REVIEW FINDS MARIJUANA MAY HELP MS PATIENTS

Cancer patients, glaucoma patients and others can benefit from
medical marijuana, and now a new analysis shows that it can help
multiple sclerosis (MS) patients find relief from the muscle spasms
that are the hallmark of the debilitating autoimmune disease.

"The therapeutic potential of cannabinoids in MS appears to be
comprehensive, and should be given considerable attention," said lead
researcher Dr. Shaheen Lakhan, executive director of the Global
Neuroscience Initiative Foundation.

"Spasticity, an involuntary increase in muscle tone or rapid muscle
contractions, is one of the more common and distressing symptoms of
MS," the researchers noted in their review. "Medicinal treatment may
reduce spasticity, but may also be ineffective, difficult to obtain
or associated with intolerable side effects," they added.

"We found evidence that cannabis plant extracts may provide
therapeutic benefit for MS spasticity symptoms," Lakhan said.

Although some objective measures showed improvement, there were no
significant changes in after-treatment assessments, Lakhan said.
"However, subjective assessment of symptom relief did often show
significant improvement post-treatment," he added.

For the study, Lakhan and his colleague Marie Rowland reviewed six
studies where marijuana was used by MS patients. Five of the trials
showed that marijuana reduced spasms and improved mobility, according
to the report published Dec. 3 in the online journal BMC Neurology.

Specifically, the studies evaluated the cannabis extracts
delta9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These
studies found that both THC and CBD extracts may provide therapeutic
benefit for MS spasticity symptoms, Lakhan said.

Although there was a benefit from using marijuana there were also
side effects, such as intoxication. This varied depending on the
amount of marijuana needed to effectively limit spasms, but side
effects were also seen in the placebo groups, Lakhan and Rowland noted.

The careful monitoring of symptom relief and side effects is critical
in reaching an individual's optimal dose, Lakhan said. "Moreover,
there is evidence that cannabinoids may provide neuroprotective and
anti-inflammatory benefits in MS," he added.

"Considering the distress and limitations spasticity brings to
individuals with MS, it would be important to carefully weigh the
potential for side effects with the potential for symptom relief,
especially in view of the relief reported in subjective assessment,"
Lakhan said.

Dr. Moses Rodriguez, a professor of neurology and immunology at the
Mayo Clinic, said that "the idea of using cannabis to treat MS has
been around for a long time."

Rodriguez noted that the effects of using marijuana have been mixed.
"It has been difficult to know whether the effect has been just a
general well-being or whether it has a direct effect on muscle fibers
and spasticity," he said.

If drugs could be developed that take away the intoxicating effects
of marijuana, it could have a direct effect on spasms without the
high, Rodriguez said.

The Obama administration announced in October that it will no longer
prosecute medical marijuana users or suppliers, provided they obey
the laws of states that allow use of the drug for medicinal purposes.

Rodriguez said he is often asked by his MS patients about whether
there is a benefit to using marijuana.

"What I tell my patients," he said, "is if they want to try it they
should try it. They should understand that there is a potential for
it to be habit-forming and there may be a potential that they are
fooling themselves."

Patricia A. O'Looney, vice president of biomedical research at the
National Multiple Sclerosis Society, said the society has studied
this issue and does not think enough is known to recommend that MS
patients use marijuana.

"Because the studies to date do not demonstrate a clear benefit
compared to existing therapy, and issues of side effects and
long-term effects are not clear, the recommendation is that it should
not be recommended at this time," she said.

Another expert, Dr. William Sheremata, director of the Multiple
Sclerosis Center at the University of Miami School of Medicine, also
doesn't think MS patients necessarily benefit from marijuana use.

Sheremata noted that the objective measures in the study did not show
any benefit from marijuana. "Those are the only valid measures.
Subjective responses are subjective; they really don't have much in
the way of validity," he said. "I am not convinced that the use of
marijuana benefits patients as a whole."

More information

For more information on multiple sclerosis, visit the National
Multiple Sclerosis Society.