According to the U.S. National Multiple Sclerosis Society, more than 2.3 million people worldwide are afflicted with multiple sclerosis. This unpredictable, progressive disease causes damage to the brain and spinal cord, as well as affects the body’s immune system. The failure of medicine to solve mysteries like multiple sclerosis prompts many patients to seek for alternative medications suggested by relatives, friends, or the Internet. Here is a close look at the most prominent scientific findings on medical marijuana for multiple sclerosis available so far.
Multiple sclerosis is an unpredictable disease of the central nervous system (CNS) that disrupts the flow of information within the brain and between the brain and body. Multiple sclerosis occurs when the immune system attacks nerve fibers and the fatty substance surrounding and insulating the fibers (the myelin sheathing) in the brain and spinal cord. It causes inflammation that destroys nerve cell processes and myelin, altering electrical messages in the brain.
The disease also causes loss of motor coordination and muscular weakness. People with the condition typically experience one of the four disease courses, which can be mild, moderate, or severe. Symptoms of MS also include overwhelming fatigue, altered sensation, tremor, vertigo, memory problems, and visual disturbances. Early symptoms are usually mild, but as MS progresses, the patient’s condition may worsen.
The cause of MS is still unknown, but scientists believe that destruction of the immune system and failure of the myelin-producing cells may play a role. There are also genetics and environmental factors among proposed causes.
There is no cure for MS. No therapies have shown effect in slowing the progression of primary-progressive MS, though some FDA-approved medications have been shown to modify the course of the condition by reducing the number of relapses and delaying the progressing of relapsing-remitting MS to some degree.
Disease-modifying treatment. As of 2016, there are nine disease-modifying treatments approved by FDA for relapsing-remitting multiple sclerosis. They include beta interferons, glatiramer acetate (Copaxone), dimethyl fumarate (Tecfidera), Gilenya, Aubagio, Tysabri, Lemtrada, and Mitoxantrone.
Managing MS symptoms. Certain medication and neurorehabilitation are used to manage MS symptoms such as pain, fatigue, spasticity, bladder problems, sexual dysfunction, and cognitive problems. Among the most common medications used to treat those symptoms, there are tamsulosin and prazosin for bladder problems, meclizine for vertigo, docusate for bowel dysfunction, isoniazid for tremors, and baclofen for spasticity. In order to manage muscle weakness and reduce pain, treatment for MS symptoms may also include physical therapy.
Usually, doctors prescribe MS patients a massive cocktail of drugs: Valium for anxiety, OxyCotin for pain, steroids, antidepressants, drugs for digestive problems and muscle spasms, and drugs to treat drug interaction. That is why medical marijuana takes pride of place among alternative treatments. Many patients consider cannabis as a much cheaper, safer, and more potent medication. Numerous case studies, surveys, and double-blind studies have reported improvements in MS patients treated with cannabinoids for symptoms.
The main villain all patients with multiple sclerosis face is the inflammation of neural tissue.
Marijuana is well-known to have anti-inflammatory effects. In recent years, the ability of the drug to reduce the symptom has been thoroughly investigated and taken as the basis for the world’s first FDA-approved pharmaceutical called Sativex.
In 2003, a study at the Cajal Institute in Madrid, Spain showed that synthetic cannabinoids might act as immunosuppressive compounds that have a therapeutic potential in chronic inflammatory disorders, including multiple sclerosis. In particular, researchers reported that the possible involvement of CB2 would enable a non-psychoactive therapy suitable for long-term use.
That same year, the Oxford University Press published a study at London’s Institute of Neurology on anti-inflammatory effects of cannabinoids. It was reported that the agonists of the CB1 receptor (such as THC or anandamide) exerted a neuroprotective effect in patients with MS by reducing the immune response and therefore reducing inflammation. During the study, scientists bred mice deficient in CB1 receptors and infected them with an animal model of multiple sclerosis. The mice lacking the CB1 receptors tolerated inflammatory and excitotoxic insults poorly and developed substantial neurodegeneration following the immune attack in the animal model of the disease.
In addition to studying the potential role of cannabis and its derivatives in the treatment of multiple sclerosis symptoms, researchers were exploring the potential of cannabinoids to inhibit neurodegeneration. It was found that in addition to symptom management, marijuana may also slow down the neurodegenerative processes that ultimately lead to chronic disability in MS and probably other conditions.
In 2014, researchers decided to conduct a systematic review of medical marijuana (1948-2013) in order to find out whether cannabinoids relieved symptoms in patients with MS. They found that oral cannabis extract containing THC and CBD was highly effective in reducing spasticity and improving mobility. Smoked marijuana was also found to be helpful for patients with treatment-resistant spasticity: more than eighty percent of participants reported a significant spasticity and pain reduction. Furthermore, no serious side effects occurred during the trial.
According to a 2004 trial, marijuana may lower spasm frequency and increase mobility with tolerable side effects in MS patients with persistent spasticity that do not respond to other medications. During the study, participants received escalating doses of oral extract containing THC and CBD for two weeks followed by placebo, or placebo for one week and then marijuana treatment for two weeks. Those who received at least ninety percent of the drug reported significant improvement in spasm frequency.
Marijuana is also known for its amazing pain-relieving effects—it is a potent analgesic. Cannabinoids engage pain receptors in the body, suppressing pain through different mechanisms. According to a 2005 “gold-standard” trial of a whole-plant cannabis extract (THC:CBD), the drug is twice as effective as the placebo in reducing pain and three times more effective in sleep disturbances.
Gastrointestinal problems including constipation, difficulty digesting, and problems with bowel control ruin many MS patients’ lives. Fortunately, scientists believe that marijuana can help: the drug helps control gut response and modulate gastrointestinal issues.
In 2001, a Scottish researcher Roger Pertwee conducted a survey. He found that after smoking marijuana on a regular basis, up to sixty percent of respondents experienced a decrease in defecation urgency, 44 percent of patients reported a decrease in incontinence, and 30 percent were less constipated.
A 2004 study done at the National Institute of Health of Maryland showed that cannabinoids inhibited motility and secretion in the intestine. The novelty of the findings was the active protective role of the endocannabinoid system, as indicated by the altered inflammatory response of mice lacking CB1 receptors. Endocannabinoids were found to protect the gut not only by decreasing bowel motility but also by inhibiting the inflammatory process itself.
The effectiveness of marijuana and its derivatives for treating gastrointestinal disorders has been known for centuries. Recently, its anti-emetic and analgesic value has been shown by numerous studies and reviews, including those conducted by the Institute of Medicine, the Austrian National Task Force on Cannabis, and the UK House of Lords Science and Technology Committee.
According to statistics, more than half of MS patients experience stress, sleeping problems, poor concentration, and depression. Depression may occur as a reaction to a difficult life situation, as a result of the disease process itself (when MS damages areas of the brain involved in emotional expression and control), after MS-related changes occurring in the immune system, or as a side effect of some medication.
In his survey, Pertwee wrote that more than ninety percent of the MS patients using the drug experienced improvement in the quality of sleep, mood, ability to concentrate on intellectual work, and overall well-being.
Several studies have indicated that certain cannabinoids—THC, CBD, and CBC—can exert an antidepressant effect. In 2010, researchers reported significant antidepressant-like effects of cannabinoids, thus concluding that they may contribute to the overall mood-elevating properties of marijuana.