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.
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.
Some people with MS use cannabis in a variety of ways to help ease their symptoms.
CBD products are not well-regulated in the U.S., making the decision to use them a little tricky. Depending on the laws in your state, you might be able to buy CBD at your local health food store or dispensary, but beware: “You may not get the amount of CBD stated on the label because each batch is not regulated the same way as a pharmaceutical, so it may or may not be effective,” Costello says. There could also be toxins like pesticides in some hemp-derived CBD products.
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.
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.
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.”