Multiple sclerosis is a degenerative condition that affects the nerves in the central nervous system. There is currently no cure. Marijuana (cannabis) may be useful for treating several symptoms of the condition.

Multiple sclerosis (MS) is a serious and lifelong condition that causes a range of symptoms.

In people with MS, the immune system is overactive and causes damage to cells in the brain, spinal cord, or optic nerves that make up the central nervous system.

Marijuana, which is also known as cannabis, is now legal in many areas of the United States.

The term “cannabis” is preferable to marijuana, as the latter term has racist roots and connotations.

The National Multiple Sclerosis Society supports the use of medical cannabis for people with MS in some instances and where it is lawful.

According to a 2018 review, cannabis products were generally well-tolerated, and serious adverse effects were rare. However, adverse effects may occur, and cannabis may not be suitable for everyone.

More research is necessary before the Food and Drug Administration (FDA) can approve its use for MS.

Share on Pinterest
Olena Ruban/Getty Images

The chemicals in cannabis have different effects on the body, some of which can be medicinal.

Tetrahydrocannabinol (THC) is one of the primary chemicals in cannabis, and it has psychoactive properties that cause the “high” of the drug. Conversely, a compound called cannabidiol (CBD) does not have psychoactive effects. There are many other components of cannabis, but most research to date has focused on these two.

THC may increase appetite, reduce nausea, and improve muscle control issues.

CBD may be useful for controlling some types of epileptic seizures and is a promising option for some mental health conditions such as social anxiety and PTSD.

CBD is also a promising option for helping with pain and spasticity.

More evidence is needed to determine the therapeutic potential of CBD and to determine safe and effective dosages for each use.

People should check on their local laws before using cannabis or cannabis products.

Seek guidance from a healthcare provider, if possible, before using any CBD products.

In a 2012 study in the UK, researchers gave 279 people with MS either an oral extract of cannabis or a placebo for 12 weeks. The extract was taken from Cannabis sativa L and the main cannabinoid was THC.

The researchers found that people in the cannabis group experienced almost twice as much relief from muscle stiffness.

A 2014 systematic review published by the American Academy of Neurology (AAN) found strong evidence to support the use of cannabis-based treatments for MS-related muscle problems.

This review found that oral cannabis extract (OCE) does help with muscle spasms, while THC probably does not help.

A 2010 analysis of three studies (666 participants in total) on the use of nabiximol (Sativex), a cannabinoid-derived mouth spray, by people with MS and spasticity found that it reduced subjective spasticity.

A 2018 review looked at 11 reviews of cannabis and cannabinoids’ use in treating symptoms of MS. Five of the 11 reviews concluded that there is enough evidence that cannabis can help with muscle spasticity.

A 2012 trial looked at the effect of smoking cannabis on the symptoms of MS. The researchers found that smoking cannabis led to more pain reduction than a placebo.

In another 2012 study, people with MS who took a THC oral cannabis extract had a more significant reduction in pain than those who received a placebo.

If someone with MS experiences aches in their muscles and joints, topical CBD could help.

A 2016 study on a rat with induced arthritis found that topical CBD, applied for four consecutive days, significantly reduced joint swelling and inflammation.

While cannabis appears to help relieve pain in some people with MS, there is not yet enough research to know which form or balance of CBD and THC is most effective.

There are not enough studies on CBD, taken orally, to prove its effects on pain relief.

Scientists conducted a trial to investigate the use of the oral cannabis extract nabiximols (Sativex) for bladder dysfunction.

They gave the participants either the extract or a placebo for 10 weeks.

The results were not statistically significant, but they indicated that cannabis might improve the symptoms of bladder problems in people with MS.

The 2014 AAN review also found evidence to suggest that oral cannabis extract is likely to be effective for treating these issues.

Cannabis is unlikely to be beneficial for reducing tremors, another primary symptom of MS.

The 2014 AAN review found that the existing evidence did not support the use of cannabis to reduce tremors in people with MS. However, it is still possible that cannabis might be useful for the treatment of tremors in people with conditions other than MS.

Guidelines from the American Academy of Neurology for people with MS state that oral cannabis extracts, synthetic THC, and oral cannabis sprays are likely to be effective for treating some MS symptoms. They note that it is unclear whether smoking cannabis may also be beneficial.

Taking cannabis for MS may not always be appropriate, and there may be side effects.

Possible side effects include:

  • confusion and possibly paranoia
  • problems with thinking and reasoning
  • nausea and vomiting
  • dry mouth and eyes
  • sedation
  • increased hunger
  • headache
  • problems with balance and coordination
  • a raised heart rate

Smoking cannabis can also damage the lungs.

THC can have psychoactive and other unwanted effects, but combining it with CBD may reduce these effects.

There are many different strains and forms of cannabis, and some may be more helpful than others.

Depending on legality, medical professionals may suggest different types of cannabis medications.

One such medication, Dronabinol, is a capsule made of synthetic THC. The other, nabiximols (Sativex), is a mouth spray comprised of THC and CBD extracts.

If a person lives in a state where medical cannabis is legal, they can obtain a medical card allowing the use of a variety of cannabis products.

If a person lives in a state where recreational cannabis is legal, those products may be available without a medical card.

Licensed dispensaries sell cannabis products to the public in states where medical and recreational cannabis is legal.

Dispensaries carry a variety of cannabis products such as:

There are many different strains of cannabis to choose from. Each cannabis strain may have a different percentage of THC and CBD, which can determine its effects.

Cannabis strains also have a variety of terpenes, or aromatic compounds, which may determine its effects.

Research suggests that it may be important to get the right combination of THC and CBD, as CBD might help reduce some of the negative effects of THC. Experts still don’t know which combination is best.

A 2018 survey identified cannabis strains that were reported as preferred by participants using medical cannabis for various conditions that caused chronic pain.

There were 2,032 patients in the survey. They ranged in age from 9 to 85 years old. Only 1,839 participants revealed their ethnicities, of which 90.5% self-identified as Caucasian, 3.1% Metis, 3% Aboriginal/First Nation, 1.8% South Asian, 1.7% Asian, 1.2% Black, 1.2% Hispanic, and 1.8% other.

Participants using cannabis to help with chronic pain preferred strains such as:

  • OG Shark
  • Pink Kush
  • CBD House Blend
  • Skywalker
  • Warlock
  • Jack Herer
  • Master Kush

Around 2.2% of participants reported treating their MS with medical cannabis. The survey does not say what specific strains those people preferred.

Note that these preferred cannabis strains came from user reports and not clinical trials. More research is needed to confirm that these products are safe and effective to use with MS.

Cannabis strains may affect everyone differently. Speak with a healthcare provider, if possible, to determine a suitable strain.

Cannabis is not legal in all states.

So far, the FDA has only approved one cannabis-derived drug, Epidiolex, to treat some people with a specific kind of epilepsy.

The FDA has approved three synthetic cannabis products, but not for use with MS. More research is necessary to confirm the effectiveness and safety of cannabis extracts before the FDA can approve them for MS.

A person should speak to their doctor about whether cannabis is legal and suitable for them to use and how to obtain an appropriate product.

Cannabis may be beneficial for people with MS.

Scientific evidence suggests that it can lessen pain, muscle problems, and bladder issues. Additional, larger-scale clinical studies are necessary to confirm these findings.

The long-term safety of treatment with this drug needs more research. It is not yet clear which form of cannabis is likely to be most beneficial. Any treatment containing THC may have some psychoactive effects.

People should speak with their doctor before deciding to use cannabis for MS. Their doctor can help them weigh the costs and benefits of the treatment and determine whether it is safe and suitable for them.

Read this article in Spanish.