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Ben Thrower MD
Earlier, we noted that MS is an autoimmune disease with an immune attack directed against myelin and axons. Does cannabis affect this immune dysfunction? In the laboratory, cannabinoids have been shown to decrease inflammation and have neuroprotective effects that should make them useful as therapies to slow MS progression.
Unfortunately, the few studies looked at cannabinoids as disease modifying therapies for MS have not shown an effect on the disease course. In fairness, some of these studies have looked at people with more advanced MS where no FDA-approved therapy has been effective either. For now, we can say that cannabinoids are effective for some MS symptoms, but have not been proven to alter the disease course itself. Studies are ongoing, however.
As a healthcare provider, I would like to see several things happen to help me guide my patients on the safe and effective use of cannabinoids in MS.
The FDA needs to move cannabis from its current listing as a Schedule I drug to a Schedule II. Listing cannabis with heroin and cocaine is scientifically preposterous and limits legitimate medical research.
Ideally, we would have some standardization of medical cannabis laws across the U.S. We currently have a patchwork of confusing and conflicting state and federal laws. This leaves consumers and healthcare providers feeling uneasy about what is legal and what is not.
The FDA should approve standardized cannabinoid medications like Sativex, once testing is completed. This THC spray is approved for MS-related pain and spasticity in the U.K., Canada and Spain. FDA-approval would also allow for insurance coverage.
Consumer information, education and transparency about cannabinoid products that are not FDA-approved is needed. Recently, the FDA did send out warning letters to companies selling CBD oil products that may not have actually contained any CBD oil. For companies selling cannabinoid products, having lab testing results available is desirable.
Hopefully, we will see ongoing legislation and research on the use of cannabinoids in MS and other health conditions. It’s always nice to have more treatment options.
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