Only 1.2% of autistic individuals in Israel's largest health system were prescribed medical cannabis | Research

The takeaway

In a retrospective study of 36,610 autistic individuals in Israel's largest HMO, only 462 (1.2%) were prescribed medical cannabis. Those prescribed it were diagnosed earlier, had more complex clinical profiles, came from higher socioeconomic backgrounds, and most prescriptions did not fully comply with guidelines requiring prior antipsychotic trials.

Families of autistic individuals considering medical cannabis, and clinicians navigating cannabis prescribing for autism.

Only 1.2% of autistic individuals received medical cannabis; most prescriptions bypassed required antipsychotic trials

What the researchers found

Only 1.2% of autistic individuals received medical cannabis prescriptions. The cannabis-prescribed group was diagnosed earlier (median 3 vs 5 years), had more complex clinical profiles, and higher socioeconomic status. 4.3% of prescriptions were for children under 5. Most prescriptions did not fully comply with Ministry of Health guidelines requiring prior trials of two FDA-approved antipsychotics.

Why it matters

Despite growing clinical interest and media attention around cannabis for autism, this large real-world dataset shows that actual prescribing remains rare and is concentrated among higher-SES families with more complex cases. The finding that most prescriptions bypassed required antipsychotic trials raises regulatory concerns.

The numbers in context

36,610 autistic individuals. 462 (1.2%) prescribed cannabis. Median diagnosis age: 3 years (cannabis group) vs 5 years (non-cannabis). 4.3% of prescriptions for children under 5. Higher SES in cannabis-prescribed group. Most prescriptions did not meet guideline requirements for prior antipsychotic trials.

How the study worked

Retrospective cohort study using electronic medical records from Clalit Health Services (Israel's largest HMO, serving ~4.7 million). All individuals with autism diagnoses from 1990-2025 were identified (N=36,610). Cannabis-prescribed (n=462) and not-prescribed (n=36,148) groups were compared on demographics and clinical characteristics.

What this study cannot tell us

Single HMO in Israel may not generalize to other healthcare systems. Cannabis prescription does not mean the patient actually used it or benefited. Clinical complexity was assessed from administrative data. The study could not evaluate treatment outcomes or side effects.

How to read the evidence

Large real-world cohort from a national health system with comprehensive records, but descriptive and unable to assess outcomes.

When this study was published

Published in 2026, using records from 1990-2025.

The bigger picture

The socioeconomic gradient in cannabis prescribing suggests that access may be influenced by health literacy, advocacy ability, or provider networks rather than clinical need alone. The non-compliance with prescribing guidelines highlights the tension between clinical demand and regulatory frameworks in emerging therapeutic areas.

Questions still open

Why do higher-SES families obtain cannabis prescriptions more frequently? Is the low prescribing rate appropriate given the limited evidence, or does it represent undertreatment? Should prescribing guidelines be updated as new evidence emerges?

Common questions

Is medical cannabis effective for autism?

Evidence remains limited. This study did not assess effectiveness but found that very few autistic individuals in Israel's largest health system were prescribed cannabis (1.2%), despite growing interest.

Why were prescriptions not following guidelines?

Israel requires prior trials of two FDA-approved antipsychotics before prescribing cannabis for autism with severe behavioral disturbances. Most prescriptions in this study did not fully meet this requirement, suggesting clinical demand is outpacing the regulatory framework.

Read the original research

Medical Cannabis Use in Autism: Insights from an Israeli HMO on Patient Characteristics and Alignment with National Guidelines.

Journal of child and adolescent psychopharmacology, 36(1), 29-34

View on PubMed ↗Publisher’s paper ↗

Citation

Sadeh, Hadar; Razi, Talish; Arbel, Ronen; Netzer, Doron; Meiri, Gal. (2026). Medical Cannabis Use in Autism: Insights from an Israeli HMO on Patient Characteristics and Alignment with National Guidelines.. Journal of child and adolescent psychopharmacology, 36(1), 29-34. https://doi.org/10.1177/10445463251404404