In November 2018, the UK government legalised cannabis for medicinal use, but also put a strict criteria in place for who could access it. Only specialist doctors are allowed to prescribe medicinal cannabis, and so far only a handful of people have benefited from the change in law.
Cannabis is made up of compounds called cannabinoids. The main ones studied for their therapeutic effect are tetrahydrocannabinol (THC), which gets you ‘high’, and cannabidiol (CBD), which doesn’t.
There’s a medically approved cannabis-based treatment called Sativex, but it doesn’t work for everyone. In England, Wales and Northern Ireland it’s approved for use on the NHS for ‘moderate’ to ‘severe’ spasticity (muscle spasms and stiffness). But you can have it only if other treatments haven’t worked. It’s not yet approved in Scotland but we hope it soon will be.
One in five people with multiple sclerosis (MS) surveyed in 2014 told us they’d used cannabis to help with their symptoms. They said it can help with muscle spasms or stiffness (spasticity) and pain.
Some people with MS use cannabis in a variety of ways to help ease their symptoms.
Results: During treatment with cannabis preparations containing 10-25 mg/mL THC, the most common AEs were dry mouth, drowsiness, dizziness and nausea of mild to moderate degree. Two patients experienced pronounced symptoms with excessive dreaming and drowsiness, respectively, which led to treatment stop during the titration. Three serious adverse events (SAE) were reported but were not associated with the treatment. Mean doses of THC and CBD were 4.0 mg and 7.0 mg, respectively, and primarily administered as a once-daily evening dose. Furthermore, pain decreased from a median NRS score of 7 to 4, (p = 0.01), spasticity decreased from a median NRS score of 6 to 2.5 (p = 0.01) and sleep disturbances decreased from a median NRS score of 7 to 3 (p < 0.001). No impairment in disability, ambulation, dexterity or processing speed was observed.
Introduction: The use of cannabis as medical therapy to treat chronic pain and spasticity in patients with multiple sclerosis (MS) is increasing. However, the evidence on safety when initiating treatment with medical cannabis oils is limited. The aim of this study was to investigate the safety of sublingual medical cannabis oils in patients with MS.
Methods: In this prospective observational safety study 28 patients with MS were treated with medical cannabis oils (THC-rich, CBD-rich and THC+CBD combined products) and were followed during a titration period of four weeks. Patients were evaluated at treatment start (Visit 1) and after four weeks treatment (Visit 2). At each visit neurological examination (Expanded Disability Status Scale – EDSS), ambulation (Timed 25-Foot Walk Test – T25FWT), routine blood tests, plasma cannabinoids, dexterity (9-Hole Peg Test – 9-HPT) and processing speed (Symbol Digit Modalities Test – SDMT) were tested. Adverse events (AEs) and tolerability were reported at Visit 2. Secondary, efficacy of medical cannabis on pain, spasticity and sleep disturbances were measured by numeric rating scale (NRS-11) each day during the 4-week treatment period.
Conclusion: Treatment with medical cannabis oils was safe and well tolerated, and resulted in a reduction in pain intensity, spasticity and sleep disturbances in MS patients. This suggests that medical cannabis oils can be used safely, especially at relatively low doses and with slow titration, as an alternative to treat MS-related symptoms when conventional therapy is inadequate.
Harvard Medical School: “Cannabidiol (CBD) — what we know and what we don’t.”
CBD oil is a common way to take it. You can put it under your tongue or add it to your food or drinks. You can also put it on your skin. Some research found sprays you put under your tongue might be best for MS.
Frontiers in Neurology: “Cannabidiol to Improve Mobility in People with Multiple Sclerosis.”
What to Watch For
National Institute on Drug Abuse: “What is marijuana?”
MS Trust: “Sativex (nabiximols).”
It comes in many forms. You can find CBD in:
The FDA hasn’t approved CBD to treat multiple sclerosis, or MS. Studies are ongoing, but the evidence is mixed. Here’s what we know.