Therapeutic cannabis for treatment & management of symptoms of multiple sclerosis

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Until the first half of the 1900s, cannabis was considered in many countries a commonly used drug, especially for the treatment of certain neurological symptoms. Confidence in cannabis was high, as with any other drug, but later cannabis was cancelled from the international pharmacopoeia and classified as having no therapeutic effects.
Today we know that this was a big mistake and that many neuro-degenerative diseases such as multiple sclerosis, thanks to cannabinoids, have new possibilities for treatment.
In this article, we will discuss how cannabis and its specific molecules help in curing a debilitating condition such as multiple sclerosis, by analysing some of the many studies that favoured CBD and THC-based drugs recently published in some of the most accredited scientific journals in the industry.

What is Multiple Sclerosis?

Multiple sclerosis is a demyelinating neurodegenerative disease, which means that it injures the central nervous system with a loss of myelin in several areas of the system. Many studies claim that the underlying cause of this disease is a malfunction of the immune system that triggers unusual inflammatory harmful reactions against myelin and the cells that produce this substance.
In these demyelinated areas “plaques” of damaged tissues are formed which are often localised in the cerebral hemispheres, with a preference for the optic nerves, the cerebellum and the spinal cord. The plaques can be in the inflammatory phase (at the beginning of the attack) and usually evolve into a chronic stage in which they appear as scars (from these the term sclerosis). In general, people with MS have different symptoms based on the location of lesions in the central nervous system, and they can be perceptive, motor or functional, or various types of pain.
This disease can affect any age group even if it often begins between the ages of 20 and 40 and is more common in women (doubly affected than men). There are 2.3 million people with MS reported worldwide, which has been declared the most frequent chronic inflammatory neurology in young adults.

How can cannabis help those who suffer from multiple sclerosis?

The treatments for multiple sclerosis are of different types but mainly concern two aspects: the management of pain / symptoms of the disease and the slowing down of the progression of the damages.
Several studies have shown that cannabinoids have the potential to act in both directions. Every day we hear and read testimonials from people suffering from this disease who are spokesmen for the benefits of cannabis in MS. In U.S some informal surveys say that almost half of the affected people use cannabis and derivative drugs with positive effects (even in states where it is still illegal).
Many scientific studies that have made specific evaluations on the validity of cannabinoid- based treatments concerning the treatment and management of this degenerative disease and among them those ones that favour cannabis-based treatments are the majority.
But, how can CBD and THC help people with this condition to get better? Cannabis has been shown to act favourably on many mechanisms that cause apoptosis (massive and abnormal neuronal death) and therefore seem to be able to limit “nerve degeneration” and disease progression. At the same time, some CBD molecules are very effective in reducing and limiting the onset of the inflammatory phase of nerve tissue and myelin in particular.
Another known action of the cannabinoids is to regulate the “leukocyte trafficking”, which is the flow of action of white blood cells that attack nerve tissues. In addition to this, cannabinoids also have pain-relieving, anti-emetic, muscle relaxant and antidepressant effects, which can be very useful in managing the characteristic symptoms of MS.

Scientific studies in favour of therapeutic cannabis in Multiple Sclerosis

In 2017, a committee of the American Academy of Neurology published in the Neurology journal an in-depth review of the clinical literature concerning the efficacy of cannabinoid- based treatments in MS and other neurological diseases (examining 34 studies). The conclusions for the management of spasticity were that the oral preparations with cannabis extract were able to reduce the subjective scores of spasticity (with limits in the objective assessment using scales). Also, it showed that THC is probably effective to reduce subjective scores (here once again the objective evaluations are conflicting) as well as the cannabinoids-based drug Sativex, and finally it claims that the smoked marijuana is of uncertain efficacy.
For the management of central, general pain or painful spasms, the oral preparation with cannabis extract such as THC concentrates as well as smoked marijuana and Sativex was shown to be effective.
Sativex has proven to be an extremely effective treatment based on cannabinoids in urinary problems following the pathology.
The results on the use of marijuana-based therapies in neurological diseases have also been summarized in these guidelines (bringing some emphasis on the results obtained in the management of MS symptoms).
It is also interesting to mention another study published in the Journal of Neuroimmune Pharmacology, which has tried to take stock of the use of cannabinoids as neuroprotectors in neurodegenerative diseases. The authors in fact affirm that the endocannabinoid system (on which the cannabinoids have a strong influence) can certainly be a valid tool to control some aspects of multiple sclerosis since with its activities it is theoretically able to lead to a significant slowing of the progression of disabilities and of the disease itself.
Many countries in the world (including Italy) today recognize cannabis with proven therapeutic capabilities in managing the symptoms of Multiple Sclerosis and many studies are focusing on the healing possibilities that cannabinoids could represent for this disease.

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