Cannabis (mostly CBD) dramatically reduced disruptive behavior in 5 people with fetal alcohol spectrum disorder | Research

The takeaway

In 5 individuals with FASD and severe disruptive behavior, cannabis use (primarily CBD) reduced behavior scores from 18 to 6 on a validated rating scale (p=0.0002).

Clinicians treating FASD, families managing FASD behaviors, and pediatric psychiatrists.

Disruptive behavior scores dropped from 18 to 6 (p=0.0002)

What the researchers found

All 5 cases (2 children, 3 young adults) with FASD and severe disruptive behavior showed significant improvement after cannabis use, primarily CBD. Nisonger Child Behavior Rating Form disruptive behavior scores dropped from 18 to 6 (p=0.0002). The improvement was described as "marked" by the researchers.

Why it matters

FASD affects up to 5% of American children, and treatment options for their disruptive behaviors are extremely limited (mainly stimulants and antipsychotics). CBD's favorable safety profile could make it an attractive option if larger studies confirm these findings.

The numbers in context

5 cases (2 children, 3 young adults). Disruptive behavior score: 18 before cannabis to 6 after (p=0.0002). Cannabis type: mostly CBD.

How the study worked

Retrospective case series of 2 children and 3 young adults diagnosed with FASD and severe disruptive behavior. Behavioral changes after cannabis introduction measured using the parent version of the Nisonger Child Behavior Rating Form.

What this study cannot tell us

Only 5 cases with no control group. Retrospective design. Parent-reported outcomes. Cannot rule out placebo effects, natural behavioral fluctuation, or concurrent changes. "Mostly CBD" is not a precise formulation.

How to read the evidence

Very small case series with no controls. Statistically significant but cannot establish causation.

When this study was published

2021 retrospective case series.

The bigger picture

The FASD population shares some behavioral features with autism spectrum disorder, where CBD has also shown promise. If CBD works for FASD disruptive behaviors, it could represent a new treatment avenue for a condition with very few evidence-based pharmacological options.

Questions still open

Would CBD show similar effects in a controlled trial? What is the optimal CBD dose for FASD behaviors? How does CBD compare to current pharmacological treatments for FASD?

Common questions

What is FASD?

Fetal alcohol spectrum disorder (FASD) results from prenatal alcohol exposure and affects up to 5% of American children. It causes behavioral problems including disruptive behavior, for which there are very few effective treatments.

Was this THC or CBD?

The cannabis used was described as "mostly CBD." All 5 cases showed marked improvement in disruptive behavior regardless of exact formulation.

Read the original research

Use of Cannabis in Fetal Alcohol Spectrum Disorder.

Cannabis and cannabinoid research, 6(1), 74-76

View on PubMed ↗Publisher’s paper ↗

Citation

Koren, Gideon; Cohen, Rana; Sachs, Ornie. (2021). Use of Cannabis in Fetal Alcohol Spectrum Disorder.. Cannabis and cannabinoid research, 6(1), 74-76. https://doi.org/10.1089/can.2019.0056