Symptoms and Diagnosis
Multiple Sclerosis (“MS”) is an autoimmune disease in which the body’s immune system attacks the central nervous system, which is made up of the brain, spinal cord and optic nerves. When the immune system mistakenly attacks myelin, the protective coating around nerve fibers in the CNS, it causes damaging inflammation. According to the National Multiple Sclerosis Society, when myelin or nerve fibers are damaged or destroyed in MS, messages within the CNS are altered or stopped altogether. The damaged areas then develop scar tissue which may produce a range of neurological symptoms.
MS symptoms are unpredictable, varying from person to person and even changing or fluctuating over time. More common symptoms include numbness or tingling, fatigue, weakness, dizziness and vertigo, pain, depression, spasticity, bladder and bowel problems and vision problems.
Researchers from the Consortium of Multiple Sclerosis Centers in Tennessee have reviewed the safety and effectiveness of medial-cannabis as well as studied the impact on disability and disability progression, pain, spasticity, bladder function, tremor/ataxia, quality of life and adverse effects and have concluded there is sufficient evidence cannabinoids may be beneficial for symptoms of pain and spasticity in multiple sclerosis.
The American Academy of Neurology, conclude that pill or oral spray medical-cannabis has therapeutic benefits in treating short-term and long-term spasticity and pain in MS patients. Below is a table directly from this publication, outlining what they believe the body of research shows for each MS related treatment option:
The National Library of Medicine published a study on February 7, 2015 by Sumner Burstein from The University of Massachusetts Medical School on the effects CBD on inflammation. The study concluded reduced immune response, which results in less oxidative stress by decreasing the production of reactive oxygen species. These studies also showed that CBD binds to CB1 and CB2 endocannabinoid receptors which are important naturally occurring homeostasis regulators in the brain.
This same study also concluded CBD attaches to Adenosine A2A receptors which can down regulate over-reactive immune cells, resulting in protection of tissues from collateral inflammatory damage. It was also reported that CBD has the ability to enhance adenosine signaling through inhibition of uptake and provide a non cannabinoid receptor mechanism by which CBD can decrease inflammation. This same study also identified benefits to 5HT1A receptor, TRPV1 receptor, and GPR55 receptor as a result of being a functional antagoinist of CBD to these receptors.
The Frontiers in Neurology released an article on March 22, 2018 by Thorsten Rudroff and Jacob Sosnoff called, “Cannabidoil to Improve Mobility in People with Multiple Sclerosis”, which concluded CBD supplementation is advisable in a 1:1 or greater CBD:THC ratio to reduce fatigue, pain, spasticity and ultimately improve mobility.
In this article by the Frontiers in Neurology, the authors also reviewed the ability of medical-cannabis to reduce the usage of prescription drugs used to treat those suffering with MS. The authors state, “A recent epidemiological study by Piper et al. (19) showed that among people that frequently used opioids, over three-quarters (77%) indicated that they reduced their use since they started medical-cannabis. Approximately two-thirds of patients decreased their use of anti-anxiety (72%), migraine (67%), and sleep (65%) drugs following medical-cannabis which significantly exceeded the reduction in antidepressants or alcohol use.” The article states, “Complete or part replacement of these drugs by specific cannabis products should definitely be the long-term goal.”
What MS Patients are saying after trying Medical-Cannabis
In a web-based survey, hosted by the National Multiple Sclerosis Society, 66 percent of people with MS said they currently use medical-cannabis for symptom treatment.
The Rocky Mountain MS Center at the University of Colorado published the preliminary results from its 25-person study evaluating use of medical-cannabis. Patients were asked to complete questions assessing willingness to use medical-cannabis in MS treatment, previous and current use, impact of medical-cannabis on MS symptoms, MS history, and demographics. The preliminary results showed that slightly more than half of the respondents believe medical-cannabis has some benefit on MS symptoms. About 76 percent of respondents indicated they would consider trying medical-cannabis to manage their MS symptoms. And 28 percent reported medical-cannabis use in the past year. Medical-Cannabis products were mostly used for pain, spasticity/muscle tightness, and muscle spasms. The most common side effect listed was slower cognitive processes. The most common objections to using medical-cannabis included limited scientific proof, uncertainty of legal status, social stigma, potential addiction problems, and negative psychoactive effects of medical-cannabis.
MS Patient Reports of How Medical-Cannabis Helped Them
Another study from the University of Rochester MS Center in New York looked at the “real world” experience of medical-cannabis in managing symptoms of multiple sclerosis and transverse myelitis. Researchers conducted a cross sectional study, asking subjects to complete a survey reporting their experience with medical-cannabis certification, usage, and effects. About 77 percent said medical-cannabis was helpful in managing symptoms, mainly spasticity and pain. They reported no side effects. Another 70 percent felt their quality of life improved with medical-cannabis. Some patients actually reduced other medications used for symptoms. Most of the participants said they spent $100 to $300 per month on medical-cannabis. The Rochester study concluded that medical-cannabis appears to have a role in managing the symptoms of MS through direct symptom relief and reduction in other medications. It also suggests that improving affordability may enhance patient benefit.
In Italy, researchers recently concluded that a medical-cannabis based spray is beneficial in reducing pain in patients with multiple sclerosis. During their study involving about two dozen patients, the researchers also found the spray improved pain sensitivity caused by cold temperatures.