Cannabis is made up of compounds called cannabinoids. The main ones studied for their therapeutic effect are tetrahydrocannabinol (THC), which gets you ‘high’, and cannabidiol (CBD), which doesn’t.
There’s a medically approved cannabis-based treatment called Sativex, but it doesn’t work for everyone. In England and Wales you can get it on the NHS for ‘moderate’ to ‘severe’ spasticity (muscle spasms and stiffness). But you can have it only if other treatments haven’t worked. It’s not yet available in Scotland or Northern Ireland but we hope it soon will be.
In November 2018, the Government legalised cannabis for medicinal use, but also put a strict criteria in place for who could access it. Only specialist doctors are allowed to prescribe medicinal cannabis, and so far only a handful of people have benefited from the change in law.
One in five people with MS we surveyed in 2014 told us they’d used cannabis to help with their symptoms. They said it can help with muscle spasms or stiffness (spasticity) and pain.
Some people with MS use cannabis in a variety of ways to help ease their symptoms.
This article has been fact checked by a Board Certified Pediatrician. Sources of information for the article are listed at the bottom.
Spastic quadriplegia is the most severe form of cerebral palsy, affecting all of the extremities, the face, and the trunk. The majority of children with spastic quadriplegia are unable to walk, and their speech is usually profoundly affected. While the limbs can be extremely stiff, their neck muscles may be weak, making it difficult for them to hold their head up.
Survey of Pain Treatment Study
One of the legitimate concerns of parents considering medical marijuana treatment for their children is the “getting high” factor. According to David Casarett, MD, author of Stoned: A Doctor’s Case For Medical Marijuana, THC is the compound in marijuana that’s responsible for producing the feeling of being high. 
Jacqueline Patterson has lived with cerebral palsy and a severe stuttering issue since she was a little girl. In 2007, she created a documentary entitled In Pot We Trust, where she detailed how marijuana not only helped reduce her speech problem significantly but also improved her severe muscle pain and stiffness. 
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Serious drug interactions have not been seen with CBD in combination with any other drugs.
These medications continue to be widely prescribed in the majority of PwMS suffering from pain, spasticity, anxiety, and panic disorders. Common side effects of opioid administration include physical dependence, dizziness, sedation, nausea, vomiting, tolerance, constipation, and respiratory depression. Physical dependence and addiction are clinical concerns that may prevent accurate prescribing and in turn insufficient pain management. Traditional benzodiazepines are associated with sleep disturbances and anterograde amnesia. Another concern with long duration benzodiazepines such as diazepam or flurazepam, is drowsiness and “hangover effect.” Antidepressants can cause a wide range of unpleasant side effects, including nausea, fatigue and drowsiness, blurred vision, dizziness, and anxiety. It is obvious that those drugs delay or even prevent successful physical rehabilitation. A recent epidemiological study by Piper et al. (19) showed that among people that frequently used opioids, over three-quarters (77%) indicated that they reduced their use since they started cannabis. Approximately two-thirds of patients decreased their use of antianxiety (72%), migraine (67%), and sleep (65%) drugs following medical cannabis which significantly exceeded the reduction in antidepressants or alcohol use. Complete or part replacement of these drugs by specific cannabis products should definitely be the long-term goal.
However, objections to the notion that cannabinoids should be used to improve the mobility in PwMS include the following: (1) limited scientific evidence for the effectiveness of cannabis on mobility in PwMS; (2) uncertainty of legal status; (3) social stigmatization from friends, family, and authorities such as employers, landlords, and law enforcement; (4) incidence of dependency; and (5) negative psychoactive effects of cannabis. These objections have some merit and should be taken into consideration. It is important to note that the psychoactive effects of cannabis, such as cognitive impairments, psychosis, and anxiety are due to tetrahydrocannabinol (THC). However, CBD has antipsychotic properties and can also counter several negative side effects of THC. Most PwMS prefer to avoid feeling high. Therefore, individuals should seek out strains of cannabis containing equal or higher levels of CBD, compared to THC. Another concern is the risk of addiction. It is estimated that
Labeling Accuracy of CBD Extracts
Despite the common use of and interest in cannabis by people with MS (PwMS), there is very limited empirical data pertaining to its impact on physical mobility. The benefits related to cannabis use in PwMS are still under investigation. However, data indicates that cannabis, with 1:1 or greater CBD:THC ratio, reduces muscle spasticity (11) and pain in PwMS (12). The American Academy of Neurology (13) has highlighted cannabis’ safety profile as well as these benefits. However, there are currently no studies, which investigated the effects of cannabis on mobility in PwMS, some studies have suggested that cannabinoids may exert positive effects on health by decreasing inflammation and decreasing pain (6). Furthermore, inflammation plays an important role in the generation of MS related fatigue (14). Specifically, chronic peripheral inflammation and a resulting overactivity of the vagus nerve are related to fatigue in PwMS (14). There is indirect evidence that reductions in spasticity, pain, and fatigue may result in improvements in the mobility of PwMS (15–17). Furthermore, it is suggested that CBD showed a dose-dependent antidepressant-like effect in the animal model (18). The exact mechanism underlying such activity is still unknown. Depression is an important contributory factor to the observed impaired mobility in PwMS (15). Based on extant evidence we propose that the impact of cannabidiol (CBD) on mobility to be investigated.
In the CBD products without THC, then a urine test would not yield a positive result for THC metabolites. However, most CBD products contain minimal amounts of THC in CBD. An important aspect in cannabinoid compounds is the entourage effect. The entourage effect means that the compounds in cannabis work more sufficient together than if the compounds are isolated. Therefore, CBD products may contain more cannabis compounds, including THC, to increase the effectiveness of the product (7). Furthermore, often a study by Merrick et al. (24) is cited which showed that CBD could be converted into THC after prolonged exposure to “simulated” gastric acid. However, there is no scientific evidence that this reaction occurs in vivo in humans (25). If someone is using a CBD product and needs to undergo urine drug tests, lab reports should be requested and examined to ensure that the CBD product contain exactly what is expecting and on the label.
9% of individuals utilizing cannabis will become dependent on the drug (20). Although a significant risk, this incidence of dependency is significantly lower than that of approved chronic pain management pharmaceuticals (21). Observing for cannabis dependency is suggested for all patients.
Based on the following considerations, it is our opinion that CBD supplementation maybe advisable for PwMS to reduce fatigue, pain, spasticity, and ultimately improve mobility. An overview of the potential impacts of CBD on mobility of PWMS is show in Figure Figure1 1 .