Mitigating MS

Multiple Sclerosis (MS) is the most common autoimmune inflammatory disease, affecting one of every 1,000 people worldwide. The immune system attacks the myelin protective sheath covering of neurons in the brain and spinal cord, interfering with the ability of nerves to function properly. Symptoms include numbness and/or weakness of limbs, problems with vision, body tingling or pain, fatigue, tremor, unsteady gait, bowel or bladder problems and muscle spasticity. Symptoms can progress over time or can come as episodes called attacks or “flare-ups.” There is no known cure for MS, but cannabis is becoming widely used as a treatment for those who suffer from the condition.

Traditional treatment is aimed at preventing attacks and at treating symptoms to maintain quality of life. New pharmaceuticals have recently come onto the market with claims of delayed progression of MS symptoms, but long-term safety of these drugs remains unknown. Drugs used to treat MS affect the immune system and can have serious side effects, such as flu-like symptoms, mood disorders, changes in the skin at the injection site, headache, joint pain, rash, nausea, hair loss and low white blood cell count.

“Since the human immune system contains many cannabinoid receptors that serve to help balance the immune system and the inflammatory response, targeting these receptors with plant cannabinoids can help to stabilize and modulate multiple sclerosis.”

Many of my patients who seek cannabis treatment for MS have had intolerable side effects with MS medications and are looking to use a natural alternative. Since the human immune system contains many cannabinoid receptors that serve to help balance the immune system and the inflammatory response, targeting these receptors with plant cannabinoids can help to stabilize and modulate multiple sclerosis.

Numerous studies have examined the use of cannabinoids to treat MS. Much of the research comes from investigations on the efficacy of Sativex (GW Pharmaceuticals), a sublingual preparation of plant derived CBD and THC in a 1:1 ratio. This compound, which is available in 27 countries (not the U.S.) has been shown to be effective for spasticity, nerve pain and MS-induced pain.

Other research shows similar efficacy of cannabinoid treatment for MS:

• Nine patients were shown to have improvement of muscle tone, reflexes, and strength with THC. (Petro, 1981)
• In a study of 167 patients, whole plant cannabinoid extracts relieved pain, spasticity and bladder incontinence. (Wade, 2006)
• Researchers at the University of California in San Diego reported that inhaled cannabis significantly reduced objective measures of pain and spasticity in a placebo-controlled, randomized clinical trial. (Corey-Bloom, 2010)
• Spanish researchers treated 50 MS patients with inhaled CBD+THC for spasticity and pain, and they found it to be 80 percent effective. (Fernandez, 2014)
• A recent meta-analysis of three studies totaling 426 patients reported that cannabis treatment decreased the number of incontinence episodes. (Abo Youssef, 2017)

One of my favorite patients, Ed W., is a 58-year-old man who was diagnosed with MS at the age of 40. He struggled with many different medication side effects and now relies on cannabis treatment for his symptoms. He reports that a mixture of CBD-rich cannabis and THC-rich cannabis has helped to decrease his pain and spasticity and has allowed him to continue to exercise regularly. He also reports that cannabis helps to alleviate the anxiety that comes from having this diagnosis. He uses CBD-rich oil daily (taking it under the tongue), and if he is having an acute pain episode, he will use a vaporized CBD+THC in a 1:1 ratio to get immediate relief. He told me that his physician is amazed at how well he is doing, telling him “keep doing what you are doing.”

Both CBD and THC play an important role in MS treatment. The anti-inflammatory “raw” cannabinoids THCA and CBDA are also being used by MS patients with good results. Beta-caryophyllene, a terpenoid found in many strains of cannabis, has anti-inflammatory and pain-relieving properties, especially for nerve-based pain. Since cannabis treatment has an excellent safety profile and is generally well-tolerated, many MS patients find a better quality of life with its use.

Sources

Petro, D. and Ellenberger, C. “Treatment of Human Spasticity with ?9?Tetrahydrocannabinol.” The Journal of Clinical Pharmacology (1981) 21.S1.

Wade, D., et al. “Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis.” Multiple Sclerosis Journal 12.5 (2006): 639-645.

Corey-Bloom, J., et al. “Short-term effects of medicinal cannabis on spasticity in multiple sclerosis.” Headache 17 (2008): 20.

Fernández, L. Lorente, et al. “Clinical experiences with cannabinoids in spasticity management in multiple sclerosis.” Neurología (English Edition) 29.5 (2014): 257-260.

Abo Youssef, Nadim, et al. “Cannabinoids for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta?analysis.” BJU international (2017).

Klauke, A-L., et al. “The cannabinoid CB 2 receptor-selective phytocannabinoid beta-caryophyllene exerts analgesic effects in mouse models of inflammatory and neuropathic pain.” European Neuropsychopharmacology 24.4 (2014): 608-620.