Medical Cannabis and Multiple Sclerosis is one of the most talked about topics. Multiple Sclerosis (MS) is a condition that affects the brain and spinal cord and results in a wide variety of symptoms such as issues with vision, arm or leg movement, sensation, pain and balance. Multiple Sclerosis is a lifelong condition, and, in many cases, it is possible to treat the symptoms.
What is Medical Cannabis?
There is evidence to suggest medical cannabis can be helpful in the management of chronic pain, including neuropathic pain; spasticity; nausea and vomiting, particularly in the context of chemotherapy; and in the management of anxiety. Patients with Multiple Sclerosis have found relief from their symptoms and a reduction in pain through medical cannabis treatment.
Read more about Medical Cannabis here.
An Overview of Cannabis Research for Multiple Sclerosis
60-84% of multiple sclerosis patients experience spasticity. When severe, it can be extremely challenging in terms of mobility. Studies have shown that cannabis treatment for multiple sclerosis can show an improvement in spasticity measures in over half of the patients treated.
A study titled the Multiple Sclerosis and Extract of Cannabis study (MUSEC) conducted in the UK by Zajicek et al showed the benefits of cannabis and cannabinoids in patients with multiple sclerosis. The study was conducted on 277 patients with Multiple Sclerosis and saw patients given 2.5mg of Tetrahydrocannabinol (THC) and revised upwards to a maximum of 25mg for up to 12 days. This study showed the relief from muscle stiffness for those people taking the medical cannabis extract was “almost twice as high than with placebo.
A controlled trial of cannabis-based medicines for spasticity relating to Multiple Sclerosis was conducted in the UK in 2007 by Collin, Davis et al. The study used whole-plant cannabis-based medicine containing Δ-9 tetrahydrocannabinol (THC) and cannabidiol (CBD) in 189 patients. Over 6 weeks patients were treated with 2.7 mg of delta-9-tetrahydrocannabinol (THC) and 2.5mg of cannabidiol (CBD). Patients illustrated a 30% reduction in spasticity over the course of the trial. Patients also showed an increase in muscle power in the legs, suggesting a reduction in spasticity was not gained at the cost of increasing weakness.
In 2022 Haddad , Dokmak and Karaman reviewed the Efficacy of Cannabis on Multiple Sclerosis -Related Symptoms. They reviewed a number of symptoms such as Spasticity, MS-Related Pain , MS-Related Tremor and Ataxia, Bladder dysfunction and quality of life of MS patients. The study found that medical cannabis was successful in treating pain and spasticity which are the most common symptoms in Multiple Sclerosis patients.
Medical Cannabis Access Programme
In June 2019 the Minister for Health launched the Medical Cannabis Access Programme to be operational on a pilot basis for five years. The programme will help facilitate access to medicinal cannabis for suitable candidates.
The programme makes it possible for a consultant to prescribe medicinal cannabis for a number of conditions, where a patient has failed to respond to traditional pharmaceutical treatments.
Currently, three conditions qualify under the Medicinal Cannabis Access Programme.
- Spasticity associated with multiple sclerosis
- Intractable nausea and vomiting associated with chemotherapy
- Severe, refractory (treatment-resistant) epilepsy
The Medicinal Cannabis Access Programme is currently under review by the Department of Health.
If you wish to learn more in detail about the following conditions, please check out our blogs below:
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How could Medical Marijuana help with Multiple Sclerosis ?
A study from the University of Rochester MS Centre in New York looked at the “real world” experience of medical cannabis in managing symptoms of multiple sclerosis. 77% said medical cannabis was helpful in managing their symptoms, mainly spasticity and pain. A further 70% felt their quality of life improved. The Rochester study concluded that medical cannabis appears to have a role in managing the symptoms of MS through direct symptom relief and reduction in other medications.
What is THC?
THC, known by its scientific name, Tetrahydrocannabinol is the principal psychoactive constituent of cannabis and one of at least 113 total cannabinoids identified on the plant.
CBD Vs THC
CBD, also known as Cannabidiol, is the second most common cannabinoid found in the cannabis plant. CBD does not produce any psychoactive effect.
Both CBD and THC are chemically similar to your body’s endocannabinoids. This allows them to interact with your cannabinoid receptors. Although CBD Oil and THC have similar chemical structures, they don’t both have the same psychoactive properties. While CBD is psychotropic, it does so differently than THC. It doesn’t result in a THC-related high. The brain’s cannabinoid 1 (CB1) receptors bind with THC. It results in a high or euphoric feeling. According to research, this high can be more intense if the THC is inhaled as opposed to consuming.
Different Methods to take Medical Cannabis
Depending on the medical cannabis product you are prescribed there are multiple ways to administer medicinal cannabis.
- Inhalation: Inhaled cannabis may be the most well-known method of administration for medical cannabis flowers. The main benefit of inhaled cannabis is that the onset of action is practically quick, making it simple for a patient to titrate the dosage for maximal benefit. At Oleo we have developed our Panacea Inhaler which is available to patients prescribed medical cannabis under the Medical Cannabis Access Programme and is also available to buy on Amazon.
- Sublingual: Sublingual delivery is another option for the administration of oil-based medical cannabis. Medical cannabis oil can have a rapid onset of action by being administered under the tongue or in the oral cavity. The patient feels the effects after a few minutes. Other cannabis products may come in a spray bottle that can be sprayed directly into the mouth.
- Tablet/ Pill format: Cannabinoids are soluble in fat, their absorption through the gut is slower and less predictable, depending on both the metabolism of the individual and the contents of the stomach. Determining an effective dose is more challenging, especially for the inexperienced patient, because the onset of the effect may take up to an hour to occur.
Are there any side effects to watch out for?
The most frequent negative effects of cannabis are related to the THC content and include nausea, drowsiness, and dizziness. Depending on the particular product, they may occur to varying degrees, but in general, these adverse effects are self-limiting and frequently manageable.
Patients often worry about their driving ability, which can be affected by cognitive side effects of medications as well as by symptoms such as weakness and spasticity. A recent review of medical cannabis showed no detrimental effect on driving; indeed, some patients report improved driving ability, possibly due to reduced spasticity and spasms. Patients should be counselled that using cannabinoids may affect their ability to drive and they should monitor any cognitive symptoms.
Is cannabis legal in Ireland?
Prescribed medical cannabis is legal in Ireland. Cannabis obtained without a valid prescription will fall under the Misuse of Drugs Act 1977 and will be deemed illegal. Recreational cannabis is illegal in Ireland. You can view a breakdown of the laws relating to illegal cannabis here.
Read our similar blog on: Is Medical Cannabis Legal in Ireland
Medical cannabis and multiple sclerosis have a successful relationship. It has proven to be an effective weapon in the treatment of MS. Patients have reported a reduction in symptoms and increased muscle strength due to medical cannabis. If you suffer from spasticity due to Multiple Sclerosis, take our eligibility checker to see if you can avail of medical cannabis, or discuss medical cannabis with your healthcare provider.