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

BMJ Open. 2021 Dec 16;11(12):e053814. doi: 10.1136/bmjopen-2021-053814.


Objectives: To 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.

Design: Cross-sectional survey.

Participants: Respondents 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.

Results: Autistic 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).

Conclusion: Results 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.

Keywords: epidemiology; public health; substance misuse.

MeSH terms

  • Adolescent
  • Adult
  • Autistic Disorder* / epidemiology
  • Cannabidiol* / therapeutic use
  • Cannabis*
  • Cross-Sectional Studies
  • Humans
  • Propensity Score
  • United Kingdom / epidemiology


  • Cannabidiol