In November 2018, the UK government legalised cannabis for medicinal use, but also put a strict criteria in place for who could access it. Only specialist doctors are allowed to prescribe medicinal cannabis, and so far only a handful of people have benefited from the change in law.
One in five people with multiple sclerosis (MS) surveyed in 2014 told us they’d used cannabis to help with their symptoms. They said it can help with muscle spasms or stiffness (spasticity) and pain.
There’s a medically approved cannabis-based treatment called Sativex, but it doesn’t work for everyone. In England, Wales and Northern Ireland it’s approved for use on the NHS for ‘moderate’ to ‘severe’ spasticity (muscle spasms and stiffness). But you can have it only if other treatments haven’t worked. It’s not yet approved in Scotland but we hope it soon will be.
Cannabis is made up of compounds called cannabinoids. The main ones studied for their therapeutic effect are tetrahydrocannabinol (THC), which gets you ‘high’, and cannabidiol (CBD), which doesn’t.
Some people with MS use cannabis in a variety of ways to help ease their symptoms.
Cannabinoids are a group of compounds found in the cannabis plant. The two main cannabinoids are THC (the psychoactive ingredients in marijuana) and CBD (which does not have a psychoactive component).
In a recent meta-analysis, researchers concluded that cannabinoids, including CBD, are “probably effective” at alleviating certain symptoms of MS, including pain and abnormal muscle tightness (spasticity), but “probably not effective” for treating muscle tremors or incontinence.
Cannabinoids and the Immune System
The severity of MS symptoms varies, depending on the location of the attack and the extent of the damage to the myelin sheath, but they most often include fatigue, muscle weakness or stiffness, and cognitive dysfunction.
Benefits of CBD for MS
The body processes cannabinoids via cannabinoid receptors, which are found in the brain and in immune cells. This is all part of the endocannabinoid system, which regulates inflammation, immune function, motor control, pain, and other bodily functions commonly affected by MS.
It represents an increase from previous studies of CBD/THC use in MS, as more states legalize marijuana use recreationally and/or medically. However, there’s a wide gap between the proportion of people with MS who have used a cannabinoid in the past year (42%) and the proportion who have spoken with their physician about it (only 18%). Furthermore, fewer than 1% of cannabinoid users received information from their provider about the type of cannabinoid product recommended for their symptoms.
“Reasons for the disconnect between respondent use and provider guidance in our sample requires further study, but reinforces a longstanding concern that research focused on the use of cannabinoids for MS symptoms has not caught up with consumer use of these products,” says lead author Tiffany Braley, M.D., M.S., an associate professor of neurology and an MS specialist at Michigan Medicine.
And those who turned to products with some combination of compounds derived from the cannabis plant (CBD, or cannabidiol, and THC, or tetrahydrocannabinol) were most likely to try them for help with chronic pain and sleep—two symptoms that are common and often go together in this chronic neurological disease.
The study included survey responses from more than 1,000 people with a diagnosis of multiple sclerosis from across the nation.