Multiple Sclerosis (MS) is a chronic neurological condition, which affects the central nervous system (the brain and spinal cord). In patients with MS the immune system attacks the myelin sheath around the nerves, which interrupts the communication of signals to and from different areas of the body. As a result, various functions such as mobility may be affected.
The areas of damage caused by this demyelination are known as lesions. It is these lesions that cause the symptoms that patients with MS may experience.
While the past few years have seen important developments in the management of multiple sclerosis, many patients continue to experience troublesome symptoms such as weakness, spasticity and pain.
Alternative therapies offer another avenue for exploration: here we take a closer look at medical cannabis as a potential therapeutic option.
Cannabis contains compounds known as cannabinoids, THC (delta-9-tetrahydrocannabinol ) and CBD (cannabidiol). These substances act on the endocannabinoid system in the body, which plays a central role in regulating various physiological functions, including immune response, pain and inflammation. THC produces the psychoactive effects associated with cannabis, while CBD has anticonvulsant effects and is associated with a range of potentially therapeutic properties, including anti-inflammatory effects.
The ratio of THC to CBD content in a medical cannabis product affects its overall performance, so it is important to obtain it from reliable, professional sources.
Could medical cannabis be of benefit to patients with MS?
Medical cannabis has shown promise in the management of a range of symptoms, several of which are commonly experienced by people with multiple sclerosis.
- Pain management– medical cannabis has been used in the management of long-term pain conditions, and a 2015 study found that it improved pain experienced by patients with MS.
- Spasticity reduction-. A number of studies have also pointed to its efficacy in reducing spasticity and improving mobility.
- Sleep improvement– medical cannabis is also used in the management of sleep disturbance, which can also have an important impact on quality of life in patients with multiple sclerosis.
- Anti-inflammatory properties – CBD, the non-psychoactive component of cannabis, has demonstrated anti-inflammatory capability. An area of current research is that of ‘smouldering lesions’; it has been suggested that these may be responsible for the earlier appearance of some of the more troubling effects of the disease. The role of inflammation in the progression of MS has been increasingly recognised, and it is hoped that CBD might help to mitigate this process. This is a relatively new area of research, however, and the neurologist should be consulted regarding any new treatment.
Evidence for medical cannabis in MS
Various studies have explored the potential of medical cannabis in spray and pill forms and have demonstrated that it can help to manage symptoms such as pain, pins and needles, spasms, spasticity and urinary frequency.
Currently, there is insufficient evidence to draw conclusions on the safety and efficacy of smoked cannabis in managing the symptoms of MS. Research continues into the potential role of medical cannabis in conditions such as multiple sclerosis. It should always be used under medical supervision.
General safety considerations
While cannabis can offer real benefits, as with all medicines, care is required in its use and it may interact with other medications that you are taking. Some people experience side effects when using CBD, these include tiredness, changes in appetite, and diarrhoea. Your doctor should monitor you closely to manage any side effects.
The quality of the cannabis you are taking is also important. Not all cannabis products are created equal. It is essential to ensure you are taking high-quality, tested medical cannabis products to get the most benefit and avoid harmful substances. THC-containing products can cause psychoactive effects like feelings of euphoria and/or relaxation. This can be a concern for some people, especially if they need to stay alert and focused. NICE advises people to stop any non-prescribed cannabis, including over-the-counter, online and illicit products
Medical cannabis, multiple sclerosis and MyAccess Clinics
In the United Kingdom, although medical cannabis was legalised in 2018, it can only be prescribed by a registered specialist. At MyAccess Clinics, a leading UK medical clinic, our specialists aim to provide high-quality, personalised medical care to those who have tried at least two other types of therapies and treatments. Dr Michal Modestowicz, MD, PhD, MRCP(UK), FEBN, (known to his patients as Dr Mike) is a Consultant Neurologist at MyAccess Clinics specialising in a range of neurological conditions including multiple sclerosis. He trained in both the UK and Poland and he is an advocate of holistic approach to health and wellbeing.