Symptoms of MS
The studies showed that medical marijuana in pill or oral spray form can help treat certain MS symptoms.
The studies examined here looked at four forms of medical marijuana:
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Oral cannabis extract (OCE), a pill made of either pure CBD or a combination of CBD and THC
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Synthetic THC, a human-made form of THC available as a pill
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Nabiximols (Sativex), a mixture of THC and CBD available in Oral Spray form
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Smoked marijuana in cigarettes of standard drug strength
Table: Evidence for Safety and Effectiveness of Medical Marijuana
| Findings, by Disorder and Drug Formulation |
|
OCE
- Can reduce patients’ reported symptoms of spasticity
|
|
Strong |
OCE
- Probably does not lead to improvement short-term (12-15 weeks) on tests for spasticity a doctor performs
Synthetic THC
- Can probably reduce patients’ reported symptoms of spasticity
- Can probably lessen cramp-like pain or painful spasms
- Probably does not lead to improvement short-term (15 weeks) on tests for spasticity a doctor performs
Oral Spray (Nabiximols)
- Can probably lessen patients’ reported symptoms of spasticity short-term (6 weeks)
- Probably does not lead to improvement short-term (6 weeks) on tests for spasticity a doctor performs
- Can probably lessen cramp-like pain or painful spasms
|
|
Moderate |
OCE and Synthetic THC
- Might lessen patients’ reported symptoms of spasticity if continued for at least one year
- Might lead to improvement on tests for spasticity a doctor performs, if treatment continued for at least one year
|
|
Weak |
Smoked Cannabis
- Not enough evidence to show if safe or helpful for pain related to spasticity
|
|
Unknown |
| MS: Central Pain |
|
OCE
- Can help lessen central pain (feelings of painful burning, “pins and needles,” and numbness)
|
|
Strong |
| MS: Bladder Problems |
|
OCE and Synthetic THC
- Probably do not help lessen frequent urination and bladder control problems
|
|
Moderate |
Oral Spray (Nabiximols)
- Not enough evidence to show if helps lessen bladder problems overall
|
|
Unknown |
| MS: Tremor |
|
OCE and Synthetic THC
- Probably do not help lessen tremor in MS
|
|
Moderate |
Oral Spray (Nabiximols)
- Might not help lessen tremor in MS
|
|
Weak |
| PD: Temporary, Uncontrolled Movements |
|
OCE
- Probably does not help lessen abnormal movements caused by levodopa
|
|
Moderate |
| HD: Motor Symptoms |
|
Synthetic THC
- Not enough evidence to show if helps lessen motor symptoms
|
|
Unknown |
| Tourette Syndrome: Tic Severity |
|
Synthetic THC
- Not enough evidence to show if helps lessen tic severity
|
|
Unknown |
| Cervical Dystonia (Abnormal Neck Movements) |
|
Synthetic THC
- Not enough evidence to show if helps lessen abnormal neck movements
|
|
Unknown |
| Epilepsy: Seizure Frequency |
|
Any Form of Cannabis
- Not enough evidence to show if helps lessen how often seizures occur
|
|
Unknown |
| |
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Dystonia is a neurological movement disorder characterized by abnormal muscle tension and involuntary, painful muscle contractions. It is the third most common movement disorder after Parkinson's disease and tremor, affecting more than 300,000 people in North America.
A small number of case reports and preclinical studies investigating the use of cannabis and cannabinoids for symptoms of dystonia are referenced in the recent scientific literature. A 2002 case study published in the July issue of the The Journal of Pain and Symptom Management reported improved symptoms of dystonia after smoking cannabis in a 42-year-old chronic pain patient. Investigators reported that subject’s subjective pain score fell from 9 to zero (on a zero-to-10 visual analog scale) following cannabis inhalation, and that the subject did not require any additional analgesic medication for the following 48 hours. "No other treatment intervention to date had resulted in such dramatic overall improvement in [the patient's] condition," investigators concluded.
A second case study reporting “significant clinical improvement” following cannabis inhalation in a single 25-year-old patient with generalized dystonia due to Wilson’s disease was documented by an Argentinian research team in the August 2004 issue of the journal Movement Disorders.
Also in 2004, a German research team at the Hannover Medical School reported successful treatment of musician’s dystonia in a 38-year-old professional pianist following administration of 5 mg of THC in a placebo-controlled single-dose trial. Investigators reported “clear improvement of motor control” in the subject’s affected hand, and noted, “[Two] hours after THC intake, the patient was able to play technically demanding literature, which had not been possible before treatment.” Prior to cannabinoid treatment, the subject had been unresponsive to standard medications and was no longer performing publicly. “The results provide evidence that … THC intake … significantly improves [symptoms of] … focal dystonia,” investigators concluded.
By contrast, a 2002 randomized, placebo-controlled study investigating the use of the synthetic oral cannabinoid naboline (Cessamet) in 15 patients afflicted with generalized and segmental primary dystonia did not show a significant reduction in dystonic symptoms. Investigators speculated that this result may have been dose-related, and that administration of a higher dosage may have yielded a different outcome.
At least one recent preclinical trial indicates that both synthetic cannabinoids as well as high doses of the natural non-psychoactive cannabinoid cannabidiol (CBD) could moderate the disease progression of dystonia in animals.[5] Limited references regarding the use of cannabinoids for dystonia in humans[6] and animals[7] in the 1980s and the 1990s also appear in the scientific literature. It would appear that additional, larger clinical trials are warranted to investigate the use of cannabis and cannabinoids for this indication.
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