Researchers Examine Clinical Effects of Marijuana for MS Sufferers
Does marijuana reduce the debilitating physical symptoms of multiple sclerosis (MS)… or does it just help patients care a little less about them? If you or a loved one suffers from MS, this could be a very important question.
It’s widely accepted that marijuana has some therapeutic value for MS-related symptoms, including for painful muscle spasticity. In fact, clinical studies have demonstrated that when two of marijuana’s active ingredients, 9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are isolated and then combined into a drug, they can reduce muscle spasticity with only minor psychotropic effects. Sativex, a pharmaceutical formulation of marijuana that is approved for neuropathic pain in MS patients in Canada but not in the US, contains both ingredients.
Yet for many, the intoxicating effects of marijuana’s ingredients are troubling.
With the hope of making a case for FDA approval here, researchers at the Global Neuroscience Initiative Foundation in Los Angeles selected six recent randomized controlled trials involving a total of 481 patients with MS who took oral preparations of combination THC and CBD extracts. The findings are interesting — according to the admittedly subjective reports of the patients, the extracts relieved spasticity… but when several objective measures of spasticity (including a mobility index and patients’ “walk time”) were examined, no significant improvements were evident. And, though the combination dose was thought to keep people from getting high, patients in each of the six trials experienced adverse effects in the form of intoxication and sedation. The study was published last December in the online journal BMC Neurology.
Good Stuff or Not?
So — is marijuana helpful for MS patients? The answer, according to Moses Rodriguez, MD, a neurologist at the Mayo Clinic College of Medicine in Rochester, Minnesota, and a nationally recognized MS expert, is yes and no. Dr. Rodriguez told me that although many MS patients (including some of his own) report that marijuana is effective in alleviating spasticity, he said that there are no standards regulating how it should be used and “the data proving its efficacy is weak and its side effects are worrisome.”
One challenge, he explained, is that scientists still don’t understand why marijuana helps. “We know that it works on receptors in the brain, but marijuana does not have a direct effect on the muscles, so it is difficult to break away the drug’s general well-being effects from its anti-spasticity effects,” he said. He also pointed out that little is known about marijuana’s systemic and long-term effects on MS patients, which is of potential concern. Therefore, Dr. Rodriguez remains “very cautious” about recommending marijuana to his patients, “especially when other agents are available on the market that can effectively control spasticity, such as baclofen and tizanidine,” he said. (Note: There is also little data on long-term effects of these drugs and they, too, have side effects.) The National Multiple Sclerosis Society takes a similar stance — it does not recommend medical marijuana, citing “insufficient evidence of a clear benefit compared with existing therapies and issues of side effects, systemic effects and long-term effects.”
Dr. Rodriguez believes that there may come a day when new marijuana agents will be manufactured that offer the anti-spasticity effects without the side effects. Until then, he recommends staying with FDA-approved drugs for MS-related spasticity.