Weed for MS: What the Latest Research Says

Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the brain and spinal cord. In MS, the immune system mistakenly attacks the myelin sheath, the protective covering of nerve fibers. This can lead to communication problems between the brain and the rest of the body. 

According to a 2019 National MS Society prevalence study, nearly 1 million people in the United States live with MS. This condition is challenging to manage, prompting many patients to explore alternative therapies like cannabis for MS. Although the FDA doesn’t approve weed for MS, a NuggMD survey shows that patients ranging from age 42 to 57 listed Multiple Sclerosis as a top condition for seeking medical cannabis.

So, what has the latest research discovered about cannabis for MS?

What is MS?

Multiple sclerosis is a disease where the immune system attacks the myelin sheath, a protective layer around many nerves, including those in the brain and spinal cord. Damage to this covering disrupts communication between the brain and body. 

Symptoms vary widely but often include numbness or weakness in limbs, vision problems, tremors, and fatigue.

The exact cause of MS is unknown, but researchers believe it is a combination of genetic and environmental factors. Treatment typically includes medications to manage symptoms, slow disease progression, and treat relapses.

Benefits of Using Weed for MS

Research indicates that using weed for MS may be beneficial for treating symptoms. Studies show that cannabinoid-based therapies may effectively reduce symptoms such as spasticity, pain, sleep disturbances, and tremors. Cannabis boosts the production of endocannabinoids in the body, activates CB1 receptors in the brain, and reduces the release of neurotransmitters. These actions may help calm overactive neurons and protect the brain.¹ 

Reports on prescription formulations of CBD and CBD plus THC show promising results in understanding the effects of weed, and MS. Prescription Sativex® (Nambiximols) delivers 2.5mg CBD and 2.7mg THC per oral spray dose. The combined effects of THC and CBD in Sativex® (Nambiximols) decrease spasticity and improve the quality of life for MS patients, with a low incidence of side effects.  Using both THC and CBD in low doses provided a 200-fold increase in effectiveness.²

Additionally, there is evidence from high-quality clinical trials that THC and a CBD:THC combo may have positive effects on bladder symptoms like urgency and incontinence. Patients using these products often experience improvements in their condition.

A double-blind clinical study, which included 630 MS patients, found that those who used oral cannabis products showed significant improvements in sleep problems compared to those who used placebos.³

Most studies also reported similar side effects from using cannabinoids. These were generally mild to moderate and included dizziness, dry mouth, feeling unusually happy (euphoria), diarrhea, and difficulty concentrating.⁴

MS patients using online forums to communicate with others report significant relief from symptoms with marijuana and MS, especially for pain, spasticity, bladder issues, and sleep.

Weed and MS: Are There Any Risks?

Numerous studies find cannabis effective for the treatment of MS symptoms like pain, spasticity, and bladder issues. While using weed for MS has many potential benefits, it also carries some risks. Common side effects include dizziness, dry mouth, euphoria, diarrhea, and difficulty concentrating. Some users may experience psychological reactions such as panic, fear, or depression, particularly with high doses of THC.⁵ 

Multiple sclerosis often causes vision issues due to its effect on the optic nerve. Studies continue on the impact of MS and marijuana, and patients should use caution before engaging in activities where spatial and motor distortion is an issue.

Weed can interact with other medications, potentially altering their effectiveness or increasing the risk of side effects. Patients should consult with their healthcare provider before combining MS and weed to avoid potential drug interactions.

Weed as a Treatment for MS

Current research suggests that while cannabis does show promise for aiding in symptom management, more research is needed to determine if it can replace conventional MS treatments entirely.

Cannabis for MS may be most effective as an adjunct therapy, complementing existing treatments to enhance overall symptom relief. Combining weed with conventional therapies may provide better pain management and spasticity control, improving the quality of life for MS patients.

Tips for Using Weed for MS

Consult with healthcare professionals before changing or adding to your multiple sclerosis management plan. Always speak with a healthcare provider before starting cannabis for MS, especially if you are currently on medication or have other health conditions.

Options include a CBD or THC-only protocol or some combination of THC and CBD for spasticity and pain.

Managing MS symptoms with weed requires attention to dosing. A start low, go slow approach may help minimize side effects and allow the body to adjust gradually. 

Doctors advise starting with a predominately CBD-rich strain for daytime use. CBD has a lower chance of side effects and no impairment risk. Many also find CBD alone sufficient for inflammatory pain. The addition of THC in the evening may lessen nighttime pain and overnight bladder issues and improve sleep quality.

A suggested starting dosing schedule includes a twice-daily CBD dose of 5mg to 10mg. Introduction of a low dose of 2.5mg to 5mg THC in the evening may be added if needed for pain, nighttime symptoms, or to improve sleep. 

Elderly patients or those on multiple medications may want to begin with a lower evening dose of 1mg to 1.25mg of THC.⁶ THC use can cause intoxication at higher doses, requiring caution during daytime activities. Doses can be gradually increased over time in amount and frequency, as needed for symptom relief and recommended by a physician. Doctors suggest daily CBD intake should not exceed 1,500mg.⁷

THC products taken in high doses may cause very unpleasant side effects or greening out. Incremental and low-dose adjustments over time can avoid these effects. 

To achieve the best results with weed and MS, use it consistently as part of a daily routine to maintain steady levels in the body. Keep a journal to track symptoms, dosages, and any side effects. A record can help both the patient and the healthcare provider adjust the treatment plan as needed.

Ask a Budtender: Which Weed Products are Best For MS?

Patients specify several types of weed products as particularly effective for managing MS symptoms.

Overall, products with a 1:1 ratio of THC:CBD may offer relief from many multiple sclerosis symptoms. Preferences include fast-acting methods, such as tinctures and vaping. Tinctures allow for a precise dose and are quickly absorbed when taken sublingually. Smoking acts rapidly on symptoms, and vaping weed carts provide discrete dosing with a wide variety of strains to choose from. However, some physicians may believe the risks of smoking weed outweigh the benefits for MS patients.

In many cases, patients prefer a longer-lasting method of relief. CBD gummies and other edibles offer a convenient way to consume cannabis with consistent dosing, which may be helpful for ongoing symptom management. Weed creams, balms, and lotions can be applied directly to muscle spasms or pain areas, providing targeted relief.

When selecting cannabis products for MS, source selections from a licensed dispensary or trusted CBD retailer.  High-quality cannabis products will offer a certificate of analysis (COA) from a reputable third-party lab. A COA certifies potency and that it is free from contaminants such as heavy metals, pesticides, and mold. Ask the budtender for a copy, or check the packaging label for test results or a QR code that links to the COA. At a licensed dispensary, ask for producers that follow a state organic program for hemp or cannabis. This helps avoid any synthetic additives or residue in products.

The addition of cannabis may aid multiple sclerosis challenges in symptom control. By choosing high-quality cannabis products and following these dosing guidelines, MS patients may find effective relief from their symptoms and improve their overall quality of life.

References

1. Nouh RA, Kamal A, Oyewole O, et al. Unveiling the Potential of Cannabinoids in Multiple Sclerosis and the Dawn of Nano-Cannabinoid Medicine. Pharmaceutics. 2024;16(2):241. doi:https://doi.org/10.3390/pharmaceutics16020241 ↩︎
2. Mlost J, Bryk M, Starowicz K. Cannabidiol for Pain Treatment: Focus on Pharmacology and Mechanism of Action. International Journal of Molecular Sciences. 2020;21(22):8870. doi:https://doi.org/10.3390/ijms21228870 ↩︎
3. Haddad F, Dokmak G, Karaman R. The Efficacy of Cannabis on Multiple Sclerosis-Related Symptoms. Life. 2022;12(5):682. doi:https://doi.org/10.3390/life12050682 ↩︎
4. Nielsen S, Germanos R, Weier M, et al. The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews. Current Neurology and Neuroscience Reports. 2018;18(2). doi:https://doi.org/10.1007/s11910-018-0814-x ↩︎
5. Turner AR, Spurling BC, Agrawal S. Marijuana Toxicity. In: StatPearls [Internet]. StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK430823/ ↩︎
6. MacCallum CA, Eadie L, Barr AM, Boivin M, Lu S. Practical Strategies Using Medical Cannabis to Reduce Harms Associated With Long Term Opioid Use in Chronic Pain. Frontiers in Pharmacology. 2021;12. doi:https://doi.org/10.3389/fphar.2021.633168 ↩︎
7. MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine. 2018;49(49):12-19. doi:https://doi.org/10.1016/j.ejim.2018.01.004 ↩︎

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.