Many multiple sclerosis (MS) patients report that cannabis has beneficial effects on their symptoms with minimal side effects, according to a survey that also showed that varying effects on health may be due to differences in how users consume cannabis.

Findings from the survey were reported in the study, “ Exploring cannabis use by patients with multiple sclerosis in a state where cannabis is legal, ” published in the journal Multiple Sclerosis and Related Disorders.

Increasing evidence suggests that cannabis and cannabinoid-based medicines may have therapeutic effects on different diseases, including MS, triggering increased public interest in its medicinal use.

Previous studies have, in fact, shown symptom relief in MS patients using cannabinoid-based medicines, namely reduced pain and muscle spasticity. It is estimated that 16 percent of MS patients use cannabis for medicinal purposes.

The medicinal properties of the plant can be attributed to cannabinoids, which are chemical compounds in cannabis. Cannabinoids can bind to cannabinoid receptors in human cells, affecting their cellular behavior.

Although cannabis contains more than 100 cannabinoids, two of them, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are the most well-known. While the psychoactive THC molecule stimulates certain receptors of the central nervous system, the non-psychoactive CBD molecule suppresses these receptors as well as other receptors found on immune cells.

As a result of its therapeutic benefits, cannabinoid-based medicines are becoming increasingly available, which has also resulted in more variability in cannabis consumption practices, namely concerning types of cannabinoids or ingestion methods.

To better understand these characteristics, researchers investigated cannabis use among MS patients and its perceived effect on MS-related symptoms.

The team conducted a survey that included 251 randomly selected MS patients from the Rocky Mountain Multiple Sclerosis Center at the University of Colorado. Cannabis is legal both for recreational and medicinal use in the state of Colorado.

Participants answered questions about their opinions on cannabis, consumption, MS-related clinical information, and perceived physical and mental health.

Of the participants, 38% (96 patients) said they had used cannabis for a recreational and/or medicinal purpose within one year before the survey.

Researchers found no significant sociodemographic differences between cannabis users and non-users. Similarly, they found no differences in clinical features, including age at the time of the survey, age at MS onset, or symptom control.

However, they did find that cannabis users had a significantly greater physical disability than non-users. They noted that this association could be correlational, reflecting the extent of alternative medicines used by MS patients with more severe disease burden.

Many participants (60%) believed that cannabis had at least some benefits or combined benefits and implications on MS symptoms, especially pain, anxiety, and muscle spasms. On the other hand, 2% of the participants perceived cannabis as harmful, reporting side effects such as slowed thinking, decreased attention, and memory problems.

The team further grouped cannabis users according to their preferred practices: CBD only versus THC with or without similar quantities of CBD; and strictly medicinal versus recreational and medicinal use.

The most common reasons for cannabis use among MS participants using CBD or THC were to manage pain (32% and 52%, respectively), poor sleep (21% and 32%), and muscle tightness (42% and 23%). Both CBD and THC users said that slowed thinking, weight gain, and reduced attention were the most bothersome or worrisome side effects, although most users (75%) did not report any side effects at all.

Interestingly, 90% of participants who reported consuming CBD used it strictly for medicinal purposes. This was only true for 52% of the THC users.

Based on the results, the team concluded that with cannabis legalization, there appears to be a growing number of MS patients using “highly efficacious” cannabinoid-based medicines “with minimal side-effects.”

However, they highlighted the need for more research in the field and awareness about cannabis effects. While 74% of the participants would consider using cannabis for therapeutic purposes, 62% of them cited lack of a knowledge as the reason why they didn’t use it.

“In order to provide sound evidence-based advice to patients, further objective studies regarding both treatment effects and unwanted side-effects of varying levels of particular cannabinoids, including but not limited to THC and CBD, are needed, as is further objective evidence on the health effects of differing methods of ingestion,” the researchers wrote.

“Fortunately, 87% of [cannabis users] in the current study reported being comfortable discussing their use with their physicians,” they added.