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COLUMBUS, Ohio – Members of the public are again asking the State Medical Board of Ohio to consider adding autism spectrum disorder to the list of conditions for which medical marijuana is permitted.

Their renewed request comes as state lawmakers consider a bill in the Ohio Senate that would add autism spectrum disorder to the list of permitted conditions and strip the State Medical Board entirely of its regulatory oversight of the drug.

Senate Bill 9 would create a new agency, the Division of Marijuana Control, and an oversight board. Republican senators who are sponsoring the bill say it’ll be more responsive to the medical marijuana industry. The legislature also is weighing an initiated statute for recreational marijuana. If the legislature doesn’t pass a bill based on the initiated statute proposal, which is likely, voters could decide the issue as soon as November.

It is at least the third consecutive year in which the public has asked the State Medical Board to allow marijuana for autism. Over 15 states with medical programs include autism among the conditions for which it can be prescribed.

At the end of each year, the State Medical Board seeks petitions of new conditions from the public. The Medical Board released the list of conditions last week on its website. It will spend the coming months considering the petitions, which involves looking at any research showing efficacy, as well as testimony from experts.

The Medical Board has been fairly conservative in adding conditions, often requiring double-blind, randomized, placebo-controlled studies before adding them. Since the state’s medical marijuana law went into effect in 2016, the Medical Board has added only four conditions. It added cachexia in 2020. It added Huntington’s disease, spasticity and terminal illness in 2021.

Small studies have shown that cannabis is effective for autism spectrum disorder. A June review of those studies found some of the studies showed marijuana products reduced the number of symptoms, or their intensity, such as self-mutilation, anxiety, agitation and aggression. The studies also found an improvement in cognition, language and attention. The June review concluded that cannabis has promise, but randomized, blind, placebo-controlled clinical trials are necessary to clarify findings.

Currently before the State Medical Board are 10 petitions, including three separate requests that autism be added:

· Bipolar 2: Depression/Anxiety

· Chronic migraines. This condition is currently allowed, falling under the current condition of pain that is either chronic and severe or intractable.

· Autism spectrum disorder

· Uterine cancer. This condition is currently allowed under cancer.

· Anxiety

· Irritable bowel syndrome. IBS is already a “qualifying condition” for which marijuana is allowed.

· Obsessive-compulsive disorder.

· DDD (degenerative disc disorder,) neuropathy, depression

The State Medical Board hasn’t released the actual petitions yet, which sometimes include research about marijuana’s efficacy. But the Ohio Medical Cannabis Industry Association said it submitted IBS, OCD and autism to the board for consideration.

Matt Close, the association’s executive director, said he’s seen in person in Alabama how marijuana can be effective for autism. He watched a teenager with autism take the drug, which helped curb self-injury.

Leslie Stokes of the Columbus suburbs said her son began taking medical marijuana for seizures, which is a qualifying condition, in 2019. He also has autism and almost immediately noticed benefits for that condition.

Stokes has always given her son “microdoses,” or small amounts – often in the micrograms – of his medicine.

“He said, ‘I really like that medicine,’” Stokes said. “I asked why. He said, ‘Because it helps me think.’ All the information is in his brain. It’s just jumbled up. That’s the way it affected him. I know this could help a lot of kids on the spectrum and their families. You want a functional family unit. You don’t want a child who is so disruptive.”

When Stokes’ becomes frustrated, he flies into a rage. Her son self-injures by banging his head or biting himself. Some kids on the spectrum will attack their siblings. Anti-psychotics weren’t helping her son, she said.

Prior to medical marijuana, she said she acted like a prison warden, constantly watching over her son and trying to control him. He had rage episodes daily. There wasn’t much of a family life, she said.

“It’s really scary. You have a child who is so out of control they can bite themselves, or head bang,” she said. “That is part of autism. I know a lot of people think of autism and they think of the quirky kid. And it’s a population that I think could benefit from microdosing. There’s a lot of parents who are really at their wit’s end with effective medication.”

With microdosing marijuana over time, Stokes’ said her son’s raging episodes decreased gradually. First they decreased from daily to a couple times a week. Now episodes occur a couple times a month.

“Is it perfect? Probably not 100%. But does it help? Yes, it totally helps,” she said.

Each year, when the Medical Board has considered marijuana for autism, physicians with Nationwide Children’s Hospital in Columbus have attended its meetings to testify against it. Nationwide ran clinical trials for Epidiolex, a cannabis-based medication for seizures manufactured by GW Research. It received $263,000 for its trials, which led to U.S. Food and Drug Administration approval of the drug.

Physicians from Nationwide believe that there isn’t enough medical evidence that marijuana could help autistic children. In 2019, a Nationwide doctor said parents can get respite care to get a break from their children, instead of using medical marijuana. Parents have expressed outrage over the allegation that they want to drug their children, noting that they have to live with and worry about the potential for a child who self-injures.

Below are the 25 conditions for which medical marijuana is currently allowed:

1. AIDS

2. Amyotrophic lateral sclerosis

3. Alzheimer’s disease

4. Cachexia

5. Cancer

6. Chronic traumatic encephalopathy

7. Crohn’s disease

8. Epilepsy or another seizure disorder

9. Fibromyalgia

10. Glaucoma

11. Hepatitis C

12. Huntington’s disease

13. Inflammatory bowel disease

14. Multiple sclerosis

15. Pain that is either chronic and severe or intractable. In February 2021, the Medical Board determined arthritis, chronic migraines and complex region pain syndrome fall under pain.

16. Parkinson’s disease

17. Positive status for HIV

18. Post-traumatic stress disorder

19. Sickle cell anemia

20. Spasticity

21. Spinal cord disease or injury

22. Terminal illness

23. Tourette syndrome

24. Traumatic brain injury

25. Ulcerative colitis

Laura Hancock covers state government and politics for Cleveland.com and The Plain Dealer. Read more of her work here.

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