A Guide to Treating MS with Cannabis
We hear lots of success stories of people treating MS with cannabis when other treatment methods have been unsuccessful. It’s estimated that 1 in every 385 Canadians over the age of 20 years old is living with MS (source) and the number of people turning to cannabis as a treatment is continuing to grow. When it comes to cannabis, anecdotal evidence is often all we have as clinical research has just begun. Though the evidence suggests that cannabis is an effective alternative in treating MS.
What is Multiple Sclerosis (MS)?
Multiple sclerosis (MS) is an autoimmune disease that impacts the central nervous system (brain and spinal cord). In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibres and causes communication problems between the brain and the rest of the body. Eventually, the disease can cause permanent damage or deterioration of the nerves.
Symptoms vary widely and depend on the amount of nerve damage and which nerves are impacted. Some people with severe MS may lose the ability to walk independently, or at all, while others may experience long periods of remission without any new symptoms.
Symptoms often affect movement, such as:
- Numbness or weakness in one or more limbs that typically occurs on one side of the body at a time, or legs and trunk
- Shock sensations that occur with certain neck movements, especially bending the neck forward
- Tremor, lack of coordination or unsteady gait
Vision problems are also common, including:
- Partial or complete loss of vision, usually in one eye at a time, often accompanied by pain during eye movement
- Prolonged double vision
- Blurry vision
Symptoms may also include:
- Slurred speech
- Tingling or pain in parts of your body
- Problems with sexual, bowel and bladder function
There’s no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease, and manage symptoms.
According to the Mayo Clinic, many of the disease-modifying therapies used to treat MS carry significant health risks.
Selecting the right therapy for you will depend on careful consideration of many factors, including duration and severity of the disease, the effectiveness of previous MS treatments, other health issues, cost, and child-bearing status.
Many of the treatments include medications and injections, read more on the Mayo clinic’s website. Some other treatments include; physical therapy, muscle relaxants, medications that reduce sleepiness as well as other conditions that often accompany MS (like depression, pain, sexual dysfunction, insomnia, and bladder/bowel control).
Treating MS with Cannabis
It’s common for individuals with MS to use cannabis. In a 2017 study, 59% of individuals reported reducing their other prescription medications as a result of using cannabis as well as increased quality of life overall.
Sativex is one of the most widespread and popular cannabis-derived drugs intended for treating MS. It’s the brand name for the nabiximols drug produced by GW Pharmaceuticals.
As a part of Sativex’s development, GW Pharmaceuticals has sponsored numerous clinical trials studying its effects on the symptoms of MS, with specific focus given to improvements in spasticity (muscle stiffness/spasms) and neuropathic pain.
What the research says
Pain is a complex phenomenon and a common symptom of MS (affects around two-thirds of people with MS). People with MS can experience many different types of pain, including headaches (43%), nerve pain in their arms or legs (26%), back pain (20%), painful spasms (15%) and trigeminal neuralgia (3.8%) (source).
Most pain experienced by people with MS is central neuropathic pain (pain caused by damage to the central nervous system) or pain from spasms. Cannabis has proven to be effective for pain but the mechanisms involved are complex and not well understood. Some evidence suggests that the CB1 receptors in the brain and peripheral nerves play a role in modulating and processing pain. Cannabis may also decrease pain by decreasing inflammation.
A 2006 study into Sativex’s effect on neuropathic pain found that when patients self-administered, on average they were using approximately 22-32 mg/day of THC and 20-30 mg/day of CBD to manage their pain. At these doses, Sativex showed positive results.
Several studies have looked at the effect of cannabis on neuropathic pain in people with MS. One study lasting four weeks in 64 people with MS found a 41% decrease in pain intensity in the group taking nabiximols compared to a 22% decrease in pain in the group taking the placebo.
Spasticity is a feature of altered skeletal muscle performance that includes; a combination of paralysis, increased tendon reflex activity, and hypertonia. Or more colloquially referred to as an unusual “tightness”, stiffness, or “pull” of muscles. Over 85% of people with MS experience some spasticity, 50% have at least mild spasticity, and up to 17% have severe spasticity (source).
More than ten studies have studied Sativex’s effect on MS-related spasticity. A 2005 study of over 360 patients with various neurological conditions (including MS), found that Sativex “significantly reduced neuropathic pain, spasticity, muscle spasms, and sleep disturbances.” A later, 2012, controlled study confirmed the effectiveness of Sativex for controlling spasticity specifically related to MS.
A 2014 systematic review not related to Sativex (or GW Pharmaceuticals) also found evidence to support the use of cannabis for spasticity related to MS as well as the pain associated with spasticity.
MS and Sleep
As a result of pain and muscle spasms, people with MS regularly experience sleep disturbances. There is evidence to support the use of cannabis for sleep challenges and for treating insomnia. Though it’s important to note that THC may disrupt the REM sleep cycle, which could be what leads to some people feeling groggy the day after consuming cannabis.
CBD also has sedative effects and helps to counteract the psychoactive effects associated with THC. Newer studies even suggest CBD is more effective in treating insomnia than THC. This is, in part, due to the fact that CBD positively impacts many of the factors that cause sleep disturbances, such as; depression, anxiety, and chronic pain. Also, other studies suggest that CBD doesn’t affect a person’s sleep cycle in the same way that THC does.
What People are Saying about Treating MS with Cannabis
A large number of people are using cannabis to treat MS but not all of them were enthusiastic about cannabis initially. Some people are worried about the stigma associated with cannabis or what their friends or family might think if they found out. And some people, like Jason, find the information they’re basing their perceptions on is either wrong or outdated.
Medical Cannabis Network spoke to the first patient in Australia to receive a medical cannabis prescription, Jason Jordan, about his experience with cannabis and MS. Jason was initially skeptical about the use of cannabis, but once he was educated and experienced the effects for himself, he became an advocate for medical cannabis. In January 2019 he became the director of Medical Cannabis Research Australia, which is a registered charity with the mission is to educate, advocate, and fund cannabis research. Read his story here.
A mother, who was also skeptical about cannabis use, shared her experience treating MS with Cannabis with Healthline.
Do you have experience treating MS with Cannabis?
If you do, we want to hear about it! Let us know in the comments, reach out to us on social media, or email us at firstname.lastname@example.org.
How to Use Cannabis for Treating MS
Preliminary evidence suggests that cannabis is effective in managing symptoms associated with MS. A number of personal success stories also support its use. Much of the research has been focused on a combination of CBD and THC. Although a combination of both CBD and THC may be most effective, as a result of the entourage effect, more research is necessary to fully understand the mechanisms involved. Currently, there is no accepted dose for treating MS with cannabis. Doctors suggest to start at a low dose and work your way up slowly (over several days) until the most effective dose is determined.
Cannabis is most effective, in most cases, when used in conjunction with other treatments. Many people using cannabis to treat MS have been able to reduce or eliminate other medications, while others may still undergo physical therapy or other treatments.