The qualifying condition also requires prior prescription of  2 antipsychotic drugs – yes, even for children as young as five years old or younger. I encountered many children who were treated with these drugs at such a young age. How bad must a young kid’s condition be if he’s prescribed an anti-psychotic drug?  And if his condition is so complex, wouldn’t it be better to offer cannabis treatment first since the side effects and risks are significantly less?

The costs:

The price of the license/prescriptions is negligible compared to the average monthly expenditure of $150-$450 for the extraction itself. Most children and adults with autism need high concentrations of CBD and low concentrations of THC – since the Israeli reform and a quick glance at the stock of products in pharmacies and their prices show that competition in the field with high THC percentages exists, but the variety of products suitable for children is decreasing, and their prices are only rising.

Still, we must not give up on a treatment that helps so many children with tremendous difficulties and challenges, which is in the category of a therapeutic tool that should be in the arsenal of every specialist doctor in the field.

And what’s the solution?

First of all, make sure that CBD and other non-psychoactive cannabinoids are immediately removed from the Israeli drug ordinance, just like in any other advanced country.

It should be understood, from many years of professional knowledge – the question of treating with THC (the psychoactive component of the plant) is not a question of “if” but a question of “how much.” The autistic spectrum is vast, as is the depth of difficulties and symptoms. A significant number of the children will be able to benefit from high-quality products containing 0.2% THC or less, those who will need more will have to go through the exhausting process of licenses/prescriptions and heavy regulation. But at least we can treat some children without the need for heavy regulation.

Also, in terms of price, once orderly and legally importation begins, there will be competition both on quality and price, allowing higher accessibility to treatment for many who desperately need it.

Abigail Dar, Founder Cannafora & IACM Patient Council Israel representative

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