Multiple Sclerosis

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marijuana and ms
Multiple sclerosis (MS), a debilitating and sometimes fatal disorder of the central nervous system, is the most common debilitating neurologic disease of young people. National Multiple Sclerosis Society (NMSS) estimates suggest more than 2.3 million people worldwide suffer from the disease, with two hundred new cases diagnosed in the United States every week.

ms diagnosis

While physicians have options to slow the progression of MS, there is currently no cure. For this reason, many people suffering from MS seek out alternative treatments to slow the progression or relieve the symptoms. Medical marijuana for multiple sclerosis is one such alternative that shows promise in combating the symptoms of the disease. Learn more about how cannabis can help to determine if it is a suitable option for you or a loved one.

Multiple Sclerosis Video Transcript:

The central nervous system comprises nerve cells or neurons in the brain and spinal cord. A fatty product called myelin surrounds most nerves in the body. Myelin allows the nerves to send clear electrical impulses faster and more effectively along the neurons. Multiple sclerosis, MS, is an autoimmune disorder which means that the body’s immune system turns against itself. This autoimmune response causes the protective myelin coating, or myelin sheaf, to become inflamed and eventually destroyed in various places along the central nervous system. This destruction of myelin is called de-myelination. This destructive process keeps the neurons from sending effective nerve signals. The signals become slowed, garbled or blocked, causing the symptoms of multiple sclerosis to develop. Symptoms of MS are varied and depend on the location of the myelin damage. Common symptoms are loss of muscle coordination, impaired vision, numbness or tingling sensations in the arms or legs, fatigue and incontinence. This disease can be difficult to diagnose because the symptoms, which can last from days to months, may come and go without any pattern. Learn more below about how medical marijuana can help treat MS.

Why Marijuana Is Effective in Treating MS

While having a strong immune system is important to staying healthy, having an overactive immune system can be just as harmful as having a compromised immune system. Due to the variety of symptoms of this disease, many drugs are used to alleviate these symptoms, many with severe health risks.

ms symptoms

Smoking of medical cannabis can assuage many of the symptoms associated with multiple sclerosis. The cannabinoid receptors have been scientifically proven to alleviate many of the symptoms that accompany multiple sclerosis. The cannabinoid 1 and cannabinoid 2 (CB1 and CB2) receptors are usually activated by the cannabinoids naturally created by the body, also known as endocannabinoids. However, in order to increase the effects of these receptors via activation, other chemicals (i.e. phytocannabinoids), can also activate these receptors.  The CBreceptors are located on the cells of the immune system.

The anti-inflammatory effects of cannabinoids have much to do with its ability to be an immune suppressant.  This is characterized by the fact that when the cannabinoid receptor is activated, it has a stabilizing effect on the voltage-gated channels that influence the severity of inflammatory response.  In the case of autoimmune disorders, this can be beneficial in decreasing the progression of the patient’s condition.  Multiple Sclerosis can progress differently depending on the severity of the condition, but eventually the wiring of neurons that control essential bodily functions will deteriorate. It is important to understand that medical cannabis is not a cure for this disorder, and it is simply a treatment to alleviate the symptoms of the disease.  Nevertheless, cannabis has therapeutic effects for millions of people and doctors should have the freedom to prescribe cannabis to the individuals who find it therapeutic.

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Marijuana/Cannabis and Multiple Sclerosis

Medical cannabis for multiple sclerosis has some specific effects that relate to the disease. Some of those effects include:

  • Anti-inflammatory: MS causes inflammation related to the myelin damage. That inflammation and resulting damage cause the physical symptoms felt by MS patients, including motor control issues, weakness and spasms. Marijuana has an anti-inflammatory property that may reduce immune response and inflammation.
  • Pain relief: Pain is often a symptom of MS. That pain can be debilitating. Weed helps relieve pain, which can benefit MS patients who suffer from discomfort.
  • Antispasmodic: Another effect of cannabis beneficial to MS patients is the ability to reduce the frequency and severity of muscle spasticity.
  • Antidepressant: MS patients suffering from depression may benefit from the antidepressant qualities of marijuana. Studies have shown that THC, CBD and CBC can help with depression.
  • Abdominal issues: Cannabis may help with symptoms in the abdominal area, including pain, constipation and incontinence.
  • Sleep disturbances: MS patients who deal with sleep issues may find help from cannabis.

Research on Marijuana and MS

Medical cannabis (often referred to as medical weed or medical pot) is an effective drug that can help MS patients lessen the effects of the disease. Countless case studies, anecdotal reports, scientific studies, surveys and double-blind studies have reported improvement in MS patients treated with medical cannabis and/or cannabinoids for symptoms such as spasticity, muscle spasms, chronic pain, tremor, sexual dysfunction, bowel and bladder dysfunctions, vision dimness, dysfunctions of walking and balance (ataxia) and memory loss.

A 2003 study run by the Department of Microbiology-Immunology at the Northwestern University Medical School stated the following in their abstract titled “Therapeutic potential of cannabinoids in CNS disease”:

“Signaling is mostly inhibitory and suggests a role for cannabinoids as therapeutic agents in CNS disease where inhibition of neurotransmitter release would be beneficial. Anecdotal evidence suggests that patients with disorders such as multiple sclerosis smoke cannabis to relieve disease-related symptoms. Cannabinoids can alleviate tremor and spasticity in animal models of multiple sclerosis, and clinical trials of the use of these compounds for these symptoms are in progress.”

In 2012, a study called MS and Extract of Cannabis (MUSEC) showed promising results in the use of oral cannabis extract in treating muscle stiffness caused by the disease. Participants either received the cannabis extract or a placebo for 12 weeks of treatment, reporting their perceptions of their muscle stiffness before and after. The group that received cannabis reported a significant improvement in muscle stiffness compared to participants who received the placebo. The cannabis extract also seemed to help with pain, spasms and sleep.

A 2011 study published in the European Journal of Neurology showed the use of nabiximols, known as Sativex, an oral spray derived from cannabis, improved spasticity. Participants considered likely to respond well to the treatment took part in a controlled clinical trial. This drug is not currently available in the U.S., although it is available in 15 other countries, with approval for use in 12 other countries.

Research continues in using marijuana for MS, but studies are often challenging due to restrictions by the government and the limited availability of cannabinoids researchers need to conduct the studies.

Marijuana/Cannabis for Multiple Sclerosis: Treatment Options

Right now, nothing can cure MS, but effective treatments help ease the symptoms and slow the progression of the disease. Some patients find marijuana a suitable treatment option to get relief from those symptoms. Weed may help muscle stiffness, spasms, inflammation that contributes to nerve damage, pain, abdominal issues, depression and sleep issues. Minimizing those symptoms eases discomfort and may help the patient handle everyday activities disrupted by the disease.

Finding the best strain of marijuana to treat MS often takes some experimentation and guidance from a marijuana doctor. An expert in the field can use your personal medical history, including the type of MS you have, your usual symptoms and the progression of your disease, to find a strain of cannabis that best fits your needs.

While Sativex has been shown to work well in treating MS symptoms, it is not available in the U.S. Sativex is essentially a pharmaceutical-grade cannabis extract. It uses a 1:1 ratio of activated THC and CBD. Since you cannot get Sativex in the U.S., you may consider some strains of weed with similar profiles.

The option with perhaps the closest resemblance to the drug is One to One. Other suitable options that may help treat MS symptoms include:

  • Harlequin
  • Critical Mass
  • Sour Tsunami
  • Permafrost

Keep in mind Permafrost has a high level of THC, which is the component that causes the high feeling often associated with weed. If you don’t want a strong high feeling, you may want to choose a different strain.

ms treatment

People with MS often use different kinds of marijuana depending on the time of day and specific needs. For example, heavy Indica strains can have a sleepy effect, which is ideal for bedtime, particularly for those patients who have sleep difficulties.

Medical Marijuana for Multiple Sclerosis: How to Ingest the Cannabis

Once you decide on the best strain to treat your MS symptoms, you need to decide how to ingest the cannabis. Each method has pros and cons with differences in the side effects, how fast it works and how long you feel the effects.

Consider these methods of taking medical marijuana for MS:

  • Smoking: You’re likely familiar with the smoking method. One of the biggest benefits to smoking is the almost instant effect it has on the body. You can get relief from your MS symptoms right away instead of waiting for it to kick in. Some people don’t like the idea of smoking and the potential effects on the lungs.
  • Vaporizing: An alternative to smoking is vaping the cannabis. This method also makes the weed kick in right away with little time spent waiting to feel the effects. Vaping happens at a lower heat point than smoking, so it produces few byproducts, and it has less of an impact on your lungs.
  • Edibles: Ingesting weed via edibles has come a long way since pot brownies. You can find almost any form of edibles that contain marijuana if you find this method more appealing.

One drawback to using edibles is the longer lead time before the marijuana takes effect. You may wait anywhere from 30 minutes to a few hours to feel the effects. However, those effects tend to last much longer than they do with smoking or vaping. For this reason, some people like to use edibles before bed, so the marijuana lasts longer through the night.

  • Topical: Lotions and creams containing marijuana can treat specific areas when applied topically.

Many people try a combination of methods when using cannabis to treat MS. For example, when you want immediate relief from an MS symptom, you might choose to smoke or vape the marijuana. When you want a longer-lasting effect, you might opt for an edible. Experimenting with different methods helps you create a balanced approach to treating your MS symptoms with marijuana.

Side Effects of Marijuana

While marijuana is a natural treatment option, it’s important to understand the potential side effects. Most side effects are generally considered mild, low-risk issues. When compared to the potential for liver damage, blood pressures issues, heart rate fluctuations, hair loss and increased cancer rates associated with traditional MS treatments, the side effects of cannabis for MS seem much more manageable.

Patients using weed to treat MS may experience the following side effects:

Get Relief From Your MS Symptoms With Medical Marijuana

Many marijuana states have approved marijuana use for the treatment of multiple sclerosis. Medical cannabis is an affordable, natural alternative medicine that has helped thousands of multiple sclerosis patients. If you or someone you love suffers from MS and you’d like to find out if medical marijuana is the right treatment, we can help. We can connect you with hundreds of quality marijuana doctors across the country in all legal marijuana states and ensure you are in compliance with your state laws. Book an appointment today and let us help improve your quality of life!

Additional Multiple Sclerosis & Cannabis Resources

For more information about how cannabis can be used to treat Multiple Sclerosis, check out our resources:

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What is Multiple Sclerosis?

Multiple sclerosis is an autoimmune disease where the body’s immune system mistakenly attacks healthy tissue in the central nervous system, primarily the brain and spinal cord. Specifically, the disease causes the immune system to attack myelin, a fatty substance forming a protective, insulating sheath on nerve fibers. Scar tissue, known as sclerosis, forms due to the myelin damage.

Over time, the damage can spread from the myelin to the nerve fibers. The damage disrupts or distorts the nerve impulses in the central nervous system, which causes a variety of symptoms, primarily pain and difficulty in controlling the body.

Symptoms of Multiple Sclerosis

The symptoms of MS depend on the nerves damaged and the extent of that damage. They tend to vary from one patient to the next. Additionally, each person’s symptoms change over the course of the disease. In the beginning of the disease, the symptoms may be mild enough that the patient doesn’t need any treatment. As it progresses, those symptoms become more pronounced or last for longer periods.

Some potential symptoms of MS include:

  • Tingling or pain
  • Numbness
  • Tremors
  • Loss of balance
  • Weakness in one or more limbs, often affecting one side at a time
  • Blurred or double vision for a prolonged period
  • Eye discomfort or pain with eye movement
  • Partial or complete vision loss, sometimes affecting only one eye at a time
  • Slurred speech
  • Sudden onset of paralysis
  • Lack of coordination
  • Problems with thinking and processing information
  • Difficulty eating
  • Facial pain or tingling sensation
  • Depression
  • Constipation or bladder control issues
  • Muscle spasms
  • Coordination issues
  • Loss of dexterity
  • Fatigue
  • Dizziness
  • Electric shock sensations with certain head and neck movements

MS affects the brain and spinal cord, meaning that both the higher functioning and basic processes that keep the patient alive are affected. While there are different types of MS, the condition tends to deteriorate over time to the point that the patient can’t take care of themselves. MS is often a disabling disease. Some patients eventually lose the ability to speak and walk.

Diagnosis Rates and Causes of MS

The exact cause of MS is unknown, but researchers believe individuals who develop MS are genetically susceptible to the condition. Multiple sclerosis is not considered a hereditary disease, but people with a parent or sibling with MS have a higher risk of developing it. Environmental factors may actually trigger the disease in those individuals. Other researchers believe certain viruses early in life, such as Epstein-Barr, could trigger MS later.

ms and age

While kids and older adults can be diagnosed with MS, NMSS says the disease is usually diagnosed in patients between the ages of 20 and 50. Women are two to three times more likely to develop MS than men. These statistics could indicate hormones affect the development of the disease. While most ethnic groups are susceptible to MS, the highest rates seem to occur in Caucasians with northern European ancestry.

Location may also play a role in developing the disease. There tend to be fewer incidents of MS in areas closer to the equator, suggesting vitamin D could play a role in the disease. People living in climates near the equator may have more naturally created vitamin D than those living in areas away from the equator. A person with a different autoimmune disorder, such as Type 1 diabetes or thyroid disease, may also have a slightly higher risk of developing MS.

Testing for Multiple Sclerosis

Diagnosis isn’t always easy as there are no tests to specifically look for MS. The typically MS diagnosis occurs after eliminating the possibility of other medical conditions that could cause the symptoms the patient experiences. These evaluations may include a medical history, physical exam and blood tests. If MS is suspected, additional testing may be helpful in looking for indicators of the disease. These tests may include:

  • Lumbar puncture: Also known as a spinal tap, this procedure involves taking a fluid sample from your spinal canal. Lab testing of the sample looks for antibody abnormalities often found in MS.
  • MRI: An MRI looks for lesions in the brain and spinal cord potentially caused by MS. Contrast materials are sometimes used to get a better look at those lesions.
  • Evoked potential tests: These tests use visual or electrical stimuli to measure the speed of information traveling through your nerves.

Types of MS

There are different types of MS, each with different symptoms and progressions. Understanding the type of MS you have helps predict the progression, severity and best potential treatments:

  • Relapsing-remitting multiple sclerosis is the most common type, affecting approximately 85 percent of patients. This type is characterized by attacks, known as relapses, followed by remission with either full or partial recovery from the symptoms. The remission period can last for weeks, months or years. The time between relapses varies significantly from one patient to the next.
  • Primary progressive MS, affecting about 10 percent of MS patients, means the disease gradually progresses in severity with little or no recovery time. Primary progressive MS typically affects people at an average of age 40. Unlike other types of the disease, about the same number of men as women develop this type of MS. Primary progressive MS is difficult to treat.
  • Secondary progressive MS develops in people who initially had relapsing-remitting MS. Most people eventually move to this type of the disease. The patient no longer has periods of remission between attacks, instead dealing with the symptoms on a constant basis. Patients tend to develop this type of MS 10 to 20 years after the initial relapsing-remitting diagnosis. A patient diagnosed at an older age may develop secondary progressive MS faster.
  • Progressive relapsing MS affects about 5 percent of MS patients. While the patient does have periods of relapse, the symptoms are still present during those recovery periods. The symptoms tend to get worse as the disease progresses.

Current Treatment Options for MS

There is no cure for multiple sclerosis, so researchers and scientists aim to slow the disease’s progression and create better treatments. Current medications for MS may have negative side effects such as flu-like symptoms (such as fever, chills, fatigue, and muscle aches), allergic reactions, headaches, tiredness and joint pain. Others can even damage your heart or cause a serious and life-threatening disease called PML.

Treatments for MS have one of three main goals:

  1. Shorten recovery time after attacks
  2. Change the course of progression of MS
  3. Manage current symptoms

Corticosteroids are commonly used to treat MS attacks. Oral prednisone and intravenous methylprednisolone are two examples. The purpose of these drugs is to minimize nerve inflammation. Corticosteroids have several potential side effects, including:

  • Insomnia
  • Blood pressure increase
  • Mood swings
  • Fluid retention
  • Decreased immune response, with an increased vulnerability to infection

Plasma exchange, also called plasmapheresis, is another treatment option, particularly for those with new, severe symptoms that don’t respond to steroid treatment. In this treatment option, the plasma portion of the blood is separated from the blood cells. Albumin, a protein solution, mixes with the blood cells before returning to the body.

Other Treatment Methods for Relapsing-Remitting MS

Several options may slow the progression of MS in patients with relapsing-remitting MS, but many of those treatments come with potentially serious side effects and health risks. Some of the options include:

  • Beta interferons: Some of the most common medications, beta interferons are injected into the muscle or under the skin. The goal is to make relapses less frequent and less severe. Possible side effects include flu-like symptoms, reactions at the injection site and liver damage. It is also possible for the body to create antibodies that reduce the effectiveness of the treatment.
  • Ocrelizumab: This drug is administered through intravenous infusion. It is a humanized immunoglobulin antibody medication that can decrease the rate of relapses in relapse-remitting MS and slow the progression of disability. Possible side effects include injection site reactions, low blood pressure, fever, nausea and an increased risk of certain types of cancer, such as breast cancer.
  • Fingolimod: The goal of this oral medication is to lower the rate of relapse. Potential side effects include slowed heart rate, headache, high blood pressure and blurry vision. Heart rate monitoring for six hours after the first dose is standard due to the potential for decreased heart rate.
  • Teriflunomide: This medication also helps reduce relapses, but it has some potentially serious side effects. Those side effects include liver damage, hair loss and harm to a developing fetus. Pregnant women, women who may become pregnant and male partners of women who could become pregnant should not use this medication.

Additional treatments may address specific symptoms. For example, your doctor may prescribe medications to treat depression, pain or bladder control problems. Muscle relaxants are sometimes prescribed for muscle stiffness or spasms.


Resources:

  1. http://www.nationalmssociety.org/What-is-MS/Who-Gets-MS
  2. http://www.webmd.com/multiple-sclerosis/guide/multiple-sclerosis-understanding-the-differences-in-ms#1
  3. https://www.ncbi.nlm.nih.gov/pubmed/22791906
  4. https://www.ncbi.nlm.nih.gov/pubmed/21362108

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