In general, the chance of side effects with hemp-based CBD is low, says Dr. Thrower. If you’re taking CBD with more THC in it, side effects like cognitive changes, drowsiness, and less often, nausea and vomiting are possible, he says. Beyond that, though, the main thing to be aware of is how CBD may affect other drugs you’re taking. “I advise people to speak with their pharmacist about any potential interactions between CBD oil and their prescription medications,” says Dr. Thrower.
When you’re living with multiple sclerosis (MS), it’s wise to have a range of tools in your arsenal to manage symptoms. CBD, a.k.a. cannabidiol, is chemical compound from the cannabis plant that is becoming more widely available as a method for dealing with chronic pain. You may have heard about it, and if you have, you’re probably wondering if it’s worth a shot to help manage your MS symptoms. So, is it? This is what experts currently say about CBD and its effectiveness for MS.
Muscle tightness and involuntary spasms are other common symptoms caused, in part, by the pathways to the brain and spinal cord being compromised. “Spasticity in MS occurs because of issues in the CNS, not in the muscles,” says Costello. “So if you alter the pathways in the brain and spinal cord with CBD, then may you alter the pathways that control muscle as well.” Those changes in the CNS pathways may reduce spasticity—and in turn, help increase mobility.
You’ve got the facts, and you’re interested in trying CBD for your MS symptoms. What now? Check with your doctor, says Dr. Thrower. “Patients should discuss all complementary therapies with their health care team,” he explains. That way, everyone is in the know. But keep in mind: “Health care providers have varying comfort levels and knowledge about the use of cannabis products in MS,” Dr. Thrower says. “Reputable stores selling CBD products may be able to help with product selection and dosing.”
There are many compounds found in the cannabis plant. The two we know the most about are CBD and THC, says Kathy Costello, associate vice president of clinical care at the National Multiple Sclerosis Society. “THC is a psychoactive compound found in the plant—it makes people feel high,” she says. “CBD does not have psychoactive properties, but it’s believed to have other useful properties,” such as relieving anxiety, insomnia, and, yes, chronic pain.
Researchers have been studying the effects of cannabinoids like CBD on MS for years. The bottom line? CBD likely does help reduce pain and spasticity, as well as symptoms such as fatigue, anxiety, and urinary issues, but more studies are needed. One major catch: Most research has been done using nabiximols (Sativex), an oral spray that contains a 1:1 CBD-to-THC ratio and is not currently available in the U.S. because it is not approved by the Federal Drug Administration, says Costello.
CBD products are either made from hemp or marijuana, says Ben Thrower, M.D., medical director of the Andrew C. Carlos MS Institute at the Shepherd Center in Atlanta, GA, and senior medical adviser for the Multiple Sclerosis Foundation. Both are types of cannabis, but CBD products from hemp contains only trace amounts of THC, while CBD from marijuana—only legal in some states—can contain higher amounts of THC.
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.
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.
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.
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.
Some people with MS use cannabis in a variety of ways to help ease their symptoms.
You can’t be sure how strong cannabis is when you buy it illegally or what it might be mixed with. So its effects might not always be the same. As well as the effects you might want, cannabis can cause less welcome changes:
It’s not against the law to have these products if they only have CBD in them (and no THC). (2)
Smoking cannabis long term can affect your lungs and raise your heart attack and cancer risk. It’s possible to become dependent on cannabis, especially if you use it regularly.
Unlicensed medicinal cannabis
As of late 2019 Sativex is available on the NHS in England and Wales for ‘moderate’ to ‘severe’ spasticity – if other treatments don’t work. We hope it’ll soon be available in Scotland and Northern Ireland, too.
When they looked at the research in 2014, the American Academy of Neurology (AAN) didn’t find enough evidence that smoking cannabis was safe or effective against MS. They did find that people with MS said cannabis-based drugs (pills or sprays) helped with muscle stiffness (spasticity) and pain.(3)
There are products made using the CBD chemical found in cannabis. These include oils you take by mouth (for example, under your tongue or with a mouth spray) or by vapourising. They won’t get you high as they have little or no THC in them.
Some studies of people with MS who regularly smoke cannabis show they do worse in tests measuring their memory and how fast they process information. MRI scans have also shown abnormal brain activity. None of this is seen in people who use the cannabis-based drug Sativex.