Abstract
Objective: In that cannabis use has been linked with the development of autism spectrum disorder like conditions in gestationally exposed children, we set out to explore the extent to which rising cannabis use might contribute to the rising autism epidemic. Methods: Datasets from US Department of Education Individuals with Disabilities Act (IDEA), National Survey of Drug Use and Health, and CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network were investigated. Data on legal status was derived from SAMHSA. Results: IDEA had N=1,023 and ADDM N=87. Modelling of IDEA consistently showed that models quadratic-intime out-performed linear-only models (ANOVA p<2.0x10-16). In both datasets liberalization of cannabis legislation was associated with increased ASD (p<10-9 and p<0.05 respectively). Slopes of: ASD vs. time, Cannabis vs. time and ASD vs. cannabis curves were shown to be related on graphical analysis by geofacet plots and tanglegrams (entanglement=0.3326). CDC’s ADDM network quoted US autism incidence 168/10,000 in 2014. IDEA projections indicated rates 108.57, 131.67 and 166.49 in cannabis-illegal, -medical and -decriminalized states rising exponentially to 282.37, 396.91 and 455.54 by 2030. Conclusion: ASD is the commonest form of cannabis-associated clinical teratology. Using two independent datasets and two categorization methods we confirmed that medical, decriminalized and legal cannabis regimes are associated with higher rates of ASD than illegal ones. Findings are consistent with molecular, cellular and epigenetic mechanisms. Formerly quadratic regression curves become exponential when projected forwards to 2030; predict a lower quantum than the 2014 ADDM CDC figure; and indicate a 60% excess of cases in legal states by 2030.
Highlights
Recent reports from several sources indicate that the incidence of Autistic Spectrum Disorder (ASD) has been growing significantly in most USA jurisdictions in recent decades [1,2,3]
Given that a number of leading USA public health organisations have published data showing that pro-cannabis legalization paradigms are associated with increased rates of cannabis use [14], we investigated if these trends in individual states cannabis use were associated with increased incidence of ASD
Our study has shown that ASD is more common in states which host more liberal legislative paradigms relating to cannabis use
Summary
Recent reports from several sources indicate that the incidence of Autistic Spectrum Disorder (ASD) has been growing significantly in most USA jurisdictions in recent decades [1,2,3]. Too has cannabinoid exposure [7,8]. This opens the possibility that the recent rise in the use of cannabinoids across the USA may be linked to the disturbing rise in the prevalence of autism [9]. Such a link achieves public health importance in the light of large numbers of pregnant American women who are exposed to cannabis, reaching 161,000 in 2017 [10]. The frequent recommendation of cannabis dispensaries to pregnant users to consume cannabis during gestation [11], and the positive test or affirmation of cannabis use by 25% of Californian teenage mothers [12]
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