Multiple sclerosis and medical marijuana
By Markita Wilburn
There are nearly one million people living with Multiple Sclerosis (MS) in the United States. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed.
MS involves an immune-mediated process within the central nervous system (CNS) where the immune system mistakenly attacks its myelin. Myelin is a fatty protectant surrounding our nerve fibers, which help carry messages from the CNS to the rest of the body. The symptoms of MS are the result of damage to myelin and the underlying nerve fibers within the CNS. This produces inefficiencies in signal translation between the brain and the rest of the body, meaning how we think, see, hear, speak, feel, eliminate and move are affected. Because MS is immune-mediated and progressively deteriorating, symptoms differ significantly person to person and can change or multiply over time.
People looking to mitigate symptoms of MS with medical marijuana should tailor choices specific to their symptoms. As medical marijuana may be a considerable alternative based on existing evidence, marijuana products are probably effective for treating patient-reported symptoms of spasticity and pain, but not effective for MS related tremors or urinary incontinence.
Medical marijuana + MS
Cannabinoid and terpene profiles in medical marijuana play a major role in controlling biological function. Cannabinoids attach to cannabinoid receptors in the human body and alter neurotransmission within the brain, creating balance. For patients with MS, this interaction protects the damaged nerves within the CNS, balancing signal transmission and message translation to allow normal function of the body.
As a precaution, patients with MS should be aware of potential adverse effects of marijuana products, including new or worsening cognitive symptoms, psychosis, tolerance and dependence, as well as drug-drug interactions.
Our pharmacists recommend strains with the following combinations of terpenes and cannabinoids for patients with MS, depending on which symptoms they are treating:
THC
Reduces pain, relaxes muscles, neuroprotectant, Causes psychoactivity.
THC + B-Caryophyllene + Myrcene
Reduces pain, relaxes muscles, decreases inflammation. Potential sedative benefit
THC + TERPINOLENE
Enhances mood, produces cognitive clarity, reduces pain
CBD
Neuroprotectant, potentially more alerting and energizing for some compared to THC. Non-psychoactive and reduces euphoria from THC, .
CBD + THC
Reduces MS related spasticity
CBD + Limonene + Linalool
Enhances mood, manages depression, relax muscle spasticity and tightness.
CBD + Myrcene
Minimizes pain and inflammation, but myrcene may cause sedation.
CBC
Maybe 10 times more effective than CBD for anxiety and depression.
CBC + Limonene + Linalool
Enhances mood and manages depression
Adding cbd in equal or lesser concentration along with myrcene can enhance pain reduction and lessen psychoactivity.
On the menu
While inventory changes daily, below are some strains we often have in stock that we recommend for patients with MS.
Jordan 23 Cartridge by FarmaceuticalRx
Golden Cobra x Slymer Cartridge by Moxie
Tranquility Cartridge by Liberty
Crippy Cartridge by FarmaceuticalRx
Biscotti Disposable Pen by Grassroots
GG#4 Disposable Pen by GTI
Soothe 5:1 Cartridge and Disposable Pen By Ilera
OG 18 Disposable Pen by Cresco
Lost Coast Tribal Diesel Disposable Pen by GTI (THCV also)
Big Smooth Sugar by FarmaceuticalRx
REFERENCES
https://www.nationalmssociety.org/What-is-MS
Maione S, Piscitelli F, Gatta L, et al. Non-psychoactive cannabinoids modulate the descending pathway of antinociception in anaesthetized rats through several mechanisms of action. Br J Pharmacol. 2011;162(3):584–596. doi:10.1111/j.1476-5381.2010.01063.
Russo EB. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br J Pharmacol. 2011;163(7):1344–1364. doi:10.1111/j.1476-5381.2011.01238.
FURTHER READING
Outside of the United States, a naturally extracted cannabis product known as Sativex®️ (nabiximols), is approved for Use in the treatment of ms-related spasticity. Evidence suggests Sativex®️ can improve patient-reported symptoms of pain and urinary frequency as well, but not bladder incontinence, ms-related tremor or spasticity as measurable by tests administered by physician. Sativex®️ is a 1:1 THC to CBD oral spray, which allows the activation of both CB1 and CB2 receptors. As we know, CB1 receptors are prevalent more within the CNS. The interaction cannabis has with CB1 receptors usually commences relief of MS-related symptoms, while CB2 receptors on cells of the immune system help to manage abnormal occurrences of this immune-mediate Disease.
The National Multiple Sclerosis Society’s stance on medical marijuana use in the treatment of ms-related symptoms is inclusive to a patient’s optimal course of action. Understanding additional research is needed at the federal level, the society advocates for state legalization of medical marijuana in hopes of breaking barriers towards federal research. Their advocacy is based on guidelines for which evaluated all published research studies of MS and cannabis use, whether synthetic THC or natural cannabis extract. Studies conducted show likeness in MS symptom control with synthetic cannabis and with whole plant cannabis extract. Conclusively, the long-term safety of cannabis use for MS symptom management is not yet known and as is often the case in cannabis, there is still a lot of research left to be done of marijuana use for the treatment of multiple sclerosis.