A greater proportion of patients smoking marijuana reported reduced pain and muscle stiffness than those study participants smoking fake joints, according to research published
online in Monday's issue of the Canadian Medical Association Journal.
CBC News says
that many people with MS often suffer from spasticity –– a disabling symptom of multiple sclerosis (MS) in which the muscles become tight and difficult to control. Spasticity can be controlled with medications but the symptoms may continue or the anti-spasticity drugs may carry adverse effects such as drowsiness, sedation, and muscle weakness.
According to the New York Times
, marijuana is favored by many people who have multiple sclerosis; they say cannabis kills pain and stimulates appetite without the corrosive side effects of many alternatives.
Now, Dr. Jody Corey-Bloom, of the department of neuroscience at University of California, San Diego and colleagues has put smoked cannabis to the test.
The new study included 30 MS patients -- average 50 years of age -- with muscle cramping that had failed to get better with standard medication. Sixty-three per cent of those included in the study were women. More than half of the participants needed walking aids and 20 per cent used wheelchairs.
The participants were randomly assigned to receive either the real thing (smoked cannabis, once daily for three days) or fake pot (identical placebo cigarettes, once daily for three days).
Each participant was assessed daily before and after treatment by an examiner who did not know which treatment the subjects received. After a washout interval of 11 days, participants crossed over to the opposite group.
Feeling too high
Overall, the study found, measures of spasticity dropped an average of three points --about 30 percent -- on a 24-point scale when patients smoked marijuana, but didn't change after they smoked the placebo, Reuters
Although the marijuana was "generally well-tolerated," smoking it was accompanied by acute cognitive effects such as "feeling too high."
CBC news reported that two participants withdrew from treatment because they felt uncomfortably "high," two had dizziness and one had fatigue. Another had pain unrelated to the study and another withdrew saying the schedule was too demanding.
The medical marijuana used in the study contained four per cent delta-9-tetrahydrocannabinol, which the researchers said resembled the strength of cigarettes most commonly available in the community at the time of the study, CBC news says.
But are the pain relieving benefits worth the cognitive risks?
The issue of treating spasticity is "certainly an important one," said Nicholas LaRocca, vice president of healthcare delivery and policy research at the National MS Society.
"Spasticity is a big problem for many people with MS, and the current medications don't necessarily work for everyone," said LaRocca, who was not involved in the new study.
"But smoking marijuana does not appear to be a long-term solution, because of the cognitive effects," he told Reuters Health
However, "the clinical significance of this result is uncertain; despite the transient decrease in scores, patients were still within normal ranges for their ages and levels of education," the investigators pointed out, said MedPage
"It is worth noting that conventional treatments, such as baclofen and tizanidine hydrochloride, may also affect cognition, although published data are scarce," they added.
Nevertheless, further attention to the issue is warranted, the group acknowledged.
"Larger, long-term studies are needed to confirm our findings and determine whether lower doses can result in beneficial effects with less cognitive impact," they suggested.
What can MS patients do now? LaRocca told Reuters health that he recommends that people with spasticity see a doctor experienced in treating MS. And if you're on an anti-spasticity medication and it's not working well enough, or the side effects are too much, tell your doctor, he said.