Sierra of New York, NY wrote in recently.  Looks like she’s had Multiple Sclerosis for several years now and is asking about the effect medical marijuana would have on her Multiple Sclerosis.  Here’s what she writes…


Dr. Patel,

On my 45th birthday, I found out that I have Multiple Sclerosis.

It all began when I started stumbling at work.  I figured it was clumsiness, but turned out to be something much more serious – Multiple Sclerosis.

Multiple Sclerosis is really unpredictable.  I just don’t know when I’m going to have a good day or a bad day.  There are times when I’m fine for weeks, even months.  And, then out of nowhere my symptoms get worse.

One of my on-again and off-again symptoms has been numbness on the right side of my body.  Sometimes my limbs feels like they were emptied out and filled with sand.  Other times, I experience a burning pain from my hips down to my toes.  It feels like my legs are on fire.  Then, there are days I get tingling in my hands and feet, which could turn into an electric-shock-like pain all over my body.

When I feel good enough, I’ll take the dog out for a walk, but after just going around the block once, my legs feel like they are encased in cement.

I really pushed it on a recent trip to Italy though.  I had the hardest time keeping up with everyone.  Everyone on the tour thought I was drunk.  But, I hadn’t had any alcohol at all the entire trip.

I spend my days feeling like I’ve done 10 rounds in a boxing ring.  I feel beat up.  I’m in excruciating pain, everywhere, and it feels like I’m half dead.

I’ve been on an on-again off-again regimen of steroids so many times I’ve lost count.  And, each time I’m on them, without fail, I struggle to sleep.  It’s a constant tossing and turning from the moment I hit the sack.

The Baclofen makes me feel weak, and I’m already weak to start with.

I take Percocet and OxyContin for the pain, but they leave me feeling nauseous and constipated.

I’m just not getting the relief I need with these prescriptions.

I’ve been a square my entire life.  I don’t drink.  I’ve never come close to touching any drugs.  The smell of tobacco smoke makes me sick.

But, I’m ready to give medical marijuana a try.  At this point in my life, I’m thinking, what do I have to lose?

And, quite frankly, I’m not letting this disease push me around.

So, what’d you think Dr. Patel, would medical marijuana be right for someone like me?

Regards,
Sierra
New York, NY

Sierra, power to you for taking control of your health and taking on the challenge of writing a new chapter in your story, as hard as that may be.

I do in fact have experience helping patients with Multiple Sclerosis, but before I dive into the results they’ve experienced, let’s talk about what the research has to say about medical marijuana and multiple sclerosis.

Medical Marijuana for Multiple Sclerosis: The Research

STUDY #1:  A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols (Sativex®), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis

A study published in 2010 took a look at the effects of Nabiximols on patients with Multiple Sclerosis.

Now, you’ll notice in this particular study, they used Nabiximols (Sativex) as the medicine instead of medical marijuana.  So, what’s Nabiximols?  It’s a marijuana plant based derivative prepared in a solution of ethanol, propylene glycol, and peppermint oil flavoring, and it’s administered with a pump that sprays the medicine.

If you’re familiar with present-day marijuana products, then it’s very similar to a tincture.  It’s a form of medical marijuana that’s used as drops or sprays that are applied under the tongue.

Now, back to the study.

Conventional medications, like the following weren’t cutting it to relieve spasticity for these patients.

Screen Shot 2018 05 28 at 1.43.11 PM

These were also folks who had had Multiple Sclerosis for over 12 years.  And, in that time, they experienced spasticity for over 7 years.

This study had 2 phases to it.  Phase A included all the participants.  Phase B only included the participants in Phase A that actually responded to Nabiximols.

Now, why did they do this?

They were trying to recreate what would happen in real life.  Generally, patients who don’t respond to a certain treatment usually stop taking it anyway.

And, in those that did actually respond to the treatment, they wanted to know just how effective the treatment was.

And, here my friend are the results of this study.

Screen Shot 2017 10 25 at 7.41.11 PM

Ok, so don’t get scared by this graph.  It’s not as complicated as it looks.  I’m going to simplify for you.

First, let’s look to the left of the blue line – the results of Phase A of the study.  Basically, the patients on average rated their spasticity levels as a 6.9 at the beginning of Phase A.  After taking Nabiximols for a period of 4 week, on average, the patients rated their level of spasticity as 3.9.  You’ll notice that that’s a pretty steep drop in levels of spasticity.

Now, look to the right of the blue line – the results of Phase B of the study.  The patients who experienced a 20% improvement in their spasticity score went on to participate in Phase B of the study.

If you take a look at the top line, which represents the group that received the placebo, and you’ll notice that their spasticity levels went back to deteriorating.

But, in the group that received Nabiximols, which is represented by the bottom line, the spasticity levels continued to improve.  Overall, 74% of the group that received Nabiximols for 12 weeks showed a 30% or more reduction in spasticity levels compared to the group that received that placebo.

STUDY #2 Multiple sclerosis and extract of cannabis: results of the MUSEC trial.

Alright now let’s move to the next study, which was done in the the United Kingdom.

It looked at the effect of medical marijuana on patients with Multiple Sclerosis.

And, researchers gave 144 of the participants cannabis gelatin capsules.   And, then another 135 of the participants were given placebo – also by mouth.

These participants had a history of troublesome and ongoing muscle stiffness for at least 3 months before enrolling in the study.

And, after 12 weeks of being on either treatment, the researchers asked the participants, how their symptoms compared to before the study.  Specially, they were asked about their levels of pain, and the severity of their muscle stiffness and muscle spasms.

Overall, the rate of muscle stiffness relief was twice as much in the group that took the cannabis extract than in the group that took the placebo.

Now here’s an interesting fact.  The researchers set a max dose for the cannabis extract.  And, a good 75% of them didn’t have to take the max dose.

Medical Marijuana for Multiple Sclerosis: The Results

And, finally, let’s dive into the results the patients I’ve treated have experienced.

I want to start with the area of pain – this is the numbness, the burning, the tingling that you were talking about Sierra.  Overall, I’ve had patients with Multiple Sclerosis report that medical marijuana helps to take the edge off the pain and that it helps to get their mind off of the numbness, the burning, and the tingling.

Overall, though, it’s important to know that medical marijuana isn’t a magic bullet.  It’s not like you use it and poof your pain is gone.

The reduction in your levels of pain really depends on what level of pain you start with in the first place.  So, what I’ve found is that in patients with severe levels of pain, the pain drops to a moderate level of pain.  In patients with moderate levels of pain, the pain drops to mild level of pain.  And, it’s generally those who start off with mild levels of pain who find that the medical marijuana helps to eliminate their pain.

Next, let’s look at the area of spasticity, which is basically the severe cramps that a person with Multiple Sclerosis experiences.  Some patients have reported that they don’t experience quite as many muscles spasms.  Others have reported that their spasms haven’t lasted as long when on the medical marijuana.  And then there have been others that have reported that their spasms haven’t been as severe.

Overall, these patients report feeling reduced muscle stiffness.  They also experience reduced loss of muscular control.  By reducing the spasms, the medical marijuana allows these patients to move their arms and legs more freely.

Alright, Sierra, I hope that helps to answer your question.  And, of course if anyone else has a question for me, please post it in the comments section below and it just may be selected to be answered in the next video.

With Gratitude,
Dr. Patel


Medical Marijuana for Multiple Sclerosis: Research Referenced

Medical Marijuana for Multiple Sclerosis: More Info