Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind, and placebo-controlled clinical trial

Abstract Objective Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction and by restricted and repetitive patterns of behavior. Some studies have shown that substances derived from Cannabis sativa improve the quality of life of children with ASD without causing serious adverse effects, thus providing an alternative therapeutic option. The objective of this study was to evaluate the efficacy and safety of a cannabis extract rich in cannabidiol (CBD) in children with ASD. Methods In this randomized, double-blind, placebo-controlled clinical trial, 60 children, aged from 5 to 11 years, were selected and divided into two groups: the treatment group, which received the CBD-rich cannabis extract, and the control group, which received the placebo. They both used their respective products for a period of 12 weeks. Statistical analysis was done by two-factor mixed analysis of variance (two-way ANOVA). Results Significant results were found for social interaction (F1,116 = 14.13, p = 0.0002), anxiety (F1,116 = 5.99, p = 0.016), psychomotor agitation (F1,116 = 9.22, p = 0.003), number of meals a day (F1,116 = 4.11, p = 0.04), and concentration (F1,48 = 6.75, p = 0.01), the last of which was only significant in mild ASD cases. Regarding safety, it was found that only three children in the treatment group (9.7%) had adverse effects, namely dizziness, insomnia, colic, and weight gain. Conclusion CBD-rich cannabis extract was found to improve one of the diagnostic criteria for ASD (social interaction), as well as features that often co-exist with ASD, and to have few serious adverse effects.

Cannabis and cannabinoid use in autism spectrum disorder: a systematic review

Abstract Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, associated with the presence of restricted and repetitive patterns of behavior, interests, or activities. Cannabis has been used to alleviate symptoms associated with ASD. Method We carried out a systematic review of studies that investigated the clinical effects of cannabis and cannabinoid use on ASD, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist). The search was carried out in four databases: MEDLINE/PubMed, Scientific Electronic Library Online (SciELO), Scopus, and Web of Science. No limits were established for language during the selection process. Nine studies were selected and analyzed. Results Some studies showed that cannabis products reduced the number and/or intensity of different symptoms, including hyperactivity, attacks of self-mutilation and anger, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, aggressiveness perseverance, and depression. Moreover, they found an improvement in cognition, sensory sensitivity, attention, social interaction, and language. The most common adverse effects were sleep disorders, restlessness, nervousness and change in appetite. Conclusion Cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD, and can be used as a therapeutic alternative in the relief of those symptoms. However, randomized, blind, placebo-controlled clinical trials are necessary to clarify findings on the effects of cannabis and its cannabinoids in individuals with ASD. Systematic review registration International Prospective Register of Systematic Reviews (PROSPERO), code 164161.

Adolescentes em situação de rua: prostituição, drogas e HIV/AIDS em Santo André, Brasil / Street youth: prostitution, drugs and HIV/AIDS in Santo André-Brazil

O objetivo do estudo foi investigar as condições de vida de adolescentes do sexo feminino em situação de rua, envolvidas com o abuso de drogas e com a prostituição, visando orientar estratégias de prevenção às Doenças Sexualmente Transmissíveis - DST/AIDS. Foram entrevistadas sete adolescentes entre 14 e 19 anos, por meio de roteiro semi-estruturado com questões sobre escolaridade; desligamento da família; violência; histórico de uso de drogas, sexualidade e existência de DST/AIDS; vida na rua e futuro. Observou-se que os principais motivos que levaram essas adolescentes à rua foram violência doméstica; baixo nível sócio-econômico familiar e abuso de múltiplas drogas. As entrevistadas afirmaram conhecer medidas preventivas para as DST/AIDS, porém não as aplicaram aos clientes fixos e namorados. A análise dos resultados obtidos nesta pesquisa confirma a importância da criação de estratégias específicas para as DST/AIDS, além da adequação da rede educacional e de atenção psicossocial às necessidades das adolescentes para a garantia de seus direitos e conquista da emancipação.

The aim of this study was to investigate living conditions of female street adolescents, who are involved with illicit and licit drugs, and with prostitution, in the city of Santo André, as well as to tailor strategies for STD/AIDS prevention. We have interviewed seven adolescents, aged from 14 to 19 years old, using a semi-structured questionnaire with questions about education, family disaffection, violence, living on the streets, history of drug use, sexuality, level of information about STD/AIDS, and hopes for the future. We observed that among the reasons for these adolescents to live on the streets were domestic violence, low socioeconomic level, and drug abuse. They stated that they are aware of STD/AIDS preventive measures, but they do not bring them into effect with steady partners and boyfriends. The analysis of our results confirms the importance of creating well-defined strategies to STD/AIDS prevention, additionally to suitable educational system and psychosocial attention service. This will assure adolescents' rights and emancipation.

Adolescência e corpo: a prostituição e o abuso de droga como sintoma / Adolescence and the body: a prostitution and drug abuse as a symptom

O estudo propõe, com base na escuta das histórias de vida de dez jovens, entre 19 e 25 anos, que vivem na prostituição em boates da cidade de Santo André-SP, realizar uma discussão a respeito da prevenção das DST/AIDS e da toxicomania. A partir da fala de cada entrevistada sob o enfoque da psicanálise, evidenciou-se o fato de que as jovens, embora disponham de informações sobre medidas preventivas das DST/aids, vivenciam um conflito de identidade expresso em vários níveis de seu discurso que contribui para a vulnerabilidade dessas doenças, sobretudo nas relações que envolvem afetividade. Apoiando-se nesses discursos, foi possível pontuar a implicação dessa ambiguidade no cuidado de si e na necessidade de políticas públicas que abordem a prostituição, levando em conta esse aspecto.

The purpose of this study is to discuss the prevention of STDs/AIDS and drug adiction, starting from listening to ten life stories from youngsters, between 19 and 25 years old, who are involved in prostitution at nightclubs from the city of Santo André-SP. Through the speech of each and every one of them, under the psychoanalysis approach, it was possible to notice that, although having information on the prevention methods against STDs/AIDS, the youngsters live an identity conflict shown in many levels of their discourse, which contributes to their vulnerability towards these diseases, mainly in their affective relationships. Based on these discourses, it was possible to identify the implications of this ambiguity while caring for themselves and the need of public policies that take prostitution into account, regarding this aspect, from a woman's point of view.