Cannabis use in multiple sclerosis (MS) has been studied extensively for its effects on two major symptoms: spasticity and cognition. Spasticity refers to the involuntary muscle stiffness and spasms that many people with MS experience, which can significantly impair movement and quality of life. Cognition involves mental processes such as memory, attention, and problem-solving, which can also be affected by MS and potentially by cannabis use.
Regarding spasticity, cannabis appears to have a notable impact. Many patients with MS report that cannabis helps reduce the severity of their muscle stiffness and spasms. This effect is thought to arise from cannabinoids—chemical compounds found in cannabis—that interact with the body’s endocannabinoid system, which plays a role in regulating muscle tone and neurological function. Clinical studies have shown that cannabis-based treatments can lead to a decrease in patient-reported spasticity symptoms, improving comfort and mobility. However, the degree of relief varies among individuals, and while some experience significant benefits, others may notice only modest improvements.
The mechanism behind cannabis’s effect on spasticity likely involves its influence on nerve signaling pathways. Cannabinoids can modulate neurotransmitter release and reduce inflammation, which may help calm the overactive nerve signals causing muscle tightness. This modulation can lead to a relaxation of muscles and a reduction in painful spasms. Additionally, cannabis may help alleviate associated symptoms such as pain, which often accompanies spasticity in MS.
On the other hand, the impact of cannabis on cognition in people with MS is more complex and less uniformly positive. Cognitive functions such as memory, attention, and executive function can be sensitive to the psychoactive effects of cannabis, particularly tetrahydrocannabinol (THC), the compound responsible for the “high.” Some studies suggest that cannabis use may impair certain cognitive abilities, especially with higher doses or prolonged use. This can manifest as difficulties in concentrating, slower information processing, or memory lapses.
However, the relationship between cannabis and cognition in MS is not entirely negative. Some patients report that cannabis helps reduce anxiety and improve sleep, which can indirectly benefit cognitive function by reducing fatigue and mental fog. Moreover, cannabidiol (CBD), another cannabinoid without psychoactive effects, may have neuroprotective properties and could potentially support cognitive health, though research in this area is still emerging.
Balancing the benefits and risks of cannabis use in MS involves considering the type of cannabis product, dosage, and individual patient factors. Products with higher CBD and lower THC content might offer symptom relief with fewer cognitive side effects. Medical supervision is important to tailor treatment and monitor any changes in cognition or other side effects.
In summary, cannabis shows promise in reducing spasticity symptoms in MS, providing relief from muscle stiffness and spasms that impair daily functioning. Its effects on cognition are more nuanced, with potential for both impairment and indirect benefits depending on the specific cannabinoids used and individual patient responses. Ongoing research continues to clarify these effects to optimize cannabis-based therapies for people living with MS.
