September 15, 2016
Does Cannabis Help With Multiple Sclerosis?
Yes, MMJ treatments have been shown to be effective for managing many symptoms associated with Multiple Sclerosis, including tremors, spasms and pain. These are some of the MS symptoms that are positively impacted by cannabis-based treatments.
Inflammation & Myelin Damage
MS is largely characterized by the chronic inflammation of neural tissue. It is an autoimmune disease where a person's immune system attacks the central nervous system (CNS), resulting in systemic inflammation and damage to the myelin sheaths that protect nerve cells in the brain and spinal column. Eventually, the damage becomes irreversable (to the best of our current medical knowledge), resulting in loss of motor control, muscle weakness, spasms, unstable mood, fatigue and other neurological problems.
The anti-inflammatory properties of cannabis are well-known and it has been used for thousands of years by herbalists and physicians to reduce inflammation. Recently, cannabis has been studied for its efficacy in reducing inflammation related to MS. These results provided the basis for GW Pharmaceutical to produce Sativex, the first market-approved cannabis-based drug for treating MS.
Research suggests that CB1-receptor agonists exert neuroprotective effects in individuals with MS by reducing immune response and inflammation. A study of mice bred with a deficiency in CB1-receptors demonstrated elevated susceptibility to inflammation and neurodegeneration when exposed to experimental allergic encephalomyelitis (an animal model of MS.)
Pain is one of the most debilitating symptoms of MS and is experienced by more than half of sufferers. Pain related to MS occurs as a byproduct of neural inflammation or as a result of muscle spasms.
Cannabis is proven to help manage pain associated with Multiple Sclerosis. In a human clinical trial from 2005, cannabis-based medicine delivered as a sublingual spray was shown to be substantially more effective than placebo at reducing pain (as well as sleep issues) in MS patients. Smoked cannabis has been demonstrated to be effective at reducing MS pain in several studies, including a survey of 112 MS patients from the US/UK in which the majority reported that smoking cannabis helped manage their pain.
Because cannabis reduces inflammation by modulating the immune response it reduces pain experienced by MS patients and a scientific review that was published in 2007 showed that ??-THC was more effective for MS pain than CBD and dronabinol.
Muscle spasms are a common symptom of MS, reported by up to 80% of patients. The sharp pain from spasms typically disappears after a short time. Spasticity is a related symptom which is the state of constant contraction of a muscle that leads to pain and stiffness.
Cannabis has been demonstrated to reduce spasms frequency as well as reduce the severity of muscle spasticity. In 2005 a placebo-controlled, double-blind, randomized study found that 37 of 50 patients in the study demonstrated improved mobility and lowered the frequency of spasms. A random, controlled trial conducted in 2007 showed that cannabis preparations were more effective than placebo for treating spasticity. This second study did not reach statistical significance.
The effect of cannabis on spasms and spasticity are likely due to its ability to reduce neural inflammation and slow the overall progression of the disease. A study published in Nature demonstrated that cannabinoid receptor agonists improved symptoms of spasticity and tremors, which cannabinoid receptor antagonists worsened the symptoms.
Depression is a common feature of MS (and other autoimmune diseases). Depression in MS may be partially triggered by damage to the nerves that help regulate mood as well as a side-effect of medications used to manage the disease. Besides full-blown depression, MS can be accompanied by a range of emotional dysfunction.
It's important to note that cannabis' ability to treat depression is disputed with substantial evidence for and against this use. Several studies have shown that ??-THC, CBD and CBC can have an antidepressent effect. What we do know is that the encocannabinoid system has an important role in mood regulation and subjective happiness. It is believed that variations in the expression of CB1 receptors causes some individuals to be more susceptible to mood elevation by cannabis.
The majority of MS patients from a US/UK survey indicated that cannabis improved their symptoms of depression and emotional dysfunction. Subjective improvements in mood may be the result of improving other symptoms that cause emotional distress including chronic pain, spasms and muscle spasticity.
Multiple Sclerosis can be accompanied by gastrointestinal problems including pain, constipation and incontinence. These symptoms can be distressing and painful.
Approximately half of respondents in the patient survey indicated that defecation urgency was reduced by using cannabis or that incontinence was reduced. Nearly one third reported that constipation was eased. It is believed that the influence of cannabinoids on the CB2 receptors in the peripheral nervous system (which controls gut function) is responsible for cannabis' reported benefits for IBS and Crohn's Disease.