#CMSC2018 – Pharmacist Discusses Advances, Challenges in Cannabinoids Research to Treat MS

#CMSC2018 – Pharmacist Discusses Advances, Challenges in Cannabinoids Research to Treat MS

Several studies have demonstrated the therapeutic potential of cannabis and its derivate products to manage the symptoms of multiple sclerosis (MS) and other neurodegenerative diseases. But there is still much to be done to enhance their use and accessibility to patients who may benefit from these therapies, according to a recent presentation by Matthew Makelky, PharmD.

Makelky, a researcher at the University of Colorado, reviewed the current status and advances made in cannabinoids use for MS at the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) in Nashville, Tennessee, May 30-June 2. The presentation was titled “Hashing it out: Cannabis for Multiple Sclerosis.”

The use of marijuana for medical purposes is currently legal in 29 states in the U.S. Only nine of those states also allow recreational marijuana use. With the trend toward legalizing cannabis, additional pressure lies on clinicians who prescribe it to ensure proper use and administration.

Join the conversation about using cannabis to treat MS in the MS News Forum

Cannabis contains more than 100 pharmacologically active compounds (cannabinoids), with the most studied compounds being the tetrahydrocannabinol (THC) and cannabidiol (CBD). Both have been evaluated for their potential to modulate spasticity associated with MS, as well as to manage seizures, inflammation, pain, anxiety, and other conditions.

Theoretically, CBD holds greater therapeutic potential than THC, since the first does not have the psychoactive properties that accompany THC use. Still, this compound is linked to some adverse side effects, such as drowsiness, decreased appetite, diarrhea, fatigue, and convulsion.

The THC compound is the one responsible for the “high” experience people feel when consuming cannabis, and is linked to increased neurological risk. THC has been associated with altered brain development and cognitive impairment when used in early adolescence, but also to an increased risk of chronic psychosis disorders.

According to the American Academy of Neurology, the use of oral cannabis extract (OCE) and synthetic THC improved spasticity-related symptoms and pain in patients with MS.

In contrast, AAN considers there is limited or insufficient evidence demonstrating the effectiveness of oromucosal cannabinoid spray, such as Sativex (nabiximols), or smoked cannabis for these indications.

As for treating MS-related urinary symptoms and tremor, none of the tested forms of cannabinoids have shown compelling evidence of effectiveness, according to Makelky.

There are some cannabinoid-based drugs already available on the market and others are under development. Because of the different effects of each cannabinoid compound, finding suitable dosages and methods of administration, as well as optimal frequency of use, may be both challenging and risky.

Also, cannabinoids may chemically react with other prescribed drugs — increasing or reducing their effects — which adds another layer of potential hazard that should be discussed between patients and clinicians.

In summary, cannabis-derived compounds hold potential to treat MS and “to help specific disease states,” Makelky said. Still, there is a lot to learn about “the complex metabolism and interaction profiles” of these compounds, he added.

72 comments

  1. Joe Ryan says:

    While I appreciate that more studies need to be done all I can say is CBD oils have had a tremendous effect for me. My attitude, physical feeling have improved more than I can quantify or put into words. I will deal with the supposed side effects. The daily impact it has had for me far outreaches and expectations I had.

    Joe

    • Allis says:

      CBD has also been helpful for me. I sleep better, overall experience less pain, and it helps my anxiety. I just generally feel better with it than without it.

    • Sue says:

      Thank you. I have a meeting on the 13th to hopefully get CBD oil (prescribed here in Canada) so nice to hear it has been helpful.
      Sue

    • Scott Johnson says:

      CBD is legal in my area and I do not want to wait another 5-10 years for more testing…I have had MS 25 years and had flair up after flair up while waiting on clinical trial after clinical trial.

      • Kim says:

        Thanks for your post! I have MS diagnosed in 2014, on Copaxone and doing well. Wondering about using CBD as a sleep aid. Have you heard of any side effects with Copaxone? Thank you!

        • Shawn says:

          After being on Copaxone for 1.5 years, I began having bad exzema and frequent ‘flushed’ episodes after injection. The exzema did go away sometime after I stopped using the drug.

        • Heather Lee says:

          pure cbd oil will keep you up at night if taken late. The reason being the cannabinoids in the cbd will be active and working on your brain making it hard to shut off and rest. Thc is great for sleep and there are some cbds made for sleep that will have a higher amount of thc than cbd and some edibles have cbd and have melatonin. You will also see products that have equal amounts of cbd and thc , those won’t give you a big high due to the cbd counteracting the high the thc gives. it will be a very relaxing feeling and relieve pain.The only issue I found when doing research and trying many cbs I found the ones that are hemp based only worked a very little and it stopped working at all within a few weeks. the pure cbd with coconut oil or any other natural substance and small amount of thc are the best. Thc is crucial when fighting any illness because when you add the thc it helps direct the cbd to the damaged areas much quicker. you can also find liquid thc and take them together if you can’t find a cbd in your area that already has both. I did my research after my father passed and my son was diagnosed with ms shortly after. My son takes Jaydens juice and full spectrum oil which is a more concentrated form of cbd also called FSO. FSO is the same product as RSO also called rick Simpson oil. You can find a lot of info online for all the products I spoke about.

        • Trude Ferguson says:

          I’ve been taking copaxone for 25 years. Only side effect was at injection site. However recently my neurologist told me that this drug is now breaking down some vertebrae in my lower back because of the
          Length of time I’ve been on it. Causing a great deal of pain for me. I’ve been currently researching CBD oils. Changing my meds is kind of scary for me because I’ve done so well in Copaxone. Good luck. I believe it’s still a safe choice with little dude effects compared to some others.

          • Bridget says:

            Trude, CBD oil have had great success in MS symptoms along with bone health. I am not a MS I’m a fibro warrior. I had no luck with meds so CBD was my saving grace. Look into CBD to help with your bone health to go along with your meds that are working for you.

      • Torrey says:

        Press Pause Project is an incredible brand! The CO-founders personally correspond with farmers and manufacturing team. High quality tincture and tastes great! The balm is relief in a jar…immediate soothing relief with essential oils and menthol and deep down healing with arnica and CBd. http://Www.presspauseproject.com

      • Kelley Palomino says:

        Try Endoca. Affordable and batch tested -they add omega oil to it which actually makes it more effective. Everyone in my neuropathy group promotes this brand because it works.

      • Tony says:

        We are new and will be open for business via the web for your needs. Our prices are set below what the current market is charging because of our low overhead and dedicated staff.
        We have full spectrum 750mg. Just for your specific needs, also 250mg. But the 750 is a better value because you use less. http://www.desertedgebotanicals.com

      • Colleen says:

        I have heard that from other Hempworx customers who have left them and have come over to us. And no, I am not knocking them, just mentioning what others that I know are doing. I have customers through my CTFO CBD business that appreciate the lower prices and appreciate that we now have what is called 500 MG 10X and 1500 MG 10X exclusively with CTFO. And, CTFO is free to join and has a 60 day open bottle money back guarantee. If you or anybody is interested in learning more, please don’t hesitate to reach out to me through my link at: colleenf.myctfocbd.com/cbd. I Pray you and everybody finds relief with whatever company they get their CBD through! Happy New Year and God Bless!

      • Bridget says:

        Heather, Its also about how much CBD are you getting per dose for that price as well. We have one that gives you 33mg per dose. Yes it’s $107 per bottle but your getting 33mg. If you only are needed around 15-16 then your bottle will last twice as long. You can check us out if you would like. http://www.illuminent.com/?u=bridgethiggs I’m a fibro warrior and unable to take big pharm meds so my search was on and this is the company that provided integrity and more cbd % along with dosage mg. Great group of people. When I say integrity it starts at the top. Bridget

      • Michelle says:

        CBDinfo.greencompassglobal.com not all CBD oils are created equal and it’s super important to know what you’re buying. In this case if it’s cheap it’s likely not a good product. If you like to read “CBD Oil: Everyday Secrets” by Gretchen Lidicker. It’s a fascinating read (or I listened to it on Audible) and chocked full of great info about the differences among growing and processing.

    • Helen Mc Donnell says:

      I was told I had ms over 8 yrs ago. I only tried cbd oil tonight as I’m only starting! I have spasms an pains in my legs I’m losing the feelings in both hands. My walkin is letting me dwn I lost about 85% walkin.will I give the oil a chance or does anyone no anything stronger or better,I’d try anything at this stage! Tnx H.

      • Chelsea Ellis says:

        Hey Ms Helen my name is Chelsea I’ve had MS since I was 13 I’m 28 now my MS is getting harder an harder I can walk but just for q short period of time jus want to know what do u do jus want some advice PLEASE an thank u an I pray u get betta

    • Melissa Cox says:

      I have heard the same. But I seem to be the only ms patient who has to stay on opiates bc my insurance will cover those. All the cbd products are so expensive ill never be able to benefit from it. Why do i seem to be the only one? Im single n one income. Is that why? It really bothers me that I have to go thru painful shots n my dr bills $2000 for it. If u could afford the cbd oil i would save my insurance and not have to go thru them
      I have the same question about caregivers. I seem to be the only one w out one. Im not so selfish. Im happy there is a natural product everyone else is benefiting from n i can barely keep my power on or buy essentials. Wow

      • Bridget Higgs says:

        Jerry,
        Everyone is different on dosage. We suggest all start with a tincture (drops) under tongue to get your body back in line an in balance. Healing from the inside. These drops can be taken 2 to 3 times a day at 4-6 hours apart. I would suggest our 2000mg which gives you a full 33mg per dose. If you only need 15-16mg to see results then the bottle would last twice as long. Here is our website to look at as well to get to know more about us and our brand. https://illuminent.com/order/Exotics?u=BridgetHiggs&pg=1&items=24 this is CBD with lab showing 99.25% if you need THC as well we have a full spectrum option as well. All lab results are by product and available for your review. If you are on fb here is my page: https://www.facebook.com/groups/SilverLiningLiquid/ Lots of info there as well. I’m be glad to help you on this CBD journey.

    • Christopher says:

      Hey I’ve been recently diagnosed with ms and your comments have helped me massively thank you anxiety is terrible but I’m going to try the THC and cbd thank you again

      • Bridget Higgs says:

        Christopher,
        I would love for you to take a second and let me help you on your CBD journey. Although I am a Fibro warrior instead of MS it has been God sent for sure. Check out my fb page: https://www.facebook.com/groups/SilverLiningLiquid/ Lots of great info and articles on the benefits of premium grade CBD. We have full spectrum or isolate cbd option available. The 2000mg of either will give you 33mg per dose and that is huge when doing research on how much cbd you actually intake vs whats on the outside of bottle. Please feel free to contact me if I can help with your CBD journey. Here’s my website too if you want to do research on our company as well. http://www.illuminent.com/?u=bridgethiggs

  2. Glenda says:

    Thanks for your input, Joe. I think the pendulum has swung and clinicians are more worried about the “Opoid Crisis” or “street drug” use than a patient’s wellbeing. There HAS to something, somewhere to alleviate some of the debilitating effects of MS. Everyone has forgotten that the “high” mentioned above only is associated with the first few doses of any drug without increasing the dosage. I’m glad you’ve found some relief!

    • Beth Boggs says:

      I completely understand your feelings regarding marijuana. However, the CBD oil that can be purchased is from the HEMP plant, not the cannabis/marijuana plant. It does not have any odor & it does not have any THC, so there isn’t any “high”.

    • Robert says:

      Your religious beliefs are wrong this is something god created in the Bible says that he made plants for every disease out there ,it’s natural. Your beliefs are far from gods

    • Zoe says:

      I have probably had undiagnosed ms since I was 18. Legs would give out when pregnant with first baby. Had baby and no more symptoms for years. 15 years ago walking got unsteady. 5 years ago diagnosed with ms. Brain scan showed many many lesions. Just started CBD a month ago and WOW, I am able to walk better then I did before. Hoping it gets better and better. I can get into my bed without a stool. Wonder if memory will improve as I struggle to remember so many names that escape my airy head. I do think CBD is worth a try for you. The price seems to vary from place to place. Perhaps one day the medical insurance will cover it. My neurologist said “go for it” When I told him that I was trying it. Blessings to you. God is not against medical help He did make the plants for a reason

      • Patricia S Bullard says:

        I have had MS since 2006 and I want to begin using CBD to see if it helps me too. I have never used any prescription meds due to the terrible side effects known from them. Can you tell me what CBD Oil you use and how much and how often you use it; please.

    • International Ann of Mystery says:

      MS is against MY religious beliefs. So bring on the CBD so I can get back to helping others in need.

    • Bridget Higgs says:

      Maria,
      I totally understand your stance on Marijuana. I myself am a huge Christian and was 100% against even the idea of CBD. CBD is made from Industrial Hemp plant NOT the Marijuana plant. Kinda like different type of tomatoes there are different types of these plants as well. I have a great article on my fb page that explains the difference. Check it out: https://www.facebook.com/groups/SilverLiningLiquid/ I’m a fibro warrior and unable to take big pharm meds due to side effects so I had to find an alternative and pure 100% CBD from industrial hemp is NOT a drug. Hemp seeds are sold along side sunflower seeds in the store and have zero THC. Please let me know if I can answer or help in anyway.

    • Drug free and high on Cbd says:

      I suggest you find a new religion! Does your religion allow you to take dangerous drugs prescribed but a drug selling Dr? Cannabis is a normal plant hahah deluded

  3. Edith Cheney says:

    Shocking that AAN would say synthetic THC is helpful for spasticity and pain. Where I live that is called Spice and is responsible for many hospitalizations and deaths when smoked by young kids.

    • Kendra davidson says:

      The synthetic thc they are talking about comes from your pharmacy it is called dronabinal it isn’t the street one called spice.

  4. Elizabeth Henehan says:

    I medical marijuana for several months. It may have helped my bladder spasms but nothing else. It costs $300.93 a month. Not worth it. I had a 50T:50C ratio first month. Now I’m on
    1T:20 C.

  5. D says:

    I have tried a1:1 combo in a tincture but the THC set off vertigo. I’m looking to work w/ practitioner to work on the correct ratio for my sensitive system. I could not tolerate oral Baclofen as it too caused Vertigo. Be Well

  6. cynthia says:

    I have been taking the THC 9.12 mg.per ml.with CBD 9.76 mg. per ml. for 6 months. It is an oil that I mix with peanut butter…..it smells and tastes bad…so you have to mix it with something. I take 1 ml. at night. I do not agree with smoking it or using it to ”get high”……but for medical purposes…it is a wonder drug. The trauma clinic that I go to monitors your use carefully ,and even the supplier keeps in touch about its use. I sleep so very much better-and without jumping out of bed 4 or 5 times a night with leg cramps. It also has greatly improved bladder issues….something I have had for many years. I generally feel so much better….and all on a minimal dose. In my opinion, it is much better to take cannabis oil [ controlled by a doctor] than many prescription drugs that have low success rates and major side effects.

  7. Broce says:

    I live in Colorado, and my neurologist and my pain doctor both recommended that I get a medical marijuana license. I use it to help me get to sleep, and stay asleep. I have horrific insomnia, as well as crippling fatigue. I don’t find it does anything for spasticity, except to make me focus on it more (and the same with pain). I don’t take it during the day because I don’t much relish being stuck to the sofa even more than my fatigue requires. It isn’t very expensive – an ounce lasts me at least six months, and that’s usually around $150-200. I am concerned that the AAN seems to be suggesting that synthetic versions are ok, but natural are not. The thing which gives me pause is the amount of money involved. I don’t believe them when they say synthetics are the way to go – I don’t trust their associations with Big Pharma.

    • Yes for a couple of weeks now and I was hoping that it would help with my RA, since I am on so many meds plus infusions every 8 weeks…so far I notice I feel more relaxed and I am sleeping well and soundly.

    • Maryann Wagner says:

      i’m trying it and it seems to help. Some companies offer discount for people on disability or veterans. I find that if you order several months worth, the price is lower. And there are coupons st cbdoilusers.com

    • Nikki says:

      Debra, I’ve been on Tecfidera for 2 years and no relapses. You will prob get flushing ++ but you can tinker with what amounts of food you need to eat before taking it to help there.

    • Jennifer S. says:

      Tecfidera is okay. There is currently some evidence that treating with stronger medications before our MS gets worse seems to help keep us mobile and active. Tecfidera is considered a weaker/first line treatment. The most important thing is that it works. I just ordered CBD oil for my MS — the “hug” along my rib cage has been pretty painful lately. What dose do you use?

    • Gabrielle says:

      I have been on Tecfidera since 2013 and I have only had maybe one relapse a year if that. But my spasms are still there and my vertigo is also I have my numbness on the right side. Other than that I am stable. My neuro states as soon as our states is rdy to go with it he is going to give me the go on the CBD Oil.

  8. Glory Seal says:

    I have only been diagnosed with MS for a little a year and have to baclofen to control the tremors and muscle spasms 3 times a day and pain meds since I started vaping the cbds I only take 1 baclofen a day and that is only a half pill in morning and at night. The great thing about the cbds is you can take more if you need to without waiting the 4-6 hrs to have to with meds and the worse that can happen is you need a nap.

  9. I’ve read in most comments that price and potency are the main issues with CBD oil. I would like to offer you all a solution. We have a number of CBD products that can help with symptoms and treatments, and are also affordable. Take a look!
    theorganicway.ctfocbd.com

  10. Micki says:

    CBD and THC is available in tincture, gummy edibles and liquids. No smoking needed. Various strengths.
    CBD does not require a Medical Marijuana card. Some dispensaries let you in to purchase CBD without a card for entry.
    CBD…about 100-150 mg daily relieves pain. Can take more or less as desired. CBD is not psychoactive like THC. No chance of overdosing. Start small and work up to the daily level you need for relief.
    FYI…THC Indica for sleep…take 5-10-15 mg about 1 1/2 Hrs before you want to sleep. THC Sativa usage is more for the comfortable high and relaxed feel.
    I have cancer and both have helped me along with 1000 mg daily of Tumeric. Check with your docs . Happy Holidays

  11. Ashley knight says:

    Hello,well i hope evey one is having a safe and blessed day. Ok i was told back 2013 that i have m.s. six,months later it changed to r.r.m.s. they perscibed Beta serion. Now their talking about changing the medicine to something stronger but who do i talk to about also wanting to try a canibis treatment because i use canibis almost every day does any one have any idea’s on who i would talk with i would be very greatful?

  12. Hi I am deaf also have ms since Sept 2010…this my 2nd relapse worse one…i still walk but eyes are bad werid…hard explain…tired of waiting for treatment since my relapse 7 months ago….wondwring if cbd oil will help me relief stressing some tiny numbs I start feel my left leg stiff some pains …if so which breads of cbc oil I don’t work it will be hard to pay if expensive……

  13. Paula Somerfield says:

    Had ms for 28 yrs and not had many elapses, very mild. Taking 80 mgs. of baclofen a day. Started marijuana, vaping, but since I’m a 72 yr old innocent, I have no idea how much to take, along with CBD oils. I’m on 1:1 Harlequin flavor and several CBD’s, 1:1, under the tongue. I do 8 vapes a day, but not sure if that’s enough. I was hoping someone will guide me with suggestions.

  14. Patricia S Bullard says:

    I have had MS since 2006 and I want to begin using CBD to see if it helps me too. I have never used any prescription meds due to the terrible side effects known from them. Can you tell me what CBD Oil you use and how much and how often you use it; please.

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