As of now, Multiple Sclerosis is a disease without a cure. Researchers are working towards creating new, more effective and less harmful medications to treat symptoms of this often debilitating disease that affects more than 2.3 million people worldwide.  Multiple Sclerosis (MS) doesn’t have a single, clearly identified cause or etiology, making it difficult to research and understand. As years go by, many individuals with MS find themselves suffering from a number of progressive symptoms which can greatly lower their quality of life.  Many research groups have thus turned to studying medical marijuana as a potential treatment for MS symptoms and as an agent to fight MS.

MS is an inflammatory neurodegenerative disease with autoimmune origins, that attacks the central nervous system; the disease is characterized by demyelination of neuronal axons within the brain and spinal cord. Programmed neuronal cell death (apoptosis, necroptosis) plays a role in the etiology of MS and other neurodegenerative diseases.  MS symptoms can range from fatigue, spasticity, gait difficulties and weakness to bladder dysfunction, vision problems, cognitive changes, pain, depression and disrupted sleep.

Cannabis may help fight multiple symptoms of MS, including spasticity, pain, muscle stiffness and bladder dysfunction, while improving sleep and overall quality of life.  A recent report by the National Academies of Sciences, Engineering and Medicine confirmed the results of numerous scientific studies, as well as of longstanding anecdotal reports in the MS patient community, by concluding that there is “substantial evidence that oral cannabinoids are an effective treatment for improving patient-reported multiple sclerosis spasticity symptoms.”  Moreover, a 2015 JAMA review cited moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity.  Most studies of cannabis to treat MS spasticity have been done using a whole-plant extracted  oromucosal spray with a 1:1 ratio of THC:CBD, although some studies have also used other forms of cannabis; evidence suggests that cannabis will help approximately one-half to two-thirds of patients with treatment-resistant MS spasticity, that a short initial trial will quickly determine efficacy, and that long-term use is safe.  Studies have also found that cannabis (1:1 THC:CBD ratio) may simultaneously improve pain, muscle stiffness, overall quality of life, urinary symptoms and sleep in MS patients.  One cautionary note is provided by the fact that several studies have shown possible negative effects of cannabis on cognitive functions and neurological disability in MS patients who are street cannabis smokers.  In general population research, neurocognitive impairment associated with marijuana use appears to be dose dependent, and to resolve approximately one month after use is stopped.  Using the smallest amount of cannabis necessary to treat MS symptoms is thus advised.

It has long been known that various cannabinoids (the most abundant medicinally active components of the cannabis plant) act as potent anti-inflammatory and neuroprotective agents, suggesting beneficial possibilities for the treatment of MS.  Animal model research is being done on the anti-inflammatory, anti-apoptotic  and neuroprotective properties of cannabis in experimental MS models.   For example, an Italian group studying the effects of CBD on experimental MS (EAE) in mice recently found that purified CBD “possesses an antiapoptotic power against the neurodegenerative processes underlying MS development.” This same group found in another study that topical 1% CBD cream diminished clinical disease score in an experimental MS (EAE) mouse model, partially by improving hind limb function.

Research suggests strongly that medical marijuana can be an effective treatment for multiple sclerosis symptoms in some patients. Multiple Sclerosis organizations are advocating the legalization of medical marijuana because of its benefits for many MS patients, and are pushing for the removal of barriers to research so that we can  better understand the potential of cannabinoids to help MS patients. This treatment option is unfortunately one that is overlooked by many people because of their negative view of the plant.

MS is a serious disease.   With the removal of stigma and barriers to access, the phytochemicals found in medical marijuana can help to improve the quality of life for many people who continue to suffer.