Does Marijuana Help Your MS Symptoms, or Is It an Illusion?
A recent review of research offers surprising details about the placebo effect
A recent question on the MS News Today Facebook page generated some buzz about getting a buzz on to treat your multiple sclerosis (MS). The question was, “What helps you the most to manage your daily life with MS?” Many people with MS said the thing that helped them most was using cannabis.
“Cannabis is medicine,” one person wrote. “THC oil,” added another. Someone else called marijuana “my little miracle.”
A survey in 2020 reported that nearly half of people with MS in the U.S. said they used marijuana to ease pain or help them sleep. But when I’ve tried edible marijuana products, such as gummies, while I felt high, I’m not sure they helped my pain very much.
I also tried CBD oil, rubbing it on my legs and adding drops under my tongue, but it didn’t have much effect.
A few folks on the Facebook page also said they received little or no benefit from any form of marijuana.
Is cannabis what people believe it is?
I mention all of this because a recent review of research comparing marijuana with a placebo casts some doubt on its effectiveness. The review, published in November in JAMA Network Open, looked at 20 studies of 1,459 people with illnesses that included MS. All were given either a cannabinoid (THC or CBD) or a placebo to reduce their pain. Surprisingly, there was no statistically significant difference reported between the real medication and the placebo.
āFactors such as patientsā expectations of relief are likely to play a role in the analgesic effects associated with cannabis-based treatments,ā lead author Karin Jensen said in an email to CNN. Another pain researcher agrees: “I think we set up patients to expect a certain kind of outcome,” experimental psychologist Harriet de Wit, who studies the placebo effect at the University of Chicago, told CNN.
Is it a placebo effect?
Similar to the 2020 report, a study last year noted that more than half of Canadians with MS used marijuana to help manage their symptoms. According to the study, which was published inĀ Multiple Sclerosis and Related Disorders, more than 80% of them said it was effective for managing spasticity, pain, sleep problems, bad mood, and stress. More than 50% reported that it can help with anxiety, fatigue, and headache. Can such a large number of people all be feeling a placebo effect?
My wife buys cannabis gummies online for her chronic pain. Although I have concerns about the quality of marijuana products that can be bought online or at a store like Bed, Bath & Beyond ā yes, they sell CBD along with bath towels ā she says it helps her.
Would it matter if her relief were simply a placebo effect because she believes the gummies relieve her pain? I think not.
You’re invited to visit my personal blog at www.themswire.com.
Note:Ā Multiple Sclerosis News TodayĀ is strictly a news and information website about the disease. It does not provide medical advice,Ā diagnosis, orĀ treatment. This content is not intended to be a substitute for professional medical advice,Ā diagnosis, orĀ treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those ofĀ Multiple Sclerosis News TodayĀ or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.
Comments
Mark Genco
Good post Ed. I often wonder that about most medications Even those at has been tested and show significant improvement is always about 30%
Of course here in the UK the marijuana is illegal so I couldn't comment on that!!
Ed Tobias
Thanks for the comment, Mark. Don't worry...I won't tell anyone. :-)
Ed
Andrew Bailey
I have a prescription of sativex spray which is THC based cannabis medicine approved by NICE provided by the NHS to treat my spasticity that I get with MS. I also now have a private prescription to cannabis that is provided to me by a company in the UK called sapphire clinics.
It's not illegal now for prescription and because it is now produced in the UK it can be provided at a much better cost than before.
It works really well for me but my friend tried it and it didn't do a thing for him. the best thing is there is no harm in finding out if it works for you or not.
Ed Tobias
Hi Andrew,
Thanks for sharing. It's useful information and, you're right, there's no harm in seeing if it works or not. Best of luck with the sativex, which I'd like to try if it ever becomes available in the U.S.
Ed
Sid Rotten
I use marijuana for spasticity, pins & needles, formication sensations, restless legs, etc. I donāt use edibles. Totally different effect.
I take fewer than a half dozen puffs of herb in a plain old fashioned bong. The desired effect is practically instantaneous as opposed
to waiting hours for an edible to take effect. I can also control the dose. Nobody has studied the difference because of strength of
different strains, etc. but mostly because even a few puffs of smoke is an absolute anathema to the medical establishment. Yet the
same medical establishment is ok with prescribing medications with some truly horrific side effects to treat the same symptoms.
Ed Tobias
Good points, Sid. I appreciate your taking the time to share them.
Ed
Jane
First and foremost, there needs to be an understanding in the differences between cannabis (THC) and hemp (CBD and Hemp derived THC). The research also needs to make those differences clear. These are two different plants, like siblings, with differences in effects. Once this is understood by researchers and patients, much more will become clearly understood about the medical opportunities available with the herb.
Another thing to remember is that all CBD is not created equal or produced the same way. Some works for some and some may not. The methods used in creating the product has a lot to do with its effectiveness. The same goes for cannabis producers. This is true with almost everything since we are all individuals with different chemistry working within. Also, other medications will have an effect as well.
It is important to note that at some point in the progression of MS it becomes less important whether a successful treatment is a placebo effect, illusion, wishful thinking, or fact. Much like prayer, once something works, why question its validity? Anyone with MS who's tried big pharma medications with no results, awful side effects, or very little relief, will tell you - it's worth a try just to have less pain, more mobility, and a positive attitude toward something! It's always good to have options!!!
Ed Tobias
Hi Jane,
Thanks for your thoughtful comments. I agree with all that you've written, especially that it really doesn't matter whether the help is the result of a placebo or the real thing.
Ed
Debra Glasby
When I first met my Neurologist as we left his office, his nurse came out to talk to us. Now at this appointment present were me, my then-husband, my mother, and my father, The Nurse gave us information stating that the Doctor told her to inform me that if the pain and numbness I should use weed ( marijuana). at which point I wanted the ground to open up, as my mother was against drugs but to my surprise, she looked at me and informed me that should I need it, my cousin, whose mother had also had M.S, that would get it for me. There were times that I would eat cookies made with marijuana and they stopped the shakes in my lower legs.
Paula mieczkowski
Iām old school and smoke in a pipe.lol. It helps me tremendously get through a rough patch of spasticity. Even if itās not the right strain, it helps me laugh through it. Both medical and non medical.
Ed Tobias
Hi Paula,
My question to you is how do you find the right strain? Is it just a matter of experimentation or is there a strain that's particularly good at soothing MS symptoms?
Ed
Lezley Gibson
it is a mighty fine illusion lol i was told i would be in a wheelchair and incontinent within 5 years of my diagnosis, i am still walking and not incontinent nearly 40 years later,,,,, no dr drugs just full spectrum cannabis.
Ed Tobias
Glad to hear of your success, Lezley. How are you able to do things like driving and working if you're always under the influence of cannabis? Have you really been using it for 40 years?
Ed
Sid Rotten
Iāve had a similar experience as Lezley. I was diagnosed 23-24 years ago. Iām 72 now. I use a cane for balance when walking
a distance. When I was diagnosed I was told that I already had a number of lesions that would indicate disease activity going
back for as much as 20 years with apparently full remission. I have used marijuana most of my adult life. Apparently, Iāve most
likely had MS most of my adult life. I worked in the telecommunications industry for 30 years. Iām retired now, but I live independently
& still drive. I renew my license every 7 years because I donāt get tickets or have accidents. I donāt drive āhighā. Iām not stoned
all the time. I use cannabis Indica forward strains from a licensed grower/ dispensary. Cannabis sativa forward strains are much
more euphoria inducing. My favorite strain that helps with pins & needles, formication, restless legs, etc. is called White Cherry
Gelato. It is a high tolerance strain so it is ātwo puff stuffā. If you wish to counteract a THC high, a few puffs of CBD without THC
is helpful. I usually donāt use cannabis during the day, just Voltaren topical gel unless Iām having a really bad day. But at night
before I go to bed a few puffs on my peace pipe letās me get a good rest & therefore less fatigue the next day.
Ed Tobias
Thanks for all of that info, Sid. This kind of detail is very useful to us all.
Ed
Elizabeth
Marijuana has varying effects on my spasticity and anxiety. Sometimes it works great; like if I am hiking and my eyes start crossing and I am becoming fatigued. I think it helps to switch the path that the brain is going down. i.e. if you are encountering a lesion it helps the brain travel down a different pathway than the lesioned pathway. This is conjecture and personal experience. Sometimes it only helps me not tense up more in response to my spasticity, but does not make the spasticity go away completely. It makes it more bearable.
However, I have also sometimes had the experience when I get the high without the pain relief and this is an extremely unpleasant experience. It depends on the strain, and how much I am used to that particular strain. It is unfortunately quiet hit and miss. Needs to be studied better to understand how exactly it helps.
Placebo effect is a powerful thing, and I would never rule it out. In MS I think placebo effect is particularly powerful because it is a disease of the brain and our thought processes heavily influence how we are feeling.
Ed Tobias
Hi Elizabeth -
Thanks for sharing all of this. Your experiences are very interesting. I agree with you that it's hit and miss and we really need to be able to have quality an strength standards, just as with traditional medications, that allow users receive consistent doses.
Ed
Leanne Broughton
CBD oil dd not help my pain. Does marijuana, edibles or smoking it (THC) give you a drowsy or woozy feeling? Then I am not interested. Oral medication does that to me and I would like to avoid that. I want a clear head and walk (albiet I use a walker) without falling or feeling like I will.
Ed Tobias
Hi Leanne-
When I took a THC gummy it made my feel uncomfortably stoned. A CBD gummy relaxed me but did nothing for the nerve pain in my leg.
Ed
J. Howell
The entire basis of the hypothesis that it might be an "illusion" or placebo effect for MS patients based solely on this study is incredibly flawed.
Let's have some studies that focus ONLY on MS patients, with a larger test group, and a variety of doses and intake routes.
As it relates to MS, I can say firsthand: cannabis is better than baclofen for muscle spasticity by a couple of orders of magnitude.
No, THC isn't an analgesic; that's not why it's useful in this case. The pain it relieves isn't a direct blocking of inflammation, it's secondary, inasmuch as if my arm hasn't been cramped with spasticity every moment, it hurts a LOT less. It also enables me to do things that are otherwise difficult (like typing and playing instruments) that aren't just good for my quality of life, they're essential to how I've made a living as a musician and a writer.
I'm a ~200 pound man and take a 2.5mg dose of Dronabinol up to four times a day as needed; usually one or two is enough. I rarely have anything even approaching psychoactive effects at that dose. If I want to get high, weed is legal in my state even for recreational use now; I have that option. That's not the point though.
I will note that smoking or consuming stronger edibles is typically even more effective at reducing spasticity for me, but then there are psychoactive effects that may be counterproductive when I'm trying to work or get things done. The low dose Dronabinol, however, is reliable and effective with very little in the way of side effects. No worrying about side effects of different strains, how tightly controlled the dosage is in edibles, et c.
YMMV, of course, but cannabinoid-based medication for MS is absolutely not in my head. It works. Better than the standard baclofen therapy, by miles.