Medical Forms of Marijuana May Ease Certain MS Symptoms
Smoking or eating marijuana to relieve MS symptoms still lacks clinical evidence, but drugs derived from marijuana may help.
By Sara Altshul
Medically Reviewed by Samuel Mackenzie, MD, PhD
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Marijuana in pill or oral spray form may help ease certain symptoms of multiple sclerosis (MS), according to the American Academy of Neurology (AAN).
Clinical trials have shown that delta-9-tetrahydrocannabinol, or THC, considered the main psychoactive component in marijuana, is effective in treating the spasticity, muscle stiffness, and rigidity experienced by people with MS, says Gareth Pryce, PhD, a postdoctoral researcher in the department of neuroimmunology at Barts and The London School of Medicine and Dentistry's Blizard Institute in London. Dr. Pryce has researched the effects of cannabinoids, the active compounds in marijuana, on the symptoms of multiple sclerosis.
In its most recent MS treatment guidelines, the AAN states that evidence supports the effectiveness of oral cannabis extract in reducing spasticity and some forms of pain. But it cautions that marijuana use outside of clinical trials may cause cognitive impairment.
No Evidence for Smoking or Eating Marijuana
There is still no clinical evidence to support MS symptom benefits from smoking marijuana, or from eating it when it’s baked into foods such as brownies, says Vijayshree Yadav, MD, clinical director of the Multiple Sclerosis Center at Oregon Health and Science University in Portland.
“We have to ask ourselves, what is the level of evidence?” says Dr. Yadav. It’s one thing for clinical studies to evaluate a standardized marijuana medicine. But evaluating marijuana when a patient smokes or eats it is another story, because marijuana varies so widely from sample to sample. Concentrations of its active ingredients differ, and so researchers can’t accurately compare its effects, she notes.
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What’s more, marijuana can cause slower, less predictable effects when it’s eaten rather than smoked, according to the U.S. National Library of Medicine.
Two of marijuana’s active components, cannabidiol (CBD) and THC, are extracted from the cannabis plant or synthesized (made in a laboratory) for medical use. THC has a stronger intoxicating effect than CBD.
The FDA has approved two marijuana-derived drugs, Marinol (dronabinol) and Cesamet (nabilone), for therapeutic uses, including treating loss of appetite associated with weight loss in AIDS patients and treating nausea and vomiting caused by cancer chemotherapy.
Dronabinol, the active ingredient in Marinol, is synthetic THC, while nabilone, the active ingredient in Cesamet, has a chemical structure similar to THC.
An oral spray form of cannabis, marketed as Sativex, is available in 15 countries and approved in an additional 12 countries — not including the United States — to treat MS-related spasticity, according to the National Multiple Sclerosis Society.
Legality of Marijuana Use
As of November 2015, medical use of marijuana is legal in 23 U.S. states, the District of Columbia, and Guam.
Video: I Tried Medical Marijuana For My Chronic Pain
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