The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an understanding
of the potential applications of cannabidiol. Links to third party websites
do not constitute an endorsement of these organizations by Medical Marijuana
Inc. and none should be inferred.
Multiple sclerosis is an often-debilitating disease of the central nervous
system. Studies have shown cannabis is effective in managing symptoms
associated with the disease and may also limit the disease’s progression.
Overview of Multiple Sclerosis
Multiple Sclerosis (MS) is a disease of the central nervous system that
often leads to disablement. The body’s immune system mistakenly attacks and
destroys the myelin sheath that protects and insulates the nerve fibers.
Myelin increases the speed at which electrical impulses move between the
brain and the rest of the body and are essential for the nervous system to
function properly. A loss of myelin causes signals between the brain and the
body to become disrupted.
Common symptoms associated with multiple sclerosis include fatigue, walking
difficulties, numbness, muscle spasms, weakness, vision problems, dizziness,
bladder and bowel problems, pain, depression, and emotional and cognitive
changes. In rare cases, seizures can occur.
The most common type of multiple sclerosis is relapsing-remitting MS (RRMS),
which is characterized by day or weeklong relapses that can feature new
symptoms, followed by periods of quiet remission that can last for months or
years. Patients with RRMS will commonly transition into
secondary-progressive MS (SPMS), in which the disease progresses more
steadily, with or without relapses. Other types include primary-progressive
MS (PPMS), which is characterized by neurological function progressively
worsening over time, and progressive-relapsing MS (PRMS), which features a
steady progression but has occasional exacerbations along the way.
The cause of multiple sclerosis is unknown, but the disease mostly affects
women and those between the age of 15 and 60.
There is no cure for multiple sclerosis. Treatment efforts, including the
administering of corticosteroids to reduce nerve inflammation and plasma
exchange, can help to manage symptoms and potentially limit the disease’s
Findings: Effects of Cannabis on Multiple Sclerosis
Research findings suggest that cannabis could slow the neurodegenerative
process of multiple sclerosis. Studies have shown that cannabinoids are
involved in the regulation of the immune system by way of acting upon the
cannabinoid receptors of the endocannabinoid system. Cannabinoids have shown
they can modulate the inflammatory reaction and assist in neuroregeneration
(Kubajewska & Constantinescu, 2010) (Croxford, et al., 2008). In one study,
cannabinoids demonstrated neuroprotective effects during an animal model of
multiple sclerosis, reducing the damage to myelin caused from inflammation
(Pryce, et al., 2003). Another study found that cannabinoids administered to
animals with a model of multiple sclerosis reduced neurological disability,
improved motor coordination and limited the progression of the disease (de
Lago, et al., 2012).
Cannabis can help multiple sclerosis patients manage the symptoms associated
with their disease. Cannabis has shown to be effective at reducing pain,
muscle stiffness and spasms in multiple sclerosis patients (Koppel, et al.,
2014) (Wade, et al., 2004). In one study, multiple sclerosis patients saw
significant improvements in muscle spasticity and reduced sleep disturbances
after four weeks of cannabis treatment (Novotna, et al., 2011). A similar
study found that multiple sclerosis patients experienced pain and sleep
improvements after five weeks of treatment with cannabis containing both THC
and CBD (Rog, Nurmikko, Friede & Young, 2005). In a questionnaire, multiple
sclerosis patients responded that cannabis was effective in improving
spasticity, chronic pain of extremities, tremors, emotional dysfunctions,
fatigue, double vision, bowel and bladder dysfunctions, dysfunctions of
walking and balance and memory loss (Consroe, et al., 1997).
There is evidence suggesting that cannabis may worsen cognitive problems in
MS patients. MS patients that were regular users of street cannabis have
scored significantly worse on cognitive function tests (Honarmand, et al.,
2011) (Pavisian, et al., 2014).
States That Have Approved Medical Marijuana for Multiple Sclerosis
Currently, 14 states have approved medical marijuana specifically for the
treatment of multiple sclerosis. These states include Alaska, Connecticut, Georgia, Illinois, Louisiana, Maine, Massachusetts, New
York, Ohio, Pennsylvania and Vermont.
any condition can be approved for medical marijuana as long as a DC-licensed
physician recommends the treatment.
A number of other states will consider allowing medical marijuana to be used
for the treatment of multiple sclerosis with the recommendation from a
physician. These states include: California (any
debilitating illness where the medical use of marijuana has been recommended
by a physician), Nevada (other
conditions subject to approval), Oregon (other
conditions subject to approval), Rhode
conditions subject to approval), and Washington (any
“terminal or debilitating condition”).
Several states have approved medical marijuana specifically to treat
“chronic pain,” which is a symptom commonly associated with multiple
sclerosis. These states
include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New
Mexico, Ohio, Oregon, Pennsylvania, Rhode
Island and Vermont.
The states of Nevada, New
Hampshire, Ohio and Vermont allow
medical marijuana to treat “severe pain.” The states of Minnesota, Ohio, Pennsylvania and Washington have
approved cannabis for the treatment of “intractable pain.”
Several states will allow medical marijuana for the treatment of spasms,
which can arise in those with multiple sclerosis. These states include: California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, Oregon, Rhode
Island and Washington.
Patients whose multiple sclerosis causes seizures can use medical marijuana
to treat that specific symptom in several states, including Alaska, Arizona, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New
Hampshire, Ohio, Oregon, Pennsylvania (intractable
Island, Tennessee (intractable
seizures), Vermont and Washington.
Recent Studies on Cannabis’ Effect on Multiple Sclerosis
Cannabinoids were effective at reducing neurological disability and the
progression of the disease in mice with an animal form of MS.
Cannabinoids ameliorate disease progression in a model of multiple
sclerosis in mice, acting preferentially through CB1 receptor-mediated
anti-inflammatory effects. (http://www.ncbi.nlm.nih.gov/pubmed/22342378)
Four weeks of cannabis treatment caused significant spasm improvements
in MS patients.
A randomized double-blind-placebo-controlled, parallel-group,
enriched-design study of nabiximols* (Sativex(®)), as add-on therapy, in
subjects with refractory spasticity caused by multiple sclerosis.
Five weeks of cannabis treatment significantly reduced pain and improved
sleep in MS patients.
Randomized, controlled trial of cannabis-based medicine in central pain
in multiple sclerosis.
Consroe, P., Musty, R., Rein, J., Tillery, W., and Pertwee, R. (1997). The
perceived effects of smoked cannabis on patients with multiple sclerosis. European
Croxford, J.L., Pryce, G., Jackson, S.J., Ledent, C., Giovannoni, G.,
Pertwee, R.G., Yamamura, T., and Baker, D. (2008, January).
Cannabinoid-mediated neuroprotection, not immunosuppression, may be more
relevant to multiple sclerosis. Journal
de Lago, E., Moreno-Martet, M., Cabranes, A., Ramos, J.A., Fernandez-Ruiz,
J. (2012, June). Cannabinoids ameliorate disease progression in a model of
multiple sclerosis in mice, acting preferentially through CB1
receptor-mediated anti-inflammatory effects. Neuropharmacology,
Honarmand, K., Tierney, M.C., O’Connor, P., Feinstein, A., (2011, March 29).
Effects of cannabis on cognitive function in patients with multiple
Koppel, B. S., Brust, J. C. M., Fife, T., Bronstein, J., Youssof, S.,
Gronseth, G., & Gloss, D. (2014). Systematic review: Efficacy and safety of
medical marijuana in selected neurologic disorders: Report of the Guideline
Development Subcommittee of the American Academy of Neurology. Neurology, 82(17),
Kubajewska, I., and Constantinescu, C.S. (2010, August). Cannabinoids and
experimental models of multiple sclerosis. Immunobiology,
Multiple sclerosis. (2015, October 1). Mayo
Retrieved from http://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/home/ovc-20131882.
Novotna, A., Mares, J., Ratcliffe, S., Novakova, I., Vachova, M.,
Zapletalova, O., Gasperini, C., Pozzilli, C., Cefaro, L., Comi, G., Rossi,
P., Ambler, Z., Stelmasiak, Z., Erdmann, A., Montalban, X., Klimek, A.,
Davies, P. (2011, September). A randomized double-blind-placebo-controlled,
parallel-group, enriched-design study of nabiximols* (Sativex(®)), as add-on
therapy, in subjects with refractory spasticity caused by multiple
Journal of Neurology,
Pavisian, B., MacIntosh, B.J., Szilagyi, G., Staines, R.W., O’Connor, P.,
Feinstein, A. (2014, May 27). Effects of cannabis on cognition in patients
with MS: a psychometric and MRI study. Neurology,
Pryce, G., Ahmed, Z., Hankey, D.J., Jackson, S.J., Croxford, J.L. Pocock,
J.M., Ledent, C., Petzold, A., Thompson, A.J., Giovannoni, G., Cuzner, M.L.,
and Baker, D. (2003, October). Cannabinoids inhibit neurodegeneration in
models of multiple sclerosis. Brain,
126(Pt 10), 2191-202.
Rog, D.J., Nurmikko, T.J., Friede, T., and Young, C.A. (2005). Randomized,
controlled trial of cannabis-based medicine in central pain in multiple
Wade, D.T., Makela, P., Robson, P., House, H., and Bateman, C. (2004). Do
cannabis-based medicinal extracts have general or specific effects on
symptoms in multiple sclerosis? A double-blind, randomized,
placebo-controlled study on 160 patients. Multiple
What Is MS? (n.d.). National
Multiple Sclerosis Society.
Retrieved from http://www.nationalmssociety.org/What-is-MS.
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