Treating Multiple Sclerosis Pain and Spasticity with Cannabinoids

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According to the Multiple Sclerosis Society of Canada, Canadians have the highest rate of multiple sclerosis (MS) in the world, with approximately 100,000 people living with the disease. People with MS are likely to experience extreme fatigue, lack of coordination, weakness, vision problems, cognitive impairments, and other symptoms. There is currently no definitive cure for MS, and we have only a limited understanding of its cause. However, a variety of medications and approaches exist to manage symptoms and improve quality of life for those with MS.

In 2007, The Union: The Business Behind Getting High, a documentary on the Canadian cannabis trade, included a moving clip of Greg Cooper, a man who suffers from both MS and ataxia (abnormal and uncoordinated bodily movements). The severity of his symptoms made it difficult for him to speak clearly and impossible for him to sit still. A few hits from a pipe, however, resulted in a transformation. Greg obtained significant relief from the symptoms he had displayed moments before, now able to sit completely still and speak clearly in response to the interviewer’s questions.

Stories like Greg Cooper’s, as well as that of American TV personality Montel Williams, have brought increasing public attention to the potential usefulness of cannabis for people living with MS, and the American Academy of Neurology has itself recognized the potential of cannabis extracts and synthetic THC for managing various MS symptoms.

Now a recent review article published in the January 2016 issue of Current Treatment Options in Neurology has taken a closer look at the effectiveness of cannabinoids for managing MS pain and spasticity (muscular stiffness and tightness, present in up to 84% of people with MS) by reviewing studies that have used a variety of formulations for this purpose, including oral cannabis extracts (OCEs), synthetic THC, smoked cannabis, and oral sprays like nabiximol (trade name Sativex).

For treatment of spasticity, OCEs containing a mix of THC and CBD were found to be effective in most trials. OCEs containing THC on its own showed mixed results: in some studies, it did not affect spasticity or the progression of the disability, while other studies did show decreases in patient-reported spasticity and pain. The oral spray nabiximol (Sativex) had generally positive results in treating spasticity, although some results only showed improvements in patients who rated spasticity as their worst MS symptom. Not much research has been done on smoked cannabis. One study did show positive decreases in muscle resistance, yet another study found worsened posture and balance 10 minutes after administration.

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