While cannabis is still classed as a Class B controlled drug under the Misuse of Drugs Act 1971, in November 2018, the laws surrounding medicinal cannabis shifted in the UK. After decades of lobbying by patient advocacy organisations, doctors, and scientists, medicinal cannabis was finally made available on prescription for patients suffering from certain conditions, with multiple sclerosis (MS) making it on the list.
Multiple sclerosis (MS) is a disease that attacks the central nervous system (both the spinal cord and brain, as well as the optic nerves), and has the potential to be disabling in severe cases. Symptoms of MS vary widely and can include:
- A feeling of weakness that can also include numbness in the limbs, and usually attacks one side of the body at a time.
- A tingling sensation
- Muscles stiffness or spasms
- Bladder control issues
- Difficulty with coordination and balance
- Feelings of vertigo
- Slurred speech
- Cognitive issues
- Blurred vision, partial or full vision loss with pain when moving the eyes
- Difficulty walking
Most people living with MS go through a relapsing-remitting course of symptomatic bouts. There will be periods where the symptoms flare up, followed by periods of less-active symptoms (sometimes lasting months or years). The severity and duration of the relapses vary from person to person.
While more research is needed, there are clinical studies, and anecdotal evidence, pointing to medical cannabis for multiple sclerosis being a viable complementary, or even alternative, treatment option for symptom management.
Cannabis, multiple sclerosis, and the ECS
Cannabis contains cannabinoids (more specifically, phytocannabinoids), which, when ingested, interact with the body through the endocannabinoid system (ECS). The ECS is made up of a vast network of receptors in the brain, the central nervous system, and the peripheral nervous system. Signalling chemicals produced by the body that interact with the ECS are known as endocannabinoids.
Cannabis also contains compounds, known as phytocannabinoids, which interact directly with the ECS. Phytocannabinoids (THC, CBD, CBG, etc.) all interact with the ECS in different ways and may be administered to help control the symptoms of a variety of medical conditions. This is due to the fact that the receptors in the ECS play a role in modulating many physical and psychological processes, including pain, memory, appetite, and inflammation.
Benefits of cannabis in treating multiple sclerosis
In terms of treating MS symptoms, most of the current research has focused on the two main players – THC and CBD. Both of these cannabinoids show promise in the effective treatment of spasticity and pain that MS sufferers endure, with one report stating
“Improvement in mobility and patients' opinion of an improvement in pain suggest cannabinoids might be clinically useful”
Another study, titled ‘Cannabinoids in the management of spasticity associated with multiple sclerosis’ looked at highlighting the main findings reported in the current literature about the possible relevance of cannabinoid drugs in the management and treatment of MS. This study, while not making any concrete claims about the effectiveness of cannabis in treating MS, does conclude with
“Considering that current treatments of MS are partially effective and have risks of side effects not easily tolerated by patients, the development of new synthetic endocannabinoids or cannabinoid-derived drugs could represent an alternative strategy to pursue.”
Yet another study does come to some more solid conclusions. MS patients were given 5 mg to a maximum of 25 mg of tetrahydrocannabinol (THC) daily, with the results showing that after 4 months, the rate of relief from muscle stiffness was almost double that of the control group. These are still preliminary results, with more research needed to back these results up.
It is also believed that cannabis has potential neuroprotective qualities, meaning it might help in the fight against nerve cell degradation and damage, which is the main cause of MS. The process behind this, and the effectiveness of cannabis as a therapy tool in neurodegenerative disorders, is still not fully understood, and more research is needed.
But, when looking at anecdotal evidence, it seems to be clear that cannabis may have a positive effect on a large swath of the resulting symptoms of MS. With the research to back up this evidence continuing to grow, the potential for cannabis to become a leading treatment option for MS is expanding, albeit slowly.
Risks and side effects of medicinal cannabis for MS patients
All treatment options come with risks of unwanted side effects, with cannabis being no different. There are short-term side effects, such as dizziness, headaches, confusion, and memory problems. Long-term effects are far less common but can include dependency (although this risk is very minimal), and increased risk of depression and anxiety.
It is also important to understand that cannabis products can have negative interactions with some pharmaceutical medications, so before you decide to take cannabis as part of your therapy plan, it is highly recommended that you discuss the potential risks with your doctor.
Forms of cannabis for MS treatment
At the time of writing, the only approved cannabis-based treatment option for multiple sclerosis in the UK is Sativex, although MS patients may find relief from other forms of medicinal cannabis products.
What is Sativex?
Sativex is a medicinal cannabis oral spray that contains equal parts THC and CBD, and that is prescribed to treat muscle stiffness and spasms in MS sufferers – although patients have reported that it helps with their other MS symptoms including incontinence issues, sleeping problems, chronic pain, and muscle tremors.
Other cannabis products may be effective for ms treatment
We can see from the success of Sativex that products containing a balanced level of both THC and CBD may be effective in the fight against MS symptoms. There is now a vast range of such products available and in many different applications.
Edibles and topical creams are leading the charge, but there are many anecdotal reports that vaping THC/CBD-balanced strains of cannabis can help with the debilitating symptoms associated with MS.
Legal and ethical issues regarding cannabis use for MS
In the UK, many MS sufferers have been forced to source cannabis from the black market to help deal with the complications that MS can cause. This can open up a range of legal issues, and there is still a great deal of stigma surrounding the administration of cannabis for medicinal purposes.
While the medicinal cannabis sector is growing, changes are slow to come, and it is important that MS sufferers are aware of the implications this can have for them. The same can be said for how the wider public views users of cannabis, patients or not. But as more research is conducted, and the understanding of just how powerful and effective medicinal cannabis may very well be increased, more widespread acceptance is sure to follow.
Always consult with a doctor that is registered to prescribe cannabis products before making any changes to your current treatment plan.
Conclusion
Cannabis has, for centuries, been administered to treat a variety of medical conditions. New research is pointing to the fact that medical cannabis may be extremely beneficial for MS sufferers.
Cannabis contains numerous cannabinoids, two of the main ones being THC and CBD, which have been shown in preliminary studies to potentially reduce muscle stiffness and pain experienced by those with MS. There is also evidence that cannabis may have neuroprotective properties which could help protect against nerve cell degradation and damage.
Although more research is needed to solidify the efficacy of cannabis in treating MS, there are anecdotal reports that suggest it is already helping many sufferers. However, when deciding to take medical cannabis as part of a treatment plan, it is important to understand potential risks and side effects. Always consult with a doctor that is registered to prescribe cannabis products before making any changes to your current treatment plan.
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