One survey of people living with multiple sclerosis reported that more than 40 percent of respondents have used cannabis to relieve symptoms of the disease. Among them, nearly three quarters said that cannabis mitigated their muscle spasms, and more than half said it alleviated their pain. A similar survey found that 96% of Canadians living with MS believe cannabis is therapeutically useful for treating the disease. Of those who admitted using cannabis to treat symptoms of MS, the majority cited relief of chronic pain, spasticity, and depression116. In addition, numerous studies have reported improvement in tremor, sexual dysfunction, bowel and bladder dysfunctions, vision dimness, dysfunctions of walking and balance (ataxia), and memory loss, as well as pain and spasticity117-124.
In fact, cannabinoids have been shown in mammals to significantly lessen MS symptoms and slow or halt the progression of the neurodegenerative diseases. Cannabinoids have demonstrated effects on immune function that may reduce the autoimmune neuroinflammatory response which drives relapsing neurological attacks and increasing disability125-127. Clues as to why may lie in research that discovered that persons with multiple sclerosis have increased levels of endocannabinoids in their blood, indicating that the endocannabinoid system “may be dynamically modulated depending on the subtype of the disease128.” Previous studies of the pharmacology of cannabis have identified effects on motor portions of the central nervous system that have the potential of affecting tremor and spasticity. The distribution of CB1 cannabinoid receptors in the brain suggests that they may play a role in movement control. A controlled study of the efficacy of THC in the animal model of MS, experimental allergic encephalomyelitis (EAE), demonstrated significant amelioration of these two MS symptoms. A review of six randomized controlled trials of a cannabis extract that combines THC and CBD finds “a trend of reduced spasticity in treated patients” and “evidence that combined THC and CBD extracts may provide therapeutic benefit for MS spasticity symptoms126.” While objective measures of spasticity in humans have not consistently shown benefit from cannabinoid treatment, a randomized clinical trial with 189 MS patients being treated with a cannabis extract showed 40% achieved a greater than 30% improvement131.
MS patients also frequently report cannabis helps with bladder control, and a review of studies on cannabinoid receptors in the bladder notes that
non-psychoactive cannabinoids are effective, and psychotropic effects of THC can be mitigated by delivering cannabinoids directly into the bladder130. A dosage-controlled THC-CBD whole-plant extract—GW Pharmaceuticals' sublingual spray, Sativex®—has been shown in numerous clinical trials to ease pain, decrease spasm frequency, and improve bladder control and sleep. Clinical trials of Sativex® found that it “demonstrated a statistically significant and clinically relevant improvement in spasticity and was well tolerated in MS patients129.” As of June 2012, Sativex® is available by prescription in the UK, Spain, Germany, and Denmark for the symptomatic relief of spasticity, neuropathic pain, or both in adults with multiple sclerosis. It has been approved for distribution in Italy, Sweden, Austria and the Czech Republic, with recommendations for approval in Belgium, Finland, Iceland, Ireland, Luxembourg, the Netherlands, Norway, Poland, Portugal and Slovakia. In addition to studying the potential role of cannabis and its derivatives in the treatment of MS-related symptoms, scientists are exploring the potential of cannabinoids to inhibit neurodegeneration. A 2003 study that the National MS Society called “interesting and potentially exciting” demonstrated that cannabinoids were able to slow the disease process in mice by offering neuroprotection against EAE132. Neurodegeneration is implicated in a host of debilitating conditions.
References:
Zajicek, J. et al. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. Lancet 362, 1517–1526 (2003).
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