Using Cannabis to Treat Your MS? A Word of Caution

by Ed Tobias | July 16, 2021

People with MS who are using cannabis take heed: A research letter published in May in JAMA Network Open reports that calls to poison control centers about people intentionally or inadvertently using plant-based or processed cannabis products have been increasing over the past several years. Public health officials are concerned.

According to the letter written by various health experts in the U.S., one problem is that a growing number of retail sales involve manufactured cannabis products rather than natural ones. These synthetic products may contain higher levels of THC than natural plant-based cannabis alone. THC is the substance in the plant that alters a person’s mental state, creating the “high” associated with marijuana. According to the experts, that extra THC could result in increased negative short-term effects, such as impaired cognition and psychomotor skills.

These negative effects may not be limited to synthetic cannabis. A recent study of long-term cannabis users with MS reports that users who stopped using the drug for 28 days improved their depression and cognitive skills, inferring that cannabis use increased depression and reduced cognition.

A small survey of 1,217 people with MS in the U.S., conducted last year by University of Michigan researchers, showed 386 (about 32%) used cannabis either strictly for medical purposes, such as nerve pain or to help them sleep, or for both medical and recreational purposes. Personally, I think this percentage is low. Take a tour of MS-related Facebook groups and you’ll find many people who report cannabis is the only thing that helps their pain, spasticity, and ability to sleep. It doesn’t appear to be a small number.

Stopping Cannabis Aids Cognition in MS, But Not Awareness of Gains

Who’s advising these patients?

Many of the people with MS using cannabis may be doing so with little or no guidance from healthcare providers. The University of Michigan researchers reported that only 18% of survey takers said they’ve spoken with their physicians about using cannabis, and fewer than 1% have received guidance from doctors about how to use it.

“Reasons for the disconnect between respondent use and provider guidance in our sample requires further study, but reinforces a longstanding concern that research focused on the use of cannabinoids for MS symptoms has not caught up with consumer use of these products,” lead author Tiffany Braley, MD, MS, told the University of Michigan Health Lab’s Haley Otman.

Braley said one problem is that doctors don’t have enough clinical evidence upon which to base such recommendations.

Healthcare “provider guidance for patients must be informed by research focused on the benefits and harms of both CBD and THC, and potential mechanisms that underlie the effects of cannabinoids on MS symptoms,” Braley said.

I’m lucky. My neurologist believes that medical marijuana can be a useful MS treatment, and I think she’d be willing to prescribe it for me if I wanted to use it. I know that my primary care physician would. But there’s a problem: Cannabis can be expensive, and it isn’t covered by insurance. It’s also still not legal in many states.

Almost Half of US MS Patients Surveyed Report Using Cannabis for Nerve Pain, Sleep

Let’s teach our doctors about cannabis

Let’s get our doctors the information they need so they all feel comfortable prescribing cannabis. Let’s educate users about the potential dangers of synthetic cannabis and the possible downside of even the natural stuff. Let’s work to get insurers to pay for it, as they do for traditional medications. And let’s get all 50 states to legalize medical cannabis. Piece of cake, right?

You’re invited to visit my personal blog at www.themswire.com.

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About the Author

Ed Tobias People say to write what you know and Ed Tobias knows about MS. He's lived with the illness since 1980, when he was 32 years old. Ed's a retired, award-winning broadcast journalist and his column combines his four decades of MS experiences with news and comments about the latest in the MS community. In addition to writing his column, Ed is one of the patient moderators on the MS News Today Facebook, Twitter, and Instagram sites. He’s also the author of “The Multiple Sclerosis Toolbox: Hints and Tips for Living with M.S.” Ed and his wife split their time between the Washington, D.C. suburbs and Florida’s Gulf Coast, trying to follow the sun.

Comments

J Howell

I was fully prepared to get riled up and rage against this based on the headline, but I actually agree- people need to be cautious with the weapons-grade cannabis products on the market these days. It's often just too much, even for recreational use.

I wonder why more of these people aren't getting prescriptions for Marinol/ Dronabinol in the first place? It's readily available, not particularly expensive, and effective. Granted, it may not have the "fun" aspect of higher-does recreational products, but that's not the point. I rather like getting the benefits in a dose small enough to not be psychoactive. That said, I'm also a ~200 lb person, your mileage might vary with the same dose. Anyway...

Ed Tobias

Thanks for reading past the headline, J. I'm not familiar with Marinol but I'll look into it. I appreciate the suggestion.

Allan Kyte

Further to your comments on the supposed adverse effects of cannabis on M S Patients'. My wife carried out the trials on this product, probably twenty years ago now in this country and has been using it almost daily ,ever since, without any adverse affects. Meanwhile, we remain convinced ,that it is probably one of the best spasm pain control products available.
Allan Kyte
Husband & Primary Carer

Ed Tobias

Hi Allan,

Thanks for the useful information. I'm not anti-cannabis. In fact, I very much support its use. I just want people who use it to keep their eyes open to products for unreliable products and I want doctors to understand more about how it can help us.

Cynthia

I have been taking CBD oil for spasm relief , pain relief , and better sleep for almost 4years .... and it really works for me . I went to a medical marijuana clinic , referred by my family doctor. My dosage is very low , but works amazingly well. I figured out that it costs me about what one "specialty " coffee a day would cost . It is well worth it ! It has also allowed me to get off of Oxybutinin ..... and none of the side effects !

Ed Tobias

Hi Cynthia,

I'm very glad that CBD oil has helped you. Do you use it under the tongue? Is there a particular blend that you use and what is your dose? Oxybutinin stopped helping me and I'm very interested trying CBD as a replacement.

Valentina Dominguez

We do not trust our doctors because they do not care enough. Bureaucracy is the thing for them and we the sick do not have time for it !! They do not even use their common sense!! Everything is the FDA this FDA that, they are like ten years behind european doctors and they are not open minded at all !! In my 10 years of being sick I have not being impressed by anyone in the medical field !! Sometimes It feels like I know more than them I have to look myself for answers because their 15 minutes paid by insurance company is up and they have to go !! It's all about money for them,not us !!

Ed Tobias

Hi Valentina,

I'm sorry the doctors who have treated you haven't cared about your treatment. Unfortunately, there are too many who fit that description. I've been very fortunate to have found doctors who are excellent and caring. I hope that you will also be able to find some of those fine physicians one day.

JOSEPH KONCURAT

Two years ago I spent 2 months in Chefchaouan, Morocco and had the opportunity to use Hash oil to treat my MS. Even though I have to use 2 cane to walk, I was able to walk without them after about 2 weeks using this wonderful potion. Now since coming back to the US, I can not use it because I don't want to go to jail, so I am back to walking with my 2 canes.

Ed Tobias

Hi Joseph,

Thanks for the information. Was the oil that you used a massage oil or did you use drops under your tongue? Whichever, I'm glad it helped. Does CBD oil not provide the same benefit to you?

Tamara Sellman

Thanks for this post, Ed. I've been wondering about cannabis use a lot lately, concerned about the very things you describe. I hope people will take this to heart and be thoughtful and careful about their cannabis choices.
Tamara

Ed Tobias

Hi Tamara,

It's good to hear from you and thanks for your comments. It would be very nice if we could be certain of the quality of the cannabis from the numerous providers that exist. People can try to be careful but they really have no metrics to guide their selection.

Barbara Murray

I use medical marijuana edibles because I dislike what smoking does to my lungs. I use it sparingly, and only when my pain level is high and I think that CBD oil won’t help. I find it very effective in controlling my pain and I don’t feel I abuse it. In my younger years I was addicted to marijuana so I am very careful of never letting that happen again. Then it was for pleasure, now for pain. Marijuana is effective for both, but can become addictive in both ways.Being an adult with MS, I will not abuse that privilege.

Ed Tobias

Hi Barbara,

Thanks for sharing your experience. Is there a particular THC/CBD blend in the edibles that works best for you?

Curt

Thanks Ed for your post. Being in a Quality Assurance role in BioTech I know the value of science based decisions, and one issue is intil the US Govt declassifies canbis as a schedule 1 drug, real studies will not occur. we need less conservative politics (will not head into that rabbit hole) and more forward thinkiing like in many other countries. a couple of thousand subjects is not enough. As some forward thinking senators are proposing to remove these roadblocks is the only path forward. Are you aware that there is no MS DMT that was trialed or approved for anyone over 50? yet, how many of us (50+ year old) are currently chancing their lives by using DMTs? consider this compared to much lower risk associated with Cannabis use. so far it looks like Genetech Ocrevous may be the only one which may be concluding phase 3 trials targeted to the 50+ MS Demographic, yet it also seems there may be a higher risk of PML which did not surface in the earlier triaks targeted at the less than 50 year age group.
so, if cannabis can help the seniors with MS,.at least there is something which will not kill. We need to pressure the senators who care for themselves and their party to focus on why they were elected in the first place, for the people. They need to change, accept science
if this pandemic should have taught us anything, science and logic can save us... politics will kill us..
wish we could ask the over 4 million dead due to Covid if they would have agreed. 4 million dead, chilling stats, if only!

Ed Tobias

Hi Curt,

You're right. There aren't enough trials that involve we senior MSers. A few of us, working with the iConquerMS group, are trying to push for more inclusion but it's a go. You're also right, in my personal opinion, about focusing on science. Thanks for sharing your thoughts.

Rosemarie

Thanks for the complete look at this issue. I have used CBD oil for the last couple of years for muscle pain and spasms (3-4 episodes per year when exacerbated) applied to the skin with massage. and I find great relief when I do. No "high" involved!

Ed Tobias

Hi Rosemarie,

Thanks for sharing with us. I tried massaging CBD a few years ago without success. About how many drops do you massage to help you?

Gina61

CBD oil does nothing for me or pain. I use cannibas s(small he weed) I can’t get the gummies, it’s illegal here but hopefully nit forever. I don’t abuse it because it’s a relaxed state of mind. I only use before bed and if I am having a bad day I’ll smoke an lay down. I don’t take anything else for my MS.

Ed Tobias

Hi Gina,

Thanks for sharing and I'm glad that cannabis is useful to you.

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Using Cannabis to Treat Your MS? A Word of Caution