Marijuana and Multiple Sclerosis: Will Cannabinoids Help Treat MS?

Multiple Sclerosis, often abbreviated as MS, is a chronic autoimmune disease with no cure. MS affects the central nervous system, causing damaging inflammation and unpredictable symptoms. The condition gets its name from the scar tissue, or sclerosis, which forms around damaged nerves.

Jean Martin Charcot, a French neurologist, was the first to describe the major symptoms of MS in 1868. Since then, researchers have been working to learn more about the nature and possible causes of the disease, but this is complicated by the inconsistencies of its symptoms.

Close to one million adults live with MS in the United States. This prevalence was hugely underreported until a recent study by the National Multiple Sclerosis Society.

In 2022, research by scientists at UCSF identified differences in the gut bacteria of MS patients, paving the way for investigation into how gut bacteria affects, and might one day reverse, MS and its symptoms.¹

What Causes Multiple Sclerosis?

In people with MS, the immune system attacks the protective insulation surrounding nerves in the brain and spinal cord. Science doesn’t know what causes this, but experts think that genetics and environmental factors play a part. 

Some factors may increase the risk of developing MS: 

• Sex: MS affects more women than men.
• Age: Onset of MS often happens around ages 20 and 40.
• Family history: Having a blood relative with MS puts you more at risk.
• Exposure to infection: Certain viruses, like the Epstein-Barr virus, can increase risk of MS.
• Race: MS is more common in people of Caucasian descent, especially those from Northern Europe.
• Climate: MS is five times more prevalent in places with temperate climates.
• Medical conditions: Vitamin D deficiency, type 1 diabetes, IBS, and certain autoimmune diseases can increase risk of MS.
• Unhealthy habits: Smoking can increase risk of MS.

Multiple Sclerosis Signs & Symptoms

If you have multiple sclerosis, you may experience one or more of the following symptoms: 

• Blurred or double vision
• Distortion between red and green colors
• Pain and vision loss caused by swelling of the optic nerve
• Unsteadiness or lack of coordination
• Abnormal sensory feelings of pain, numbness, or pins and needles 
• Uncomfortable “electrical” sensations that occur with certain neck movements

These are often the first reported symptoms of MS. Other symptoms include:

• Muscle weakness or tremor
• Partial or complete paralysis
• Spasticity
• Slurred speech
• Fatigue
• Dizziness
• Hearing loss
• Depression
• Changes in sexual function 
• Bowel and bladder dysfunction 
• Cognitive problems

Because symptoms of MS vary in severity and time span, the disease has been categorized into four types:

1. Clinically isolated syndrome (CIS): The first round of MS symptoms are often categorized as CIS by doctors. Not everyone with CIS will develop MS.

2. Relapsing-remitting MS (RRMS): The most common form of MS. With RRMS, symptoms come and go in periods of flare-ups and remission. Without treatment these symptoms usually worsen.

3. Primary progressive MS (PPMS): People with PPMS have symptoms that slowly worsen over time, without any recognizable periods of flare-ups or remission. They often experience heavy, stiff limbs and changes in mobility. 

4. Secondary progressive MS (SPMS): People with RRMS will often see it progress to SPMS. Symptoms progressively worsen without discernible periods of remission.

How Cannabis Can Help Alleviate Multiple Sclerosis Symptoms

With close to 40% of MS patients using marijuana,² the conversation has shifted from whether people with multiple sclerosis use cannabis to what methods they are using and what symptoms, if any, it may improve.³

• Pain affects close to 70% of people with MS.⁴ A systematic review of data from 32 trials and studies found sufficient evidence that medical marijuana may be effective against MS-related pain, but the findings were limited due to varying methods of study on different types of pain.⁵

• Studies have repeatedly demonstrated safety and efficacy for long-term use of Sativex, an oral spray containing equal amounts of THC and CBD.⁶ It is prescribed in at least 25 countries as an add-on therapy for MS-related spasticity and neuropathic pain. Sativex is not approved for use in the United States, but a phase 3 clinical trial is currently underway.

• A 2012 randomized clinical trial (RCT) found that smoked cannabis decreased pain and reduced MS-related spasticity that was resistant to other forms of treatment. Some patients reported feeling “uncomfortably high,” but the marijuana was generally well tolerated. Although promising, this was a smaller RCT with 30 participants, and highlights the need for larger, long-term studies.⁷

• Bladder symptoms affect at least 80% of people with MS and current treatments are inconsistent. A sub-study of a multi-center RCT looked at the impact of MS and cannabinoids on bladder dysfunction and uncovered a significant reduction in incontinence. Although the original focus of the study was inconclusive, these results are fuel for targeted research into cannabis as an alternative treatment.⁸

In the absence of definitive answers about medical marijuana for MS – many studies are too small to allow for definitive conclusions – it’s only possible to speculate about possible benefits it can provide for multiple sclerosis symptoms. Cannabis may have potential to provide relief from MS-related pain, but larger clinical trials are needed to confirm this definitively. At the same time, there is a need for larger, long-term studies focused on spasticity and bladder dysfunction. Lastly, researchers must look into how specific cannabinoids, dosage, and methods of consumption can impact MS and its symptoms.

Currently, there are no studies on marijuana as a treatment for MS. The status of marijuana as a Schedule I substance keeps it federally illegal and hinders the much-needed research into its potential benefits and risks. Still, the National Multiple Sclerosis Society supports patients’ rights to non-smoked, legal, medical cannabis and advocates for further federal research on how it may impact quality of life for MS patients.

Although adverse effects have not been widely reported, it must be remembered that there are still inherent risks with cannabis use that can be worse for someone with MS. Inhaled cannabis is not recommended. The intoxicating effects of THC, in addition to side effects of lightheadedness, dizziness, and fatigue, could further impair someone experiencing symptoms of MS.

Medical marijuana that is taken orally, like tinctures, capsules, teas, and edibles, are ideal for people with MS. Start with a low dose of products containing THC and CBD, slowly increasing the dose if needed. CBD-rich products may appeal to those who want to avoid any effects on cognition.

Legality and Doctor’s Recommendation

To determine if your state considers multiple sclerosis to be a qualifying condition for medical marijuana, check out our Laws & Regulations section for the medical cannabis rules for your state.

If you find that your state recognizes multiple sclerosis or its symptoms as a qualifying medical condition, you can seek a doctor’s recommendation to get your medical cannabis card in your state.

How NuggMD Can Help

NuggMD is the nation's leading medical marijuana technology platform, serving patients in 22 states and growing. We’ve connected over 1,000,000 patients with their new medical marijuana doctors face-to-face via our state-of-the-art telemedicine platform. 

We believe that every human being has the right to explore the benefits of medical cannabis and are fully committed to helping each patient explore all of their options in their journey to wellness. For further information on whether you qualify for medical cannabis, select your state.

Frequently Asked Questions About Cannabis & Multiple Sclerosis

Can I use medical marijuana for MS?

There are no definitive studies on medical marijuana as a treatment for MS, but research is promising. The National Multiple Sclerosis Society supports access to legal, non-smoked, medical cannabis for MS patients. Additionally, Sativex, a cannabis spray containing equal parts of THC and CBD, is approved in at least 25 countries for MS-related spasticity and pain. Although the FDA has not approved it for use in the United States, clinical trials are underway. 

Can CBD help with multiple sclerosis?

Much of the current research has looked at whole plant cannabis as a treatment for symptoms of MS, which contains CBD, THC, and other cannabinoids. CBD is generally considered safe with minimal reported adverse events due to its non-intoxicating properties, but its effects on MS are not fully known. Consult with your doctor before using CBD for MS.

What symptoms of multiple sclerosis can cannabis help with?

Cannabis has been studied for its effect on pain, spasticity, and bladder symptoms as they relate to MS. So far, there are no clinically significant results, but it can be inferred that, at minimum, cannabis can be used for these symptoms with few adverse effects. More in-depth studies are needed to fully determine the scope of the risks and benefits cannabis has for symptoms of MS. 

Sources

1. Zhou, Xiaoyuan, Ryan Baumann, Xiaohui Gao, Myra Mendoza, Sneha Singh, Ilana Katz Sand, Zongqi Xia, et al. 2022. “Gut Microbiome of Multiple Sclerosis Patients and Paired Household Healthy Controls Reveal Associations with Disease Risk and Course.” Cell 185 (19): 3467-3486.e16. https://doi.org/10.1016/j.cell.2022.08.021.

2. Gupta, Sheila, Kelly Fellows, Bianca Weinstock-Guttman, Jesper Hagemeier, Robert Zivadinov, and Murali Ramanathan. 2019. “Marijuana Use by Patients with Multiple Sclerosis.” International Journal of MS Care 21 (2): 57–62. https://doi.org/10.7224/1537-2073.2017-112.

3. Weinkle, Laura, Christopher H. Domen, Ian Shelton, Stefan Sillau, Kavita Nair, and Enrique Alvarez. 2019. “Exploring Cannabis Use by Patients with Multiple Sclerosis in a State Where Cannabis Is Legal.” Multiple Sclerosis and Related Disorders 27 (January): 383–90. https://doi.org/10.1016/j.msard.2018.11.022.

4. Rudroff, Thorsten. 2019. “Cannabis for Neuropathic Pain in Multiple Sclerosis—High Expectations, Poor Data.” Frontiers in Pharmacology 10 (October). https://doi.org/10.3389/fphar.2019.01239.

5. Nielsen, Suzanne, Rada Germanos, Megan Weier, John Pollard, Louisa Degenhardt, Wayne Hall, Nicholas Buckley, and Michael Farrell. 2018. “The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: A Systematic Review of Reviews.” Current Neurology and Neuroscience Reports 18 (2). https://doi.org/10.1007/s11910-018-0814-x.

6. Conte, Antonella, and Carlos Vila Silván. 2021. “Review of Available Data for the Efficacy and Effectiveness of Nabiximols Oromucosal Spray (Sativex) in Multiple Sclerosis Patients with Moderate to Severe Spasticity.” Neurodegenerative Diseases, November. https://doi.org/10.1159/000520560.

7. Corey-Bloom, J., T. Wolfson, A. Gamst, S. Jin, T. D. Marcotte, H. Bentley, and B. Gouaux. 2012. “Smoked Cannabis for Spasticity in Multiple Sclerosis: A Randomized, Placebo-Controlled Trial.” Canadian Medical Association Journal 184 (10): 1143–50. https://doi.org/10.1503/cmaj.110837.
8. Freeman, R. M., O. Adekanmi, M. R. Waterfield, A. E. Waterfield, D. Wright, and J. Zajicek. 2006. “The Effect of Cannabis on Urge Incontinence in Patients with Multiple Sclerosis: A Multicentre, Randomised Placebo-Controlled Trial (CAMS-LUTS).” International Urogynecology Journal 17 (6): 636–41. https://doi.org/10.1007/s00192-006-0086-x.

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.