The question of whether marijuana — produced from the flowering top of the hemp plant, cannabis sativa — should be used for symptom management in multiple sclerosis (MS) is a complex one. It is generally agreed that better therapies are needed for distressing symptoms of MS — including pain, tremor and spasticity — that may not be sufficiently relieved by available treatments.

I have Secondary Progressive Multiple Sclerosis. I have had the condition for nearly twenty years. In the past nine years, I have lost the ability to walk, my body feels weak, I struggle to do the simple things such as dressing and showering without my wife's assistance and I feel thoroughly miserable, angry and frustrated. Despite that, I work every day. I own my own Architectural Practice, I see Clients and continue to keep my head above water. I'm 53 years old, too young to retire, too disabled to compete with others in my field. I don't want to give up partially because my cognitive function is excellent and walking away could bring its own problems.

Medical cannabis treatments have proved highly effective at managing many of the symptoms of multiple sclerosis (MS).

Anti-inflammatory

Inflammation of neural tissue is the primary characterisation of multiple sclerosis. MS is an autoimmune disease in which the body’s own immune cells attack the central nervous system, leading to inflammation of the myelin sheaths that enclose the neurons (nerves) in the brain and spinal column. This inflammation ultimately leads to the myelin sheaths becoming irreparably damaged, which in turn causes a range of neurological symptoms including loss of motor control, muscle weakness and spasms, unstable mood and fatigue.

Cannabis is well-known to reduce inflammation, and has been used as an anti-inflammatory for thousands of years by physicians and herbalists the world over. In recent years, the ability of cannabis to reduce MS-related inflammation has been thoroughly investigated.

Analgesic

Pain is one of the most common and debilitating symptoms of MS, and is experienced by 50-70% of sufferers. MS-related pain occurs either directly as a result of inflammation of neural tissue, or as a result of muscle spasms and spasticity exerting pressure on the musculoskeletal system.

Cannabis has proven ability to manage pain associated with MS. In a clinical trial conducted on humans in 2005, cannabis-based medicine delivered in the form of a sublingual spray was demonstrated to be significantly more effective than placebo at reducing pain and sleep disturbances in MS sufferers. Smoked cannabis has also been shown to be effective at reducing MS. Cannabis reduces pain in MS sufferers by directly working to reduce immune response and resultant inflammation, and also reduces musculoskeletal pain caused by muscle spasms and spasticity.

Antispasmodic

Muscle spasms—sudden, involuntary contractions of a muscle or muscle group—are another common feature of MS, and are reported by up to 80% of patients. Spasms can cause a sharp, temporary sensation of pain that usually disappears after a short time. Muscle spasticity is a related symptom, and refers to the state of constant contraction of a muscle or muscle group, leading to pain, stiffness and a sensation of “tightness”.

Cannabis has been demonstrated to both reduce the frequency of muscle spasms and the severity of muscle spasticity. In 2005, a randomised, double-blind, placebo-controlled, crossover study (considered the gold standard of clinical trials) found that 37 of 50 patients enrolled in the study showed improvements in mobility and the frequency of muscle spasms. A randomised controlled trial conducted in 2007 demonstrated that cannabis preparations were more effective than placebo at treating muscle spasticity.

Antidepressant

Clinical depression is a common feature of multiple sclerosis, and is experienced by up to 50% of MS sufferers throughout the course of the illness. Depression in MS may occur due to damage to the nerves that help to regulate mood, or may be a side-effect of other medications used to control the progression of the disease. As well as major depression, MS can also lead to a range of associated symptoms of emotional dysfunction.

Abdominal complaints

MS can lead to a range of gastrointestinal complaints including abdominal pain, constipation (experienced by around 50% of patients) and faecal incontinence (experienced by 30-50% of patients). These symptoms can be embarrassing, distressing and painful. 51-60% of the respondents of the patient survey reported that defecation urgency was reduced with use of cannabis, 44% reported that faecal incontinence was reduced, and 30% reported that constipation was eased. Cannabis has long been associated with gastrointestinal dysfunction including IBS and Crohn’s disease; it is believed that the effect of cannabinoids on the receptors (specifically the CB2-receptors) in the peripheral nervous system that controls gut function is responsible.

i read this article recently too. The figures involved are staggering, in fact, I've read the article more than once.

"Assuming that all of this consumption can be regulated and taxed, and using Colorado as a guide for how much UK dispensaries would charge on average (£185/oz), we can estimate that the UK cannabis economy is worth approximately £6.8 billion a year. To give you some context, that’s just under half the size of the British tobacco industry.

The system of taxation, however, would be different to the one employed in the US. Firstly, there's a proposal for a flat rate of £1 tax per every gram of cannabis sold, and VAT would be levied at 20 percent on all cannabis sales. Assuming the levels of consumption remain the same after legalisation, with £6.8 billion made through sales, this system would yield £1.037 billion in excise duty and £1.36 billion in VAT, giving an approximate total of £2.4 billion in tax revenue per year from sales alone.

That's obviously a lot of money. But to put it into perspective, £2.4 billion a year could be used to pay for the starting salaries of 110,071 teachers; 10,666,666 nights in an NHS bed; 109,090 police cars and their maintenance for four years; every single elderly person’s winter fuel allowance; or one billion school dinners."

What's the problem. I understand that somebody, somewhere will abuse the situation and not all ideas are perfect or are conceived without imperfections. However, from an MS perspective, the legalisation of cannabis in the U.K. can only be a positive step in the right direction.