Multiple Sclerosis (MS) and Medical Cannabis
By Angela Johns, PhD
Multiple Sclerosis (MS) is a condition of the central nervous system that interferes with nerve impulses within the brain, spinal cord and optic (eye) nerves. In MS, the coating that protects your nerves, called myelin is damaged and this causes a range of symptoms.
MS affects more than 23 000 Australians. Most people are diagnosed between the ages of 20-40 affecting more women than men.
The main symptoms are muscle spasms, spasticity (muscle stiffness) and problems with weakness, coordination and balance of arms and legs; fatigue; neurological e.g. dizziness, pins and needles; bladder problems and constipation and other symptoms including memory loss and depression.
There is currently no known cure for MS however there are a number of treatment options available to help manage symptoms and slow progression of the disease.
Can Medical Cannabis help?
Cannabis has been used by humans for a very long time. Most ancient cultures didn’t grow the plant to get high, but used it as herbal medicine around the time of 500 BC. The history of cannabis cultivation in America dates back to the early colonists, who grew hemp for textiles and rope. Misuse in the 20th century led to the criminalization of cannabis globally although its legal status is now changing in many countries.
There are over 80 compounds known as ‘cannabinoids’ that can be extracted from the cannabis plant (Cannabis sativa). The most well known cannabinoid that can be extracted from the cannabis plant is called tetrahydrocannabinol or THC. THC is responsible for the psychoactive effect or ‘high’. An alternative cannabinoid called cannabidiol or CBD has been found to have many of the same benefits of THC but without the negative psychoactive effects.
A review of the current scientific findings (1) have shown that dronabinol or THC extracts may be effective at reducing pain associated with MS. There is also some evidence that nabiximols and other combinations of cannabinoid extracts may reduce muscle spasticity and improve patient quality of life.
The only cannabinoid based medical treatment currently available in Australia for MS is called Sativex. Sativex is a cannabis based oral spray. This spray is specifically licensed to treat MS patients with moderate to severe muscle spasms and stiffness who have not responded well to other treatments. Other products available are cannabidiol (CBD) based, e.g. cannabidiol oil. These may help some individuals but there is not enough evidence by researchers to show that these oils will definitely help your symptoms.
There is still a lack of quality evidence to make overall conclusions about the effects of cannabinoids and MS disease progression. There have been no studies that compare cannabinoids against current standard treatments for multiple sclerosis.
However, now that medical cannabis is legal in Australia and in over half of the US states, this will help enormously with future research as more researchers can access the cannabis plants and its active ingredients to find out more about how it works. There are strict rules and regulations surrounding the use of medicinal cannabis in Australia. The use of medicinal cannabis in Australia is only for individuals with painful and chronic (long term) conditions.
The Therapeutic Goods Administration (TGA) of Australia have guidelines for the use of medical cannabis in the treatment of multiple sclerosis based on the current scientific evidence available and it is worth speaking to your cannabis access doctor to obtain the latest current research and available treatments of cannabis based medicines for MS.
1. Nielsen S, Germanos R, Weier M, Pollard J, Degenhardt L, Hall W, et al. The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews. Curr Neurol Neurosci Rep. 2018;18(2):8.