MS and Cannabis
Canada has one of the highest rates of multiple sclerosis (MS) in the world, with over 75,000 Canadians affected by the disease. Much about MS remains a mystery while it is most often diagnosed in young adults in their thirties and forties, children and older adults can also be diagnosed as well. Cannabis as a treatment for multiple sclerosis is gaining popularity for a few key reasons, namely cannabis’ ability to help manage pain and the calming anti-spastic benefits of cannabis on muscles.
What is Multiple Sclerosis?
MS is a lifelong condition that causes a range of symptoms that are often debilitating and painful. MS is an autoimmune disease that attacks the nerves and damages cells in the central nervous system, specifically brain cells, the spinal cord, and optic nerves. Often MS patients’ bodies lose the ability to send and receive signals properly, resulting in muscle spasms, fatigue, trouble walking, and blurred vision.
Why is Multiple Sclerosis so Hard to Treat?
Between 40 to 60 percent of patients living with MS experience difficulties with cognitive functioning, but that is only one-way that MS presents itself. MS has a large list of symptoms and no single patient’s diagnosis of multiple sclerosis is the same. This makes developing treatments or medications that can be prescribed easily for MS extremely difficult, and in many cases unrealistic.
MS and Cannabis
At the moment, therapies for MS aim to either slow disease progression or manage the symptoms of MS. With no cure or standard treatment practice, many people diagnosed with MS are turning to cannabis to help manage their symptoms. In fact, a published survey of people with MS showed that over 90 percent of the respondents have either used cannabis or considered using it to manage their MS symptoms.
Cannabis and MS-related Pain
Pain is a complex physical reaction involving many different chemicals, neurotransmitters, and receptors. Unfortunately, pain is a common symptom of MS, affecting nearly two-thirds of patients. The type of pain most commonly experienced by MS patients is neuropathic pain, which is essentially nerve pain and can affect many areas in different ways - from headaches to leg spasms or even nerve pain throughout their arms and hands.
Cannabis and MS - Neuropathic Pain
The role of cannabis in pain relief is complex and not well understood. The theory is that the CB1 receptors in the brain and peripheral nerves throughout the body play a role in modulating and processing pain. The cannabinoid THC in cannabis interacts with the CB1 receptors in our bodies impeding the ability of our bodies to send and receive the same intensity of pain signals, this can result in muted pain and in some cases relief altogether.
Cannabis and Inflammation
When our immune system is under attack, inflammation is one of its first defenses. With an autoimmune disease as aggressive as MS constantly attacking the immune system it comes as no surprise that many individuals who suffer from MS experience severe inflammation as a side effect. The cannabinoid CBD in cannabis has strong anti-inflammatory abilities, while inflammation may not be the main cause of pain in a patient with MS it is without a doubt a factor that can impede movement and decrease the quality of life.
MS for Cannabis and Muscle Spasms
As you may have noticed by now, a predominant symptom of MS is muscle spasms, which can be painful and debilitating. These muscle spasms are caused by nerve damage, the weakness often occurs only on one side of the body or in specific parts of the body. In one study, scientists gave people with MS either an oral extract of cannabis or a placebo for 12 weeks. The researchers found that people in the cannabis group experienced almost twice as much relief from muscle stiffness. As mentioned earlier, research is just beginning, and we aren’t certain how cannabis provides relief in all these situations. We know it’s working, we just need to understand how in order to best treat MS with cannabis. In 2014, a systematic review found strong evidence to support the use of marijuana-based treatments for MS-related muscle problems.
Cannabis Research for Multiple Sclerosis
Research on cannabis and its medical benefits is lacking in many areas, fortunately, due to the high number of patient testimonials and anecdotal evidence that cannabis improved many MS symptoms, the scientific community has begun to act.
In one study, a team of scientists enrolled over 600 patients with MS to test if cannabis extract with a 2:1 ratio of THC and CBD can repair or slow damage to brain cells within 15 weeks. While the tests did not show any improvements in brain cell repair, patients showed improvements in movement, muscle control, and sleep compared to those on placebo.
Several more studies have evaluated the effect of neuropathic pain in people diagnosed with MS. One small clinical trial involving fifteen patients diagnosed with MS found that cannabis, in combination with gabapentin, (a pain medication) was effective and well-tolerated for the treatment of neuropathic pain.
Another small study of 64 individuals with MS found that cannabis-based treatment was effective in reducing pain and was well-tolerated. Similar results were found in the CAMS study in which patient-reported outcomes revealed patient-perceived improvement in pain.
Another randomized study examined the effects of cannabis treatment for pain revealed that cannabis is modestly effective in treating pain compared to mock drugs in seven of the 11 studies. Similarly, a report from the Guideline Development Subcommittee of the American Academy of Neurology published that cannabis extract is effective in reducing pain.
Is There Risk with Cannabis?
How often cannabis is used, the quantity, how it is taken, the proportion of THC to CBD within the cannabis as well as the tolerance of the individual, are all factors that influence the individual's experience with cannabis use. Cannabis is a deeply individual experience and effects differ from person to person so what is right for one patient may not be right for another. Cannabis, especially in large dosages, can have side effects, and it may not be suitable for everyone.
Possible side effects of cannabis include:
● nausea and vomiting
● dry mouth and eyes
● increased hunger
● problems with balance and coordination
● increased heart rate
● Damage to the lungs if smoked
Before trying cannabis for MS, you should always consult with a doctor or health professional to understand how it may help or hinder your specific situation. Our hope is that soon research will understand exactly how cannabis reacts in the body to combat MS symptoms. If you would like to learn more about how cannabis may help you or a loved one, please feel free to book an appointment with one of our doctors or subscribe to our newsletter.