Dr. Dustin Sulak is respected as a top cannabis educator for good reason – he’s been on the frontlines for several years, working with medical cannabis patients in Maine.
His talks on cannabis are always excellent, and he brings a lot of positive energy and credibility to cannabis medicine and education.
In fact, you can now watch Dustin Sulak and 20+ other cannabis experts in the very first Cannabis Health Summit, now streaming on Green Flower Premium.
Dr. Sulak shared a patient story involving autism during his CHS talk, and although autism is not a qualifying condition in Maine’s medical cannabis program, Sulak sees it a lot when working with patients who also have conditions like seizures, spasticity, chronic pain, movement disorders, etc., which do qualify.
Autism is an illness that affects 1 in every 68 children, so listening to Dr. Sulak discuss what he’s observed and learned at the clinical level about cannabis and autism is an eye-opener.
Interview with Dr. Dustin Sulak on Cannabis and Autism
Green Flower: What are your thoughts on treating autism with cannabis?
Dustin Sulak: The underlying pathology in autism is complex and poorly understood, but we do know that it includes inappropriate inflammation and dysfunction in the central nervous system and gut.
We currently don’t have many treatments that are effective. The best-case scenario would be to find a treatment that is safe, decreases inflammation, protects and promotes healing in the nervous system and gut, and helps manage the most severe symptoms of autism.
Cannabis seems to fit that description.
GF: Any case studies you like to share from your own clinical experience?
DS: How about the case I presented at the Cannabis Health Summit of the 12-year-old boy, who was in the ER for a week with severe self-injurious behavior before getting 5mg THC and walking out giggling a few hours later.
His symptoms were so severe he had to be restrained much of the time, and no hospital in New England could place him.
I finally convinced the ER doc to give him 5mg dronabinol [an FDB-approved synthetic version of isolated THC) since he had previously responded well to an equivalent dose of cannabis brownies.
The latest batch of brownies must have been weaker than the previous – that’s our best guess for why he stopped responding and had to go to the ER.
He had severe self-injurious behavior (putting his head through walls) and has been stable on a low dose THC for three years.
Now he’s employed in a salsa company, grilling veggies, and lives a productive and self-injury-free life.
I had another interesting case of a 22-year-old with autism and aggression episodes who was minimally verbal – one word responses only. When he first tried cannabis he had a remarkable two-week period when he was speaking complete sentences.
This improvement gradually regressed and he is now back to his baseline speech, but cannabis still helps him with behavioral issues.
I’m not sure if there was something special about his initial dose (unlabeled and untested oil), but we have been unable to reproduce the benefit thus far.
I have another case of a 12-year-old boy who does well with cannabis but he requires an incredibly high dose: 50-200mg THC required to help him settle down to sleep or to stimulate appetite and focus on meals.
My sensitization protocol does not change these high-dose requirements. He shows no signs of impairment or intoxication at these doses. CBD doesn’t have much of an effect on him.
GF: Do you think treating autism with cannabis is more of a behavioral therapy or are we looking at targeting the endocannabinoid system and cannabinoid signaling?
DS: I think we have both, which is so often the case with cannabis. It helps ameliorate symptoms, especially the most severe symptoms like self-injury or aggressive behavior and low appetite/weight loss.
It can also help improve communication and cooperation – it appears to me that my autistic patients feel more comfortable in their bodies with the help of cannabis, and are more likely to make eye contact, initiate interaction, and even give hugs.
At the same time, it’s likely (but unproven) that long-term treatment could address the underlying pathology to some extent by protecting the nervous system, promoting neuroplasticity, and reducing inflammation.
GF: What would you say to parents or patients struggling with autism?
DS: For severe behavioral symptoms, and even mild ones, don’t be afraid to try THC. While I’m excited to see what we can learn about CBD in autism, I want to clearly dispel the myth that CBD is the medical part and THC is the recreational part of the plant.
Based on my clinical experience, THC is well tolerated and very effective in autism. Like most other conditions, it’s likely that some combination of THC and CBD will be best for most patients.
I encourage parents to set concrete goals of treatment. Some of the parents I work with will stop at nothing to help their child become neurotypical.
While that may be possible, I like to identify high impact goals that can improve quality of life and work towards those. It’s very hard on a parent-child relationship for the child to always be perceived as broken and needing fixing.
I tell my parents to look right past the dysfunctions and problems when they can, and see the health and beauty in their children.
When they do that, every interaction becomes a healing event for both parent and child.
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