Can CBD oil help multiple sclerosis?
CBD, short for cannabidiol, is one of numerous compounds known as cannabinoids found in cannabis and hemp plants. But unlike the psychoactive cannabinoid THC, it won’t get you high.
CBD is popular as a natural remedy and comes in products including vaping liquids, edible gummies, capsules, topical creams and cosmetics. However, it’s most commonly consumed as CBD oil – a bottled solution of CBD and a carrier oil such as hemp seed oil – that can be taken orally or sublingually (under the tongue).
While CBD products are not currently allowed to make medical claims, there is initial evidence that they may help with a variety of health conditions including chronic pain, and that CBD in combination with THC can help some people with certain symptoms of multiple sclerosis.
What is multiple sclerosis?
Multiple sclerosis (MS) – sometimes known as encephalomyelitis disseminata – is a condition that damages the myelin sheaths that insulate neurons in the brain and spinal cord. This disrupts these cells’ ability to send signals around the body, leading to symptoms including visual problems, muscle weakness, difficulties with co-ordination, and spasticity, a spasming and stiffening of the muscles.
MS patients can experience symptoms in isolated attacks that then subside, but the damage the disease causes is also progressive.
Multiple sclerosis affects more than 2 million people worldwide. There is currently no cure and treatments focus on relieving specific symptoms and reducing the frequency of attacks. However, many MS medications have serious side-effects.
Can CBD help with multiple sclerosis?
However, no studies have yet looked at the effects of CBD alone on multiple sclerosis symptoms. Instead, they have examined the impact of CBD when combined with THC, often in the form of the medication Sativex, which contains both of these cannabinoids.
Sativex and multiple sclerosis
Sativex (generic name nabiximols) is a medication containing almost equal amounts of CBD and THC, which is taken as an oral spray. It’s approved in the United Kingdom and a number of other countries to treat spasticity in multiple sclerosis patients who do not respond to other medication. However, some anecdotal evidence suggests it may also help with bladder problems, sleeping difficulties and tremors associated with MS.
Sativex is available on the NHS in England and Wales but not in Scotland or Northern Ireland. It can only be prescribed by a specialist doctor and its high cost will not always be covered by the NHS. In that case, patients can request a private prescription that they pay for themselves.
Sativex doesn’t help all MS patients but it does show significant results for some. In a clinical trial involving over 500 people, three quarters experienced a 30% or greater improvement in their spasticity within four weeks. A German study of patients in their regular care settings recorded similar results, with 75% demonstrating significant improvement after one month of use.
Although the effects of CBD alone on MS symptoms have not been adequately studied, one piece of research suggested that Sativex, containing both CBD and THC, was more effective for reducing spasticity than THC alone.
Are CBD and Sativex safe? What are the side-effects?
The World Health Organization considers CBD to have “a good safety profile”, while the Court of Justice of the European Union says it “does not appear to have any psychotropic effect or any harmful effect on human health”.
The UK’s Food Standards Agency now considers CBD a foodstuff but advises as a precaution that pregnant or breastfeeding women do not take it and that healthy adults use no more than 70mg per day.
Researchers generally agree that CBD is well tolerated, meaning it’s rare for subjects to drop out of clinical trials due to adverse effects. Studies of Sativex use show similar outcomes.
One study found that 17% of patients reported adverse events and concluded that Sativex was “an effective and well-tolerated treatment option” for MS spasticity.
However, because tiredness and dizziness are two of the side-effects initially experienced by some multiple sclerosis patients using Sativex, they are warned not to drive or operate machinery until they have settled into a regular daily dosage.
Other side-effects that CBD and Sativex can sometimes cause include:
- dry mouth
If you are already on medication, you should not take CBD without first consulting your doctor. That’s because CBD can inhibit the metabolization of certain drugs, potentially leading to unsafe levels in the body and accentuated side-effects.
For patients intending to take Sativex, the Multiple Sclerosis Trust advises that the prescribing doctor should be made aware of all other medications being taken, in particular sleeping pills or drugs with a sedative effect, since combining these with Sativex may cause increased fatigue or drowsiness.
Can you drive on Sativex?
Given that Sativex contains the psychoactive ingredient THC, it makes sense to question whether it might impair skills such as driving ability. However, the CBD appears to inhibit the effects of THC to some extent and a 2018 review of studies found that Sativex “was shown not to impair driving performance”.
Nevertheless, because the initial side-effects of Sativex may include dizziness and tiredness, patients are advised not to drive when they first start taking it and until they are on a regular daily dose.
It’s also possible that levels of THC in the bloodstream of Sativex users might be above the legal thresholds for some countries so it’s recommended that users make themselves aware of local driving regulations and always carry a relevant medical certificate with them.
The author of this article is not a medical expert and nothing in this article constitutes medical advice or gives rise to a medical practitioner/patient relationship. You should seek specialist medical advice where required. Never disregard professional medical advice or refrain from seeking it because of something you have read here.