Are there any benefits of cannabis for multiple sclerosis patients?

What does MS do to a person?

In MS, the immune system attacks the myelin, which is the protective covering around nerve fibers in the central nervous system. As a result, the nerve fibers are damaged, resulting in a breakdown in communication between the brain and the rest of the body.

The MS symptoms vary from person to person and may include:

• Muscle weakness or stiffness

• Difficulty with balance and coordination

• Fatigue

• Tingling or numbness in the limbs

• Vision problems

• Bladder or bowel dysfunction

• Cognitive impairment

• Emotional changes

Can medical marijuana help your MS?

Many people with MS already use marijuana, and studies have shown that half or more of research participants would consider it if it were legal or offered proven benefits.

 The marijuana plant, or Cannabis sativa, has hundreds of chemicals that can affect the mind and body.

The two main active compounds in marijuana are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is responsible for the psychoactive effects of marijuana and gets you high, while CBD does not produce psychoactive effects so it can be approved in some countries.

In the early 1990s, while researchers were exploring THC, a well-known cannabinoid,  the endocannabinoid system was discovered. It is a complex system of receptors and neurotransmitters that are found throughout the body and play a crucial role in regulating various physiological functions such as pain, inflammation, and motor control.

That is important because the cannabinoids in marijuana can bind to the cannabinoid receptors in the endocannabinoid system and affect the function of the nervous system.

What does science say about the effectiveness of treating MS with marijuana?

Studies have shown that medical marijuana can help alleviate many of the symptoms of MS,  including pain, spasticity, and muscle stiffness.

One in five people with multiple sclerosis (MS) surveyed in 2014 said they’d used cannabis to help with their symptoms. They said it can help with muscle spasms or stiffness (spasticity) and pain. At the same time the American Academy of Neurology (AAN) research didn’t find enough evidence that smoking cannabis was safe or effective against MS.

A review by America’s National Academies of Sciences, Engineering and Medicine (NASEM) in 2017 found that people who took cannabis-based treatment by mouth said it helped with their spasticity.

The results of the MUSEC (Multiple Sclerosis and Extract of Cannabis) trial showed that the rate of relief from muscle stiffness after 12 weeks of oral consumption of cannabis extract was almost twice as high with CE as with placebo (29.4% vs 15.7%).

Medical marijuana: where to get it in Europe?

It is important to know that marijuana is illegal, but medical marijuana is legal, and you need a doctor's approval and prescription to get it legally.

Cannabis-based products are permitted in many European countries; however, each country has different regulations and laws surrounding its usage. 

In Schengen, you can get a prescription for medical cannabis and travel with this medicine if needed. But it is still very difficult to get it from your doctor, and this might be because your doctor has not enough knowledge about cannabis or medical cannabis. 

Medical marijuana medications for multiple sclerosis

Nabiximols, Dronabinol, and Nabilone are three medications that contain synthetic versions of cannabinoids found in the cannabis plant. They are used to treat multiple sclerosis (MS) by reducing symptoms such as spasticity and neuropathic pain.

Dronabinol

Dronabinol is a synthetic form of THC that is approved by the US Food and Drug Administration (FDA) for the treatment of nausea and vomiting associated with chemotherapy and for the treatment of anorexia associated with AIDS.

It is highly effective in the treatment of pain in MS patients and has shown significant improvement in MS sleep problems.

Nabilone

It is the generic name for the primary synthetic analog of 9-THC carrying dibenzopyran-9-one.

Two researches showed that Nabilone has beneficial effects in lowering most MS symptoms, including spasticity, pain, bladder dysfunction, and quality of life, but not significant effects on tremors. Also, there are no clinical investigations on the symptoms of MS sleep problems and MS-related disability and progression.

Nabiximols

It is the generic name for the medically approved Sativex drug which is used as an oromucosal spray. Nabiximols contain THC, CBD, and a small number of other constituents of the plant extract, including other cannabinoids and terpenoids dissolved in ethanol.

 It has a significant effect on improvement in MS-related spasticity, pain, and sleep problems and a minor effect on the alleviation of bladder dysfunctions in MS patients. Nabiximols

is not successful in treating MS-related tremors and ataxia and didn't show significant changes in terms of disability and progression.

It is the only drug for MS approved by NHS in the UK.

How to take medical marijuana for MS?

The basic principle for dosing medical marijuana is to start with a low dose and go up slowly in order to achieve the desired effect. The benefits of cannabis are not always immediately felt.

Medical marijuana comes in various forms, each suited for different conditions and preferences. The most common forms include flower (bud), which can be smoked or vaporized, providing quick relief but not ideal for those with respiratory issues.

Edibles, such as foods or drinks infused with cannabis, take longer to feel effects but last longer.

Tinctures and oils are liquid extracts that can be taken under the tongue or added to food, offering precise dosing and relatively quick effects.

Topicals, like creams or lotions, are applied directly to the skin and are useful for localized pain and inflammation without psychoactive effects.

Capsules and pills provide controlled dosing but have a slower onset of effects similar to edibles.

Vaporizers heat cannabis to release active compounds without combustion, offering a smokeless option for those who prefer inhalation.

How to use CBD oil for MS?

CBD oil can be applied sublingually, which means you squeeze it directly underneath your tongue and hold it there for around 90 seconds, allowing it to absorb, and the oil will fast-track its way into the bloodstream. It can be also added to food or drinks or put on the skin. Some research found sprays you put under your tongue might be best for MS.

What are the possible side effects of medical cannabis use?

Side effects are usually mild or moderate and usually stop quickly, but sometimes severe side effects occur. Some of the most common side effects are dry mouth and eyes, sedation, headache, increased hunger, nausea and problems with balance and coordination.

Confusion and paranoia are possible too, just as a raised heart rate and problems with thinking and reasoning.