Cannabis and cannabidiol use among autistic and non-autistic adults in the UK: a propensity score-matched analysis

Abstract

ObjectivesTo assess whether autistic and non-autistic adults differ in their cannabis and cannabidiol (CBD) use, their perceptions of cannabinoid products and their cannabinoid-related support-seeking behaviours.DesignCross-sectional survey.ParticipantsRespondents to an online survey, who self-reported an autism-spectrum disorder diagnosis (autistic participants) or no issues relating to autism (controls). Exclusion criteria were: related/subclinical issues relating to autism, non-UK residence, under 16 years old. Propensity score matching was used to match autistic participants and controls on age, gender and ethnicity. The full-sample analysis included 269 participants and the propensity-matched sample analysis included 166 participants. Propensity-matched analysis was used for primary analysis and was considered robust if supported by triangulation with full-sample analysis.ResultsAutistic participants were more likely to have used CBD in the past 12 months compared with controls (OR=3.52, 95% CI 1.57 to 7.87, p=0.002). They used CBD on more days in the past 12 months (M=34, SD=93) compared with controls (M=17, SD=69, p=0.002). Autistic participants reported trusting the news and doctors less as sources of cannabinoid-related information than controls (p=0.024 and p=0.003, respectively). Autistic participants endorsed the following barriers to cannabinoid-related support seeking more than controls: ‘worrying they won’t understand me’ (OR=3.25, 95% CI 1.67 to 6.33, p<0.001), ‘going somewhere unfamiliar’ (OR=5.29, 95% CI 2.62 to 10.67, p<0.001) and ‘being in a crowded or chaotic place’ (OR=9.79, 95% CI 4.18 to 22.89, p<0.001).ConclusionResults indicate a higher prevalence and frequency of CBD use, but not cannabis use, among autistic individuals compared with controls. Findings also suggest appropriate methods to disseminate cannabinoid-related support to autistic individuals, and indicate differences in the potential barriers autistic and non-autistic individuals may face when seeking cannabinoid-related support.

Knowledge and perceptions about Cannabidiol use

“…Social stigma associated with the use of CBD and potential judgement of HCPs were barriers to CBD use reported by members of the public which were also concerns reported in other studies 15,16,32,33 .…”

“…Caregivers suggested that CBD should not be available over the counter but should be regulated by the government and labelled as a medicine 15 . The concern of being judged or misunderstood for using cannabis was reported as a barrier to CBD use 16 . Leszko and Meenrajan (2021) demonstrated the need for awareness about the difference between CBD and Medicinal Cannabis (MC) as the general public often confuse CBD with MC 15 .…”