Cannabinoids have been studied for a variety of neurological disorders with promising results. Strong evidence indicates THC and CBD’s ability to treat muscle spasticity and neuropathic pain in multiple sclerosis, although a clear role of cannabinoids or the treatment strategy for this condition is not yet defined by the medical community. Around the world, the majority of patients who choose to complement their therapy with cannabis derivatives don’t receive proper support from healthcare systems and from physicians that would possess competences on cannabis treatments. In some cases, patients can join specific clinical programmes that also contribute to the global knowledge about the efficacy of cannabis against muscle spasms, pain, and other typical symptoms of neurodegenerative disorders.

WHAT IS MULTIPLE SCLEROSIS

Multiple sclerosis is a neurological disease deteriorating the fatty protein that protects nerve cells. The exposed nerves lose their full functionality and the resulting symptoms include pain, muscle spasticity, fatigue, inflammation, depression, leading to reduced physical activity and a low quality of life. This demyelinating process that takes places in the central nervous system affects 2.3 million people worldwide.

Standard treatments to help the patient return to a sort of normal life include anti-inflammatory and pain management drugs, muscle relaxants and tranquillisers. Although recently we saw significant advances in therapies, none of the current treatments can definitely cure MS-related symptoms. Given an already vast anecdotal evidence about a supposed efficacy of cannabis flowers, hash, and oils against MS symptoms, many patients started turning to this herb.

There’s plenty of personal reports by patients who use medical cannabis to alleviate pain, anxiety, muscle tremors and spasms caused by MS. Moreover, today the scientific confirmation of these effects is starting to rely on a solid base of hundreds of patients under clinical trials. Let’s have a quick look at some new research results of cannabis treatments in multiple sclerosis.

THE LATEST STUDIES

Several recent studies support the efficacy of cannabis extracts[1] in oral form to treat the symptoms of MS. In a randomised, double‐blind, placebo‐controlled study involving 572 people with MS, the oral cannabis extract Sativex was given as a complementary therapy to patients with refractory spasticity. The goals were to evaluate the difference between different treatments using the mean spasticity Numeric Rating Scale, the spasm frequency score, the level of sleep disturbance, the general impression of the patients and clinicians. All these parameters were in favour of the cannabis extract.

A similar, yet smaller study on patients with MS showed the effects of Sativex in comparison to a placebo for 12 weeks. The researchers found that patients in the cannabis group experienced much more relief from muscle stiffness[2].

A review of studies from 1948 to 2013[3] addressing treatment of symptoms of multiple sclerosis, epilepsy, and movement disorders with cannabis, found strong evidence of the efficacy of its derivatives for muscle issues, reducing spasticity and central pain or painful spasms. This was according to both patient-centred and objective measures at 1 year. The cannabis compounds were found possibly ineffective in controlling urinary dysfunction and tremors, and the risk of adverse psychopathological effects hit nearly 1% of the patients.

A few years later, two high-quality systematic reviews[4] concluded that the only strong evidence for efficacy of medical cannabis in neurological disorders was for reducing the symptoms of spasticity and central pain in multiple sclerosis, and that the only complementary medicine in MS with evident efficacy was cannabis. Serious adverse events were rare and THC was generally well-tolerated. After that study, a survey by the University of Colorado including MS patients using cannabis derivatives to handle their condition resulted in similar conclusions. Patients were using CBD and/or THC to manage pain, sleep, muscle stiffness, and most users did not report any side effects, while a few experienced some dizziness or decrease in vigilance and other minor side effects. Other recent studies and meta-analysis with large numbers of patients evaluated the effects of oral or oromucosal cannabinoids as well, collecting significant findings for spasticity, pain, and bladder dysfunction. Finally, we find a study assessing the effect of CBD[5] on mobility in people with multiple sclerosis. The study indicates that cannabis derivatives with 1:1 or greater CBD:THC ratio are able to reduce muscle spasticity and pain in multiple sclerosis patients. 

USING CANNABIS AGAINST MULTIPLE SCLEROSIS

USING CANNABIS AGAINST MULTIPLE SCLEROSIS

In many countries, doctors are allowed to prescribe cannabis in order to provide relief to multiple sclerosis patients, and this is probably going to be a common option over the next years, to help alleviate pain, muscle spasms and tremors. Some of THC's side effects might affect certain multiple sclerosis patients more than others, and consequently, more research is needed in order to understand which specific medical cannabis strains and which consumption forms work best, with less adverse effects.

Even if more and more patients today are comfortable discussing their medical cannabis use, or their will to use it with their physicians, most of healthcare personnel is not yet trained to prescribe or monitor cannabis-based treatments for MS. Here too, scientific literature so far doesn’t offer many specific hints on strains and doses to rely on. Once again, prohibition is slowing down clinical research on cannabis, leaving most of MS patients on their own when it comes to experimenting with strains, devices, or doses. Not to mention when it comes to obtaining good quality medical cannabis at reasonable prices for a daily use. This shouldn’t prevent patients from conducting their own research, experiments, and eventually cultivations.  

 

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