Medical cannabis for multiple sclerosis
Karen Berger, PharmD
What is multiple sclerosis?
Multiple sclerosis (MS) occurs when the body’s immune system has an abnormal response against the CNS (central nervous system). The CNS includes the brain, spinal cord, and optic nerves.
With MS, the immune system causes damage to myelin, which protects the nerve fibers. This damage can cause a multitude of neurologic symptoms.
What are the statistics of multiple sclerosis?
Almost 1 million people in the US have MS.
Most patients with MS are diagnosed between the ages of 20 and 50 years.
MS is three times more common in women than in men.
Although MS occurs in most ethnic groups, it’s most common in Caucasians of northern European ancestry.
What causes multiple sclerosis?
The exact cause of MS is not known. Scientists believe that a combination of factors causes MS.
An abnormal immune response causes inflammation and damage in the CNS.
Environmental factors may play a role. Scientists are looking at geographic patterns, vitamin D levels, smoking status, and weight.
Infectious factors, such as previous viral or bacterial infections, may be involved.
Genetic risk: While MS is not passed down, the genetic risk may be inherited. Approximately 200 genes have been identified that each may play a small role in the risk of developing MS.
What are the symptoms of multiple sclerosis?
MS symptoms can vary and be unpredictable. Some of the most common symptoms include:
Fatigue occurs in 80% of MS patients, and can significantly interfere with the ability to function
Numbness and tingling of the face, body, arms, and legs. These symptoms are often the first symptom of MS.
Spasticity: stiffness and muscle spasms, often in the legs
Vision problems are often the first sign of MS and may include pain and blurred vision
Dizziness and vertigo
Bladder problems occur in 80% of MS patients
Bowel problems such as constipation or lack of bowel control
Pain and itching
Emotional changes like depression, mood swings, irritability, and uncontrollable laughing or crying
Clinical depression is prevalent in MS patients
Less common symptoms include problems with speech or swallowing, tremor, seizures, breathing problems, and hearing loss. All of the above symptoms are called primary symptoms and occur from the disease itself.
Secondary symptoms are complications resulting from primary symptoms, such as urinary tract infections from bladder problems.
Tertiary symptoms result from the impact of MS on one’s life, such as being unable to work or experiencing depression.
What is the usual treatment of multiple sclerosis?
There is no cure for MS at this time. A comprehensive treatment plan can help slow disease progression, treat symptoms, manage relapses, and provide emotional support.
- Oral, injectable, or infused drugs can help slow the progression of MS and reduce relapses.
- High doses of steroids (oral or IV) can help manage relapses.
- Many other medications can help manage symptoms, a few include:
- Stimulants for fatigue
- Tricyclic antidepressants for pain
- Muscle relaxants for spasticity
- Antidepressants for depression
- Stool softeners or laxatives for constipation
Can medical cannabis help with multiple sclerosis?
According to the National Multiple Sclerosis Society, although many studies had a small number of participants, outcomes show that synthetic cannabinoids help symptoms of pain and spasticity of MS. There is less information about inhaled or ingested cannabis.
The National Multiple Sclerosis Society states that it supports the rights of patients with MS to work with their healthcare provider to legally access medical cannabis. The Society also supports the need for more research on medical cannabis for MS and calls for removing federal research barriers. They also advocate for the legalization of cannabis at the state level.
A 2014 statement by the American Academy of Neurology reminds patients of a few points, including:
- Because the FDA does not regulate cannabis, every batch may not produce the same effects.
- As with any treatment, medical cannabis may have both benefits and side effects (the most common side effects are dizziness, drowsiness, difficulty concentrating, and memory problems).
- The long-term safety of medical cannabis for MS is not yet known.