CANNABIS AND MULTIPLE SCLEROSIS
An estimated 350,000 people in the United States are living with multiple sclerosis (MS), a painful, debilitating, and sometimes fatal disorder of the central nervous system. MS is the most common debilitating neurological disease of young people, often appearing between the ages of 20 and 40, and affecting more women than men. Symptoms vary considerably from person to person; however, one frequently noted is spasticity, which causes pain, spasms, loss of function, and difficulties in nursing care.
MS exacerbations appear to be caused by abnormal immune activity that causes inflammation and the destruction of myelin (the protective covering of nerve fibers) in the brain or spinal cord. MS most frequently presents at onset as a relapsing and remitting disorder, where symptoms come and go. Current treatment of MS is primarily symptomatic, focusing on such problems as spasticity, pain, fatigue, bladder problems and depression.
Anecdotal reports and a small controlled study have reported that cannabis improved spasticity and, to some extent, improved tremor in MS patients. Many studies of the pharmacology of cannabis have identified effects on motor systems of the central nervous system that have the potential of affecting tremor and spasticity. A recent carefully controlled study of the efficacy of THC in experimental allergic encephalomyelitis, the animal model of MS, demonstrated significant amelioration of these two MS symptoms. Moreover, cannabis has demonstrated effects on immune function that also have the potential of reducing the autoimmune attack that is thought to be the underlying pathogenic process in MS.
Many MS patients report that cannabis has a startling and profound effect on muscle spasms, tremors, balance, bladder control, speech and eyesight. Many wheelchair-bound patients report that they can walk unaided when they have smoked cannabis.
A House of Lords reports states that the British Multiple Sclerosis Society (consisting of some 35,000 MS-suffering patients) estimates that as many as 4% of their population already use cannabis for the relief of their symptoms despite the considerable legal risks associated with prohibition. The chairman of the committee went on to state that, "We have seen enough evidence to convince us that a doctor might legitimately want to prescribe cannabis to relieve...the symptoms of multiple sclerosis and that the criminal law ought not to stand in the way."
Many of the witnesses for that report shared the British Medical Association's view that "A high priority should be given to carefully controlled trials of cannabinoids in patients with chronic spastic disorders." The BMA has requested that the synthetic cannabinoids Nabilone and Dronabinol be officially licensed for use in MS and other spastic disorders.
Research findings on cannabis and MS
Numerous case studies, surveys and double-blind studies have reported improvement in patients treated with cannabinoids for symptoms including spasticity, chronic pain, tremor, sexual dysfunction, bowel and bladder dysfunctions, vision dimness, dysfunctions of walking and balance (ataxia), and memory loss.12-20 Cannabinoids have been shown in animal models to measurably lessen MS symptoms and may also halt the progression of the disease.21
A recent British survey of MS patients found that 43 percent of respondents used cannabis therapeutically. Among them, nearly three quarters said that cannabis mitigated their spasms, and more than half said it alleviated their pain. A survey published in August 2003 in the Canadian Journal of Neurological Sciences reported that 96 percent of Canadian MS patients believe that cannabis is therapeutically useful for treating the disease. Of those who admitted using cannabis medicinally, the majority found it to be beneficial, particularly in the treatment of chronic pain, spasticity, and depression.22 The accompanying editorial states, "This is an exciting time for cannabinoid research. There is a growing amount of data to suggest that cannabis (marijuana) can alleviate symptoms like muscle spasticity and pain in patients with MS."23
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