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Multiple Sclerosis & Medical Marijuana

Multiple sclerosis (MS) is a disease that affects the central nervous system, which includes the brain, spinal cord and optic nerves. MS essentially turns the body’s immune system against its own central nervous system. The immune system targets myelin, a substance that insulates nerves. Damaged myelin then forms scars (sclerosis), giving the disease its name, and these scars are thought to be responsible for most of the wide ranging symptoms that people with MS experience.

A survey of people with MS published in 2017 found that 47% of respondents have considered using cannabis to treat their MS symptoms, 26% have used cannabis for their MS symptoms, 20% have spoken with their physician about using cannabis, and 16% are currently using cannabis.

Spasticity that causes muscle spasms and stiffness is common in people with MS – over 85% of people with MS have some spasticity, 50% have at least mild spasticity, and up to 17% have severe spasticity. Although several medications can be used to treat spasticity, they may not be completely effective and their use or dose may be limited by side effects.

The CAMS (Cannabinoids in MS) study is the largest randomized control trial to date to examine the effectiveness of cannabis on MS symptoms. In this study, 630 people with MS from 33 centers in the United Kingdom were assigned to receive cannabinoid medications [dronabinol, cannador] or placebo twice daily for 15 weeks. Those taking either of the cannabis products reported significantly greater improvements in spasticity, spasms, and sleep compared to those taking placebo.

The MUSEC trial (MS and Extract of Cannabis) in 2012 also examined patients’ perceptions of changes in muscle stiffness. In this study, 279 people with MS took either Cannador or placebo for 12 weeks. People taking cannabis extract had almost twice as much relief from muscle stiffness as those taking placebo at both 4 and 8 weeks, and they also had improvements in spasms and sleep.

Pain is a complex phenomenon involving many different chemicals, neurotransmitters, and receptors. Pain is a common symptom of MS, affecting around two-thirds of people with MS. People with MS can experience many different types of pain, including headache, nerve pain in their arms or legs, back pain, and painful spasms. Most pain experienced by people with MS is central neuropathic pain (pain caused from damage to the central nervous system) or pain from spasms. The role of cannabis in pain relief is 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 can also decrease pain by decreasing inflammation--its anti-inflammatory properties are well documented and researched.

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