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People have used marijuana, also known as cannabis, for medicinal purposes for thousands of years. But can marijuana help with symptoms of multiple sclerosis (MS)? Medical cannabis has been studied in people living with MS and has revealed hopeful, but sometimes inconsistent, results.
MyMSTeam spoke with Dr. Aaron Boster, a neurologist and founder of the Boster Center for Multiple Sclerosis in Columbus, Ohio. He’s found marijuana to be helpful for people with MS. “I find it to be very valuable in symptomatic management,” he said.
Dr. Boster had a word of caution, though: “You’ve heard people say, ‘Oh, there’s no dependence.’ That’s not true. Some people can develop a dependence or a tolerance to cannabis. And so we want to be very careful.”
Cannabis is legally available at marijuana dispensaries in many states. It comes in a variety of forms, all derived from the cannabis plant, including:
Some MyMSTeam members have shared their experiences using marijuana to help with symptoms of MS. “I use flower, it helps with nerve pain in my lower legs and feet and also helps me sleep,” one member shared. “Also relaxes me and puts me in a better mood, but I sure do get the munchies, LOL. The only con is that my balance and coordination are bad when I’m high, so I gotta use my cane.”
Other MyMSTeam members have noted drawbacks to using cannabis. One cited “laziness” as a side effect: “I can’t use it when I have plans to get something done,” they wrote. “But it works miracles for pain, tremors, and spasticity. I have to weigh the side effects against the benefits and only use it when I don’t mind having a mellow day.”
It’s important to understand the potential benefits and risks of using marijuana as a complementary therapy, along with your standard treatment plan. Before trying any new treatment options, including marijuana, check with your health care provider.
Here are some facts to consider if you’re thinking about using marijuana to manage your MS symptoms.
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are two of the major cannabinoids (active chemicals) in marijuana. They bind to receptors which are located primarily in the central nervous system (CNS) — the brain and spinal cord. Cannabinoid receptors are believed to help regulate pain, appetite, mood, and immune system function.
The main difference between THC and CBD relates to psychoactivity — how a substance affects mood, thoughts, awareness, and behavior. THC is a psychoactive cannabinoid, which creates an altered mental state, or a feeling of being “high.” CBD is considered a nonpsychoactive cannabinoid and will not alter your mood. Some people may want to avoid the psychoactive effects of THC.
“With the pain I was in, I decided to use THC, and it worked to ease the pain and spasms. But it did make for a sporadic sleep pattern because it did give me a bit of a high feeling,” a MyMSTeam member wrote. “Today, after driving into Edmonton for a doctor’s appointment, I started to have trouble with the pain but did not want the high. So I used a larger than normal dose of the CBD strain and it helped more than average.”
Studies have found that cannabinoids can be effective in reducing pain in people living with MS. Most pain in MS (known as neuropathic pain) originates from damage that occurs in the CNS due to MS. People with MS may also experience pain related to muscle spasms. Marijuana has been found to reduce both types of pain in MS.
Research from the International Journal of MS Care has also shown that cannabis use for chronic pain can help reduce the use of opioids for pain in people with MS.
A MyMSTeam member shared that they use CBD oil, with no THC, for muscle spasms and topical cannabis cream for muscle and nerve pain. “They both work great,” the member wrote. “And neither one causes any reaction in the mind of feeling high in any way.”
Muscle spasticity is a symptom of MS that causes muscle stiffness and tightened muscles. Studies have shown that treatment with cannabinoids reduced the amount of self-reported symptoms of spasticity. However, when spasticity was measured objectively by a doctor, little difference in spasticity was observed.
Dr. Boster has also seen good results with using marijuana for spasticity. “ I consistently see benefits for spasticity — spasms, cramps, charley horse legs that are hard to bend. I consistently see benefits for neuropathic pain,” he said.
A MyMSTeam member wrote, “Cannabis works on muscle spasms. I use it about four to five times per week.”
Damage to the CNS from MS can cause incontinence (bladder problems) and urinary tract infections. People living with MS may also struggle with the need to urinate frequently. Although scientists are unsure how cannabinoids can improve incontinence, they do know that cannabinoid receptors are expressed in the bladder.
“I just know that my THC marijuana allows me to empty my bladder because all day, I retain my urine,” a MyMSTeam member wrote.
Evidence on how cannabinoids affect bladder control related to MS is mixed. Some studies from the journal Neurology suggest that cannabinoids don’t help, while others suggest they do. Several studies have shown that cannabinoids may help reduce frequent urination in MS.
Sleep disturbance and fatigue are common problems for people with MS. Some research has shown that marijuana can help improve sleep for people with MS. It’s important to note that of the two main strains of marijuana — indica and sativa — indica is considered more calming, while sativa can be more stimulating. Indica strain is more conducive to sleep.
“I learned that I need between eight to 10 hours of actual sound sleep so I have set up a routine. Taking half a blackberry gummy of medical marijuana helps,” a MyMSTeam member said.
However, heavy use of cannabis has been found to disrupt sleep.
Some research indicates that marijuana may have anti-inflammatory and immunosuppressive properties that may help reduce MS symptoms in general, particularly the sativa strain. However, as of now, researchers don’t fully understand the anti-inflammatory effects of marijuana and research is limited.
Studies have shown that the psychoactive properties of THC can make cognitive symptoms of MS worse — including memory and processing problems — in people living with MS. In addition, overuse of marijuana — known as cannabis use disorder — is a growing problem among people with MS and can lead to depression, cognitive impairment, and little symptom relief as the body becomes tolerant to marijuana.
“Cog fog or difficulties with cognition are not uncommon in MS,” said Dr. Boster. “Many, many of my patients can struggle sometimes with thinking and memory, and cannabis can impair them. And so these are things that we just need to be very open and honest about. I like to point out that many of my prescription medicines also cause very similar side effects. And so just like with anything else, we have to weigh the risks and the benefits.”
Other unpleasant side effects of cannabis — particularly products with THC — include:
Dizziness or drowsiness are adverse effects that can also affect balance and movement in people with MS. Alcohol with THC products can worsen side effects.
A member of MyMSTeam said that they experience symptom relief using marijuana but that they avoid using it during the day to avoid the side effects. “I’m not a smoker, so I only know edible [marijuana]. I keep thinking to use it when I have pain, but I don’t want to feel stoned, and I’m kind of a lightweight, so only before bed if I have muscle pain, migraine or tremors,” they wrote.
If you’re considering marijuana or currently using it for your MS symptoms, it’s essential to let your doctor know. Marijuana can negatively affect how some drugs work. Be sure to talk to your doctor if you’re taking medications for another medical condition such as:
Always consult your doctor and get medical advice before adding any alternative treatment, such as marijuana or any other herb, to your self-care routine.
Medical marijuana and recreational marijuana are legal in some states, but not all. Laws that regulate cannabis products can vary considerably from state to state. It’s important to understand legal restrictions that may exist in your state.
“In the state of Ohio where I practice, the medical marijuana law does not protect you against your employer. And so if you had a drug test and tested positive … the employer can still fire you,” Dr. Boster explained.
Marijuana is still illegal on the federal level in the United States, and it is illegal to travel across state lines or internationally with marijuana.
Dr. Boster also cautioned about traveling with marijuana. “Our federal government still considers cannabis to be a class one drug like heroin. And so if you were to use a medical marijuana card, get a hold of an edible and you drive to visit your sister in the next state, you just committed a felony crossing the state line,” he said
Synthetic cannabinoids are human-made versions of cannabinoids. The U.S. Food and Drug Administration (FDA) has approved three synthetic cannabinoid drugs for use by prescription only — dronabinol (Marino), dronabinol (Syndros), and nabilone (Cesamet).
The FDA has currently only approved one cannabis-based medicine — cannabidiol (Epidiolex) — available only by prescription.
Some types of synthetic marijuana are sold illegally. These substances are hazardous and even life-threatening.
Marijuana might help with symptoms of MS like pain, muscle tightness, and trouble sleeping. But it’s important to know it can also cause side effects, such as problems with thinking and how it works with other medicines you might take. Because the rules about marijuana can be different depending on where you live, make sure to check your local laws. Always talk to your doctor before trying new treatments to ensure they are safe for you.
MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 213,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Has using marijuana helped with your MS? Share your experience in the comments below, or start a conversation by posting on your Activities page.
Federica Polidoro, M.D.
a graduate of medical school and neurology residency in Italy, furthered her expertise through a research fellowship in multiple sclerosis at Imperial College London.
Learn more about her here.
Amanda Agazio, Ph.D.
completed her doctorate in immunology at the University of Colorado Anschutz Medical Campus. Her studies focused on the antibody response and autoimmunity.
Learn more about her here.
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I won't use because we have mental health issues in our family and quite honestly I'm trying to preserve my brain cells. The part not talked about with marijuana is the possibility of psychosis which… read more
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