Disease-modifying therapies for multiple sclerosis (MS) aim to either slow disease progression or manage symptoms of MS. Many individuals diagnosed with MS are using or considering using cannabis as part of their symptom management care plan.
A recently published survey of people with MS showed that over 90 percent of the respondents have either considered using cannabis to manage their MS, have used it for MS, or have spoken to their healthcare provider about its use.
What is Multiple Sclerosis?
Multiple sclerosis (MS) is a neurologic disease of the central nervous system that causes physical and cognitive disability. Since that includes the brain, spinal cord and optic nerve, MS can affect vision, memory, balance and mobility. It is considered an episodic disability meaning that the severity and duration of illness and disability can vary and are often followed by periods of wellness; it can also be progressive. Multiple sclerosis is also associated with a diverse range of symptoms, including pain, spasticity, fatigue, balance problems, heat intolerance, bladder problems, and tremors, all of which adversely affect quality of life. Patients with MS often seek nonmainstream treatment options to alleviate their symptoms, such as complementary and alternative medicine (CAM), herbal supplements, and marijuana.
The disease attacks myelin, the protective covering of the nerves, causing inflammation and often damaging the myelin. Myelin is necessary for the transmission of nerve impulses through nerve fibres. If damage to myelin is slight, nerve impulses travel with minor interruptions; however, if damage is substantial and if scar tissue replaces the myelin, nerve impulses may be completely disrupted, and the nerve fibres themselves can be damaged.
MS is unpredictable and may cause symptoms such as extreme fatigue, lack of coordination, weakness, tingling, impaired sensation, vision problems, bladder problems, cognitive impairment and mood changes. Its effects can be physical, emotional and financial. Currently there is no cure, but each day researchers are learning more about what causes MS and are zeroing in on ways to prevent it.
Cannabis and MS Research
Cannabis has been studied for its use in many conditions, such osteoarthritis, migraines and more recently, multiple-sclerosis. There have been numerous studies conducted to evaluate the effects of cannabinoids on MS-related pain, spasticity, and bladder symptoms. Most studies involved relatively small numbers of people with MS and the outcome measures varied among studies. However, reviews of published studies have generally shown that synthetic cannabinoids favorably impact symptoms of pain and spasticity. Less in known about the impact of inhaled or ingested botanical cannabis on MS symptoms.
Below is a summary of recent findings related to the effectiveness of cannabis in alleviating MS symptoms:
- Over 60 percent of people with MS will experience MS-related pain during the course of their disease8. MS-related pain includes neuropathic pain and musculoskeletal pain. Research has demonstrated that pharmaceutical grade cannabis-based treatments showed evidence of reducing pain.
- A review of randomized control trials examining the effects of cannabis treatment for pain (including but not limited to pain associated with MS), revealed that cannabis is an effective analgesic in treating pain compared to placebos administered.
- Another small study of 64 individuals with MS found that cannabis-based treatment was effective in reducing pain and was mostly well-tolerated. Similar results were found in the CAMS study in which patient-reported outcomes revealed a patient perceived improvement in pain.
- A report from the Guideline Development Subcommittee of the American Academy of Neurology, published that oral cannabis extract is effective in reducing pain.
- More recently, a clinical trial led by Dr. Zajicek and the MUSEC Research Group, in which 279 individuals were randomized to either oral cannabis extract or placebo treatment for 12 weeks. Results showed that individuals taking cannabis extract had nearly twice as much relief from muscle stiffness compared with the placebo group. Improvements were also reported in muscle spasms and sleep.
- In a study in the Journal of Neurology, Neurosurgery & Psychiatry, researchers gave people with MS either an oral extract of marijuana or a placebo for 12 weeks. The researchers found that people in the marijuana group experienced almost twice as much relief from muscle stiffness.
- A large 2011 study involved 572 people with MS who took either oral marijuana extract or a placebo. The authors concluded that marijuana extract is an effective treatment for spasticity in people with MS. Spasticity is the continuous contraction of certain muscles, and it is a common symptom of MS.
- Scientists conducted a trial to investigate the use of oral marijuana extract for bladder dysfunction. They gave the participants either the extract or a placebo for 10 weeks. The results indicated that marijuana might improve the symptoms of bladder problems in people with MS.
Research on the effectiveness of Cannabis for individuals diagnosed with MS is a relatively new avenue, in that researchers are seeking to delve further into this area to identify the real effectiveness of Cannabis in treating auto-immune diseases. More rigorously designed clinical trials are needed to address these research questions in MS.
Current Treatments and Options?
Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) Sativex (Nabiximols) is an oromucosal spray formulation that contains THC and CBD in an approximate 1:1 ratio and is described as an endocannabinoid system modulator. Sativex, by GW Pharmaceuticals, is available in 25 countries — including most of Europe and Canada — as an add-on therapy for MS patients with moderate-to-severe spasticity who fail to respond to other anti-spastic treatments. Nabiximols have the potential to be a rigorously tested and FDA-regulated cannabis-derived medicine for people living with MS.
What Does the Future Hold?
With more individuals and researchers exploring the use of alternative and complementary approaches, such as cannabis, for treating MS symptoms, it has become increasingly important to investigate whether cannabis or cannabis-derived therapies can effectively and safely manage common symptoms, as well as disease progression experienced in autoimmune disorders.
More recently, researchers have begun exploring the effectiveness of medical cannabis as a treatment for patients diagnosed with fibromyalgia.
**Disclaimer: The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health. We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.