An estimated 400,000 Americans are currently living with multiple sclerosis, an autoimmune disease where the body’s immune cells attack a fatty substance called myelin in the nerves. Common symptoms are gait and balance disorders, cognitive dysfunction, fatigue, pain and muscle spasticity.
Colorado has the highest proportion of people living with MS in the United States. It is estimated that one in 550 people living in the state has MS, compared to one in 750 nationally. The reason for this is unknown, but could be related to several factors, such as vitamin D deficiency or environment.
Currently available therapies do not sufficiently relieve MS symptoms. As a result many people with the condition are trying alternative therapies, like cannabis. Based on several studies, the American Association of Neurology states that there is strong evidence that cannabis is effective for treatment of pain and spasticity.
Although there are many anecdotal reports indicating cannabis’ beneficial effects for treatment of MS symptoms such as fatigue, muscle weakness, anxiety and sleep deprivation, they have not been scientifically verified. This is because clinical trials – where patients are given cannabis – are difficult to do because of how the substance is regulated at the federal level.
To learn more, my Integrative Neurophysiology Laboratory at Colorado State University is studying people with MS in the state who are already using medical cannabis as a treatment to investigate what MS symptoms the drug can effectively treat.
Medical marijuana isn’t a prescription drug
Marijuana, or cannabis, contains over 100 compounds, but THC (Tetrahydrocannabinol) and CBD (Cannabidiol) are believed to have the most medical relevance.
However, there is currently no information about the most effective ratio of THC and CBD, which form of ingestion (smoking or eating, for instance) is best, or how often people with MS should use cannabis products.
The main reason for the limited scientific evidence about how well cannabis can treat MS symptoms is because it is a Schedule 1 substance. This means that it has “no currently accepted medical use and a high potential for abuse.” This classification makes it very difficult to study cannabis in clinical trials.
Because cannabis is on Schedule 1, doctors can’t prescribe it, even in the states with medical marijuana laws, like Colorado. In those states doctors can provide patients with a “permission slip” for cannabis, which has to be approved by a state agency.
Because of the lack of scientific evidence, doctors can’t recommend a specific strain and dosage of cannabis to patients. Patients are left to choose on their own. Moreover, a recent study in the Journal of the American Medical Association showed that out of 75 cannabis products, only 17 percent were accurately labeled. And 23 percent contained significantly more THC than labeled, possibly placing patients at risk of experiencing adverse effects.
How we are studying cannabis and MS
My lab’s long-term goal is to determine whether cannabis can safely and effectively treat MS symptoms. But because of current federal regulations our lab can conduct only observational studies at this time. To conduct clinical trials with a Schedule 1 substance, investigators must have a special license, which my lab is in the process of applying for. At the moment, this means we study only people who are or are about to use cannabis and we do not provide cannabis to anyone for our studies.
We recently completed an online survey of 139 MS patients currently using cannabis to learn what types of products they used, how often they used those products and for how long.
Our results, which have not yet been published, found that 91 of our respondents (66 percent) reported that they currently use cannabis, and 56 percent of the cannabis users reported using either smoked or edible products. Seventy-eight percent of the cannabis users also indicated that they reduced or even stopped other medications as a result of their cannabis use.