Cannabis fails to slow progress of multiple sclerosis in UK study
Zajicek’s study did find some evidence to suggest a beneficial effect in less disabled patients but because this was seen in only a small group of people it was unclear how strong the effect was.
The overall study population also experienced slower disease progression than had been expected, making it more challenging to detect any treatment effect, the research team added.
MS is a disease in which immune system cells destroy the myelin sheath that protects the nerve cells in the brain and spinal cord.
The most common type is relapsing remitting MS, affecting around 85 percent of patients at the time of diagnosis. Several drugs are available to treat this stage of the disease, including injections of beta-interferons and a new pill from Novartis called Gilenya.
Early Studies Showed Mixed Results and Some Side Effects
Well known for its mind-alterning properties, marijuana is produced from the flowering top of the hemp plant, Cannabis sativa.
Early studies explored the role of THC (tetrahydrocannabinol — an active ingredient in marijuana) or smoked marijuana in treating spasticity, tremor, and balance control in small numbers of people with MS. Most of these studies were done with THC. Because THC can be given by mouth, it is easier to control the dose. The results of these studies were mixed, and participants reported a variety of uncomfortable side effects. In addition, smoked marijuana poses health risks that are at least as significant as those associated with tobacco.
For spasticity (unusual muscle tension or stiffness)
Studies of THC for spasticity have had mixed results. While some people reported feeling “looseness” and less spasticity, this could not always be confirmed by objective testing done by physicians. Even at its best, effects lasted less than three hours. Side effects, especially at higher doses, included weakness, dry mouth, dizziness, mental clouding, short-term memory impairment, space-time distortions and lack of coordination.
For tremor (uncontrolled movements)
In a small study of THC involving eight seriously disabled individuals with significant tremor and ataxia (lack of muscle coordination), two people reported improvement in tremor that could be confirmed by an examination by a physician and another three reported improvement in tremor that could not be confirmed. All eight patients taking THC experienced a “high,” and two reported feelings of discomfort and unease.
For balance
Smoked marijuana was shown to worsen control of posture and balance in 10 people with MS and 10 who did not have MS. All 20 study participants reported feeling “high.”
National Academy of Sciences/ Institute of Medicine Report
A 1999 report by the National Academy of Sciences/Institute of Medicine on the medical uses of marijuana raised additional questions. While the report concluded that smoked marijuana does not have a role in the treatment of MS, there remained the possibility that specific compounds derived from marijuana might reduce some MS symptoms, particularly MS-related spasticity. Well designed and controlled studies of the therapeutic potential of marijuana compounds (called cannabinoids) were indicated, in conjunction with the development of safe, reliable drug delivery technology.
Study on Marijuana Derivatives in Mice
Investigators in the United Kingdom and United States tested the ability of two marijuana derivatives and three synthetic cannabinoids to control spasticity and tremor, symptoms of the MS-like disease, EAE, in mice. The results, published in the March 2, 2000 issue of Nature, suggested that four different cannabinoids could temporarily relieve spasticity and/or tremor. While the study suggested that similar derivatives of marijuana might be developed for human use, it was clear that the psychoactive effects of these cannabinoids would need to be reduced sufficiently to make them a safe and comfortable treatment for people with MS.
Secondary progressive MS comes later and involves a sustained build up of disability.
THE HISTORY OF CANNABIS AS MEDICINE
The history of the medical use of cannabis dates back to 2700 B.C. in the pharmacopoeia of Shen Nung, one of the fathers of Chinese medicine. In the west, it has been recognized as a valued, therapeutic herb for centuries.
In 1823, Queen Victoria’s personal physician, Sir Russell Reynolds, not only prescribed it to her for menstrual cramps but wrote in the first issue of The Lancet, “When pure and administered carefully, [it is] one of the of the most valuable medicines we possess.” (Lancet 1; 1823).
The American Medical Association opposed the first federal law against cannabis with an article in its leading journal (108 J.A.M.A. 1543-44; 1937). Their representative, Dr. William C. Woodward, testified to Congress that “The American Medical Association knows of no evidence that marihuana is a dangerous drug,” and that any prohibition “loses sight of the fact that future investigation may show that there are substantial medical uses for Cannabis.” Cannabis remained part of the American pharmacopoeia until 1942 and is currently available by prescription in the Netherlands and Canada.
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By Ben Hirschler