Cannabis has become known as one of the oldest medicinal plants in the world. It has also been studied in the context of supportive approaches for multiple sclerosis.
Here you can find out about the different research areas on cannabis in MS, how the medicinal plant is being studied and what to consider. For example, hemp is processed in different ways. The question of prescription requirements is also clarified.
The most important facts in brief
- Cannabis has been studied in the context of symptomatic management of multiple sclerosis. Research has explored how the medicinal plant may interact with symptoms of the disease.
- Cannabis has not been clearly shown to influence the immunological or inflammatory processes in MS.
- Side effects are also possible. For example, cannabis can cause depression or lead to panic attacks.
What is cannabis?
Cannabis is a medicinal plant that originated in India. It contains a psychoactive ingredient. This is also called tetrahydrocannabinol and has become known by the abbreviation THC. THC is the trigger for the well-known state of intoxication that can be achieved through cannabis.
In Germany, cannabis is also called hashish or marijuana. It is interesting to know that these are two different things:
- Marijuana: The colloquially called "grass" consists of dried leaves, stems and also flowers of the cannabis plant.
- Hashish: Hashish is also often referred to as dope and is made from the resin found in the glandular hairs of the female cannabis.
What is the difference between cannabis and CBD?
THC and CBD are different, even though they are both cannabinoids. There are over 100 different substances and also chemical compounds in hemp itself. These are cannabinoids. The concentrations differ significantly. CBD and THC are particularly well known.
CBD - also known as cannabidiol - is an antagonist of THC. This means that when CBD is taken, there is not the same effect as noticed with THC. The intoxicating effect does not occur. Instead, CBD has been observed to interact with THC in the body. It is sometimes used to help reduce the state of intoxication.
| Cannabis | CBD |
|---|---|
| - Also known as THC | - Referred to as cannabidiol |
| - Binds to CB1 receptors | - Binds to CB1 and CB2 receptors |
| - Strong influence on perception | - Does not induce intoxication |
| - Can cause depression and negative thoughts | - May have a mood-lifting effect and may help reduce the state of intoxication caused by THC |
| - Influence on the ability to concentrate | - Has been studied for cramp-related properties |
| - Recognised as a medicinal product | - Recognised as a food supplement |
Are cannabis flowers being studied for MS?
Again and again it is pointed out that the use of cannabis flowers in MS is being explored as one possible research area. They are often mentioned as a counterpart to the well-known drug "Sativex". This is a medical product composed of CBD and THC.
Cannabis flowers can be combined in different amounts. This makes it possible to adjust them to the patient better than a ready-dosed medicine. In addition, the flowers can contain particularly relevant terpenes or also cannabinoids that may have been lost during processing for the medicine.
However, it is not quite so easy to obtain therapy with cannabis flowers. Usually, they are only considered an option when medications with cannabis as the active ingredient have proven to be insufficient.
What is cannabidiol?
As already briefly mentioned, cannabidiol is CBD. CBD has only become known in recent years, although it is one of the most important ingredients found in the hemp plant. In the meantime, however, the way CBD interacts with the human body has been increasingly researched.
An interesting aspect is that CBD can bind two receptors at the same time. Both CB2 and CB1 react here. For these reasons, CBD does not produce a state of intoxication, as is the case with THC. Instead, it has been studied for potential mood-related effects. However, larger amounts have to be taken for this.
CBD has also been researched for potential pain-related properties. It has also been studied for potential effects on inflammation. Unlike cannabis, CBD has not yet been approved as a medicine.
Background: What you should know about cannabis in the context of MS
Cannabis in the context of MS is mainly studied for mobility-related symptoms. At the same time, this approach is being explored for pain tolerance. However, this form of approach is still a path that is not easily accepted. Read on for more background information.
Is cannabis for MS only available on prescription?
Cannabis is listed in the German Narcotics Act. Possession is a punishable offence, as it is an illegal narcotic. A criminal prosecution can be initiated if there is a suspicion that you are in possession of cannabis. So how is therapy for MS supposed to work?
In the area of medical use, the law does not apply. Especially with regard to use in MS, cannabis has been recognised as a medicine since 2011. In the meantime, different medicines with different dosages are available that can be prescribed. However, there were difficulties with the assumption of costs by the health insurance companies.
A change was only brought into being in 2017. Through a change in the law, cannabis was recognised as a medicine in justified cases. In the meantime, the costs must be covered by the statutory health insurance if you get a prescription from your doctor. So you always need a prescription.
Who is prescribed medical cannabis?
Medical cannabis is primarily prescribed to people who are classified as seriously ill. According to the Ärzteblatt, between 5,000 and 10,000 people in Germany receive medical cannabis. However, this figure applies to both MS patients and patients suffering from cancer.
So far, the approach has primarily been to address the symptoms and is therefore only prescribed when those affected suffer from severe pain and limitations. Currently, it is not foreseeable to what extent and when this will change.
What dosage of cannabis?
There is no general guidance on the dose of cannabis to be given for MS. Not every patient shows the same reaction when using the medication. Therefore, it is necessary to slowly approach the optimum dosage in direct consultation with the doctor.
It should not be underestimated that cannabis can also have side effects when used as a medicine for MS. For example, the drug can also have an effect on mood and promote the development of depression. Thinking disorders, which develop with regular use, are also possible.
Patients report feeling panic attacks and disorientation after taking it. Persecutory fantasies may also occur. Besides the strong effects on the psyche, cannabis can also have an effect on attention. In some cases, it also has an effect on short-term memory.
Long-term use can also lead to dependence. For this reason, cannabis is only available on prescription. In an individual therapy plan, your doctor will work out the appropriate dosage together with you. In case of severe side effects, you should contact your doctor directly.
Do cannabis globules also work for MS?
The medical effect of globules has not been proven. Cannabis is also available in homeopathic form. For example, it is offered as Cannabis Sativa E Seminibus in different strengths. Studies have not yet been able to prove any influence of globules on MS.
Nevertheless, a trial can certainly be considered. This form is seen as a variant with low risks. If you as a patient are possibly not in the situation to receive a prescription for cannabis, the use of globules is a step that can be considered. Especially in mild forms, some users report positive experiences.
What to do with MS: Cannabis in the context of multiple sclerosis
Both THC and CBD are biologically active and have properties that have been studied in medicine. Multiple sclerosis can put a lot of strain on the body, significantly limit life and lead to severe pain. Cannabis-based medications have been studied in this context.
What is being researched about cannabis in the context of MS?
The use of cannabis in MS is increasingly being considered in research, especially for patients who are experiencing a severe course of the disease and suffer from severe pain. There are several research areas being explored:
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Cannabis and inflammation research. Multiple sclerosis causes severe pain because the nerve tissue is characterised by severe inflammation. The autoimmune disease causes the body's own cells to attack the central nervous system. The resulting inflammation places a heavy burden on the body and mind. Neurological symptoms are the result.
Spasms, muscle weakness and the lack of control over movements as well as severe fatigue and also mood swings are not uncommon. Cannabis has been studied for potential anti-inflammatory properties, which has been explored in several research contexts. Research on cannabis in MS has examined potential effects on inflammation.
Research on anti-inflammatory properties has also informed the development of Sativex, the best-known medicine containing cannabis. Cannabis has been studied for its potential to modulate the immune response in the body. This is researched in the context of inflammation.
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Pain-related research. The severe pain associated with MS is a significant burden for sufferers. Around 70 % of patients report that the pain particularly affects them. Cannabis has been studied for potential pain-related effects. A 2005 study explored a cannabis-based medicine in this context, with results documented in the research.
This effect has been studied in relation to the immune reaction. Spasms and muscle spasms have been reported to be reduced in some studies. However, the recommendation here is to rely on THC and not to resort to dronabinol and CBD, which is known as synthetic THC.
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The role of cannabis in depression research. MS patients often develop clinical depression. About 50% of patients are affected. The development in the course of the disease is based, among other things, on the fact that there is severe damage to the nerves that have the task of regulating mood in the body. However, depression can also be a side effect of medication taken to alleviate the symptoms of MS.
The suggestion that cannabis may help with depression should be taken with caution. Here it depends on the composition of the drug. A high proportion of THC sometimes has the opposite effect. Recommendations indicate to rely on CBD rather than THC in this context.
Although some tests indicate observations regarding depression and the use of cannabis, it is not clear to what extent CBD has a positive effect on depression. It is also not clear to what extent any observed differences can be attributed to a reduction in symptoms. Moreover, it can be assumed that not all people are receptive to a positive effect on mood through cannabis.
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Muscle-related research
A strong symptom of MS is muscle cramps that occur without warning. Around 80% of those affected suffer from this feature. Besides the fact that the cramps start unexpectedly, they also bring severe pain. Besides cramps that resolve quite quickly, muscle spasms are also a symptom.Research on cannabis in this context has explored potential effects on muscle cramps and spasms. This result was documented in a study carried out in 2005.
It is hypothesised that this effect relates to potential interaction with inflammation in the nerves. Research continues to explore whether this may influence the course of the disease and quality of life.
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Intestinal area research
By affecting the muscles, MS also affects the reactions in the stomach and intestines. Severe abdominal pain up to incontinence during bowel movements is not uncommon. With the use of cannabis, some patients report relaxation in the intestinal area. The strong urge to pass stool may diminish in some cases.
Trivia: What else you should know about cannabis in MS
Cannabis has been used in MS for a long time, but it is still a therapy that is only used in severely ill patients. This is also due to the possible side effects.
How long has cannabis been used for MS?
Studies on the effect of cannabis in MS were conducted as early as 2005. However, the first drug for treatment in Germany only came onto the market on 1 July 2011. This was Sativex, which is still used today. The dosage was in the form of a spray. The spray is sprayed into the oral cavity and absorbed through the mucous membranes.
The drug contains cannabidiol and tetrahydrocannabinol. The ingredients are extracted from cannabis sativa.
Are there studies on the use of cannabis in MS?
Over time, various studies have been launched to investigate the role of cannabis in MS. For example, in 2018 there was a study conducted by the Institute for Quality and Efficiency in Health Care. The study found that the use of cannabis may support therapy in MS.
But international studies were also conducted. Here, there were investigations of the relationship between cannabis and depression or muscle pain. The results indicate that the active ingredient may contribute to symptom management.
Can cannabis be smoked with MS?
Yes, in principle, the effects of cannabis in MS have also been studied when patients smoke the product. Here, studies have shown that a large proportion of patients who smoked cannabis reported significantly less pain afterwards.
However, it should be remembered that this is illegal in Germany and is subject to criminal prosecution. For this reason, it is not advisable to obtain cannabis and then smoke it. Consult your doctor about your wish for cannabis therapy.
Conclusion
Cannabis has been used as a medicine in the context of multiple sclerosis symptom management since 2011. Its potential role in severe symptoms of the disease has been documented in research.
However, treatment can only take place if the doctor issues a prescription. Since cannabis can lead to addiction, the benefits and side effects are carefully weighed. Up to now, treatment has primarily been given to patients with a severe course of the disease.
When using cannabis in MS, the dosage plays an important role. Together with the doctor, a differentiated elaboration of the dosage that suits you takes place.
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