Cannabis Helps Improve Spasticity in Multiple Sclerosis

Jessica Rice, MD

Cannabis was shown to have multiple positive effects for patients with multiple sclerosis (MS) and lower extremity spasticity, notably having a very helpful impact on pain, and a somewhat to very helpful profile for spasticity.

Among the 33 patients (36%) who reported current cannabis use, 28 (85%) found cannabis to be somewhat to very helpful for pain, and 26 (79%) found it somewhat to very helpful for spasticity.

“All subjects found cannabis helpful for at least 1 symptom, consistent with motivation for use, and most found it helpful for pain or spasticity, consistent with previous controlled trials,” the study authors, including Jessica Rice, MD, department of neurology, Oregon Health and Science University, and fellow, Portland VA Health Care System, wrote.

When recording treatments used for spasticity, 39 (43%) and 24 (26%) participants used only orally prescribed oral medications and prescribed oral medications in addition to cannabis, respectively. Solely cannabis use was reported by 9 (10%) participants, while 19 (21%) neither used prescribed oral medications nor cannabis.

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Among cannabis users, 79% found it to be somewhat to very helpful for spasticity and 85% found cannabis somewhat helpful for pain. Additionally, all current users reported cannabis was very or somewhat helpful in at least 1 of the following: pain, spasticity, sleep, depression, and/or stress.

As part of baseline data collected for a spasticity intervention trial in Oregon, patients with MS self-reported spasticity questions about cannabis use. Patients included in the study were aged 18 years and older with MS and self-reported lower extremity spasticity that interfered with daily activity.

Patients reported on whether they had used cannabis in the past or if they are a current user, with current users specifically reporting on routes of administration, frequency of use, and the perceived benefit for MS symptoms. Among the symptoms assessed were pain, spasticity, anxiety, depression, and stress, with each graded on a 1—5 scale, ranging from very unhelpful to very helpful. Patients also identified which, if any, prescribed oral anti-spasticity agents they had currently used.

Of the 91 patients with MS enrolled in the study, 49 (54%) reported using cannabis in the past, while the aforementioned 33 reported current cannabis use. Multiple routes of administration were mostly reported in current users (n = 26; 79%), with topical being the most popular (n = 18; 55%). More specifically, 17 (52%) used edible cannabis, 16 (48%) used cannabis tinctures, 14 (42%) smoked cannabis, and 10 (30%) vaped cannabis.

Cannabis used once daily was most common, reported by 19 (58%) of current users, while 12 (36%) current users used cannabis once per week to once per month. Only 2 (6%) current users noted using it less than once per month.

“There is a critical need for further research into the safety and efficacy of various cannabinoid formulations for the treatment of MS symptoms, including spasticity,” Rice and concluded.

REFERENCE:

Rice J, Hugos C, Hildebrand A, Cameron M. Cannabis use in people with multiple sclerosis and spasticity: a cross sectional analysis. Mult Scler Relat Disord. Published online February 11, 2020. doi:10.1016/j.msard.2020.102009