Patterns of Medical Cannabis Use among Patients Diagnosed with Multiple Sclerosis

Published:February 10, 2021DOI:


      • Medical marijuana used by persons with multiple sclerosis (PWMS) to treat a broad range of neurological symptoms
      • Reports of the benefit of medical marijuana to treat MS symptoms is positively associated with the severity of those symptoms
      • Greatest symptom benefit is reported by individuals with milder disability versus more moderate disability
      • The use of medical marijuana is associated with reduction or discontinuation of prescription medications for symptoms, including controlled substances



      To survey the pattern and benefits of medical cannabis use (MCU) in a cross section of persons with multiple sclerosis (PWMS).


      One hundred and fifteen subjects completed a 36-question survey online or on paper which queried aspects of their use of cannabis, including frequency of use, effect on symptoms, and changes in their use of prescription medications, as well asa number of key demographic variables such as age, gender, disease duration and clinical course, etc. All subjects were treated at a multiple sclerosis (MS) clinic in Connecticut and enrolled in the Connecticut Medical Marijuana Program (CTMMP).


      Self-reported benefit from cannabis use for two or more symptoms of MS was associated with relapsing remitting MS (RRMS) vs progressive (PMS) (OR 3.043, 95% CI 1.026-9.028, p=0.038) and less benefit for two or more symptoms for those who required a wheelchair vs. those who ambulated without assistance (OR .246, 95% CI .195-.797, p=0.016). General benefit from cannabis use was reported for mood disorders (p<0.001), insomnia (p<0.001), sensory symptoms, including pain (p<0.001), and muscle cramps and spasms (p<0.001). Furthermore, benefit was also significantly associated with symptom severity in the case of insomnia (OR 9.735, 95% CI 2.751-34.445, p<0.001), and cramps and spasms (OR 5.234, 95% CI 1.261-21.729, p=0.014). A significant proportion of respondents had stopped or reduced prescription medications (86% vs. 55%, p<0.001) as a function of finding cannabis more effective than prescription medications. These included opioids, benzodiazepines, muscle relaxers and other pain medications.


      MCU among PWMS can lead to the reduction or discontinuation of several categories of prescription medications for symptoms of MS. Persons reporting the most benefit from MCU tended to have a milder form of MS with less disability, in contrast to previous studies. This study confirms the benefit of cannabis in several common MS symptoms, extending these findings to show that benefit can be related to baseline severity of some symptoms.
      To read this article in full you will need to make a payment


      1. Anon 2020

        • Hasin DS
        • Shmulewitz D
        • Sarvet AL.
        Time trends in U.S. cannabis use and cannabis use disorders overall and by sociodemographic subgroups: a narrative review and new findings.
        Am J Drug Alcohol Abuse. 2019; 45: 623-643
        • Kerr W.C.
        • Liu C.
        • Ye Y.
        Trends and age, period and cohort effects for marijuana use prevalence in the 1984 to 2015 US National Alcohol Surveys.
        Addiction. 2018 March; 113: 473-481
        • Glazier RE
        • Kling RN.
        Recent trends in substance abuse among persons with disabilities compared to that of persons without disabilities.
        Disabil Health J. 2013; 6: 107-115
        • Clark AJ
        • Ware MA
        • Yazer E
        • Murray TJ
        • Lynch ME.
        Patterns of cannabis use among patients with multiple sclerosis.
        Neurology. 2004; 62: 2098-2100
        • Gustavsen S
        • Søndergaard HB
        • Andresen SR
        • et al.
        Illegal cannabis use is common among Danes with multiple sclerosis.
        MultSclerRelatDisord. 2019; 33: 5-12
        • Banwell E
        • Pavisian B
        • Lee L
        • Feinstein A.
        Attitudes to cannabis and patterns of use among Canadians with multiple sclerosis.
        MultSclerRelatDisord. 2016; 10: 123-126
        • Martínez-Rodríguez JE
        • Munteis E
        • Carreño M
        • et al.
        Cannabis use in Spanish patients with multiple sclerosis: fulfilment of patients' expectations?.
        J Neurol Sci. 2008; 273: 103-107
        • Chong MS
        • Wolff K
        • Wise K
        • Tanton C
        • Winstock A
        • Silber E.
        Cannabis use in patients with multiple sclerosis.
        MultScler. 2006; 12: 646-651
        • Ware MA
        • Adams H
        • Guy GW.
        The medicinal use of cannabis in the UK: results of a nationwide survey.
        Int J ClinPract. 2005; 59: 291-295
        • Gupta S
        • Fellows K
        • Weinstock-Guttman B
        • Hagemeier J
        • Zivadinov R
        • Ramanathan M.
        Marijuana Use by Patients with Multiple Sclerosis.
        Int J MS Care. 2019; 21: 57-62
        • Consroe P
        • Musty R
        • Rein J
        • Tillery W
        • Pertwee R.
        The perceived effects of smoked cannabis on patients with multiple sclerosis.
        Eur Neurol. 1997; 38: 44-48
        • Meinck H.-.
        • Schönle P.W.
        • Conrad B.
        Effect of cannabinoids on spasticity and ataxia in multiple sclerosis.
        J Neurol. 1989; 236: 120-122
        • Nielsen S
        • Germanos R
        • Weier M
        • et al.
        The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews.
        CurrNeurolNeurosci Rep. 2018; 18: 8
        • Weinkle L
        • Domen CH
        • Shelton I
        • Sillau S
        • Nair K
        • Alvarez E.
        Exploring cannabis use by patients with multiple sclerosis in a state where cannabis is legal.
        MultSclerRelatDisord. 2019; 27: 383-390
        • Rice J.
        • Cameron M.
        Cannabinoids for Treatment of MS Symptoms: State of the Evidence.
        CurrNeurolNeurosci Rep. 2018; 18: 50
        • Mücke M
        • Phillips T
        • Radbruch L
        • Petzke F
        • Häuser W.
        Cannabis-based medicines for chronic neuropathic pain in adults.
        Cochrane Database Syst Rev. 2018; 3
        • Kondrad E
        • Reid A
        • Zajicek JP
        • Hobart JC
        • Slade A
        • Barnes D
        • Mattison PG
        • Research Group MUSEC
        Multiple sclerosis and extract of cannabis: results of the MUSEC trial.
        J NeurolNeurosurg Psychiatry. 2012; 83: 1125-1132
        • Zajicek J
        • Fox P
        • Sanders H
        • et al.
        Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentrerandomised placebo-controlled trial.
        Lancet. 2003; 362: 1517-1526
        • Greenberg HS
        • Werness SA
        • Pugh JE
        • Andrus RO
        • Anderson DJ
        • Domino EF.
        Short-term effects of smoking marijuana on balance in patients with multiple sclerosis and normal volunteers.
        ClinPharmacolTher. 1994; 55: 324-328
        • Lev-Ran S
        • Roerecke M
        • Le Foll B
        • George TP
        • McKenzie K
        • Rehm J
        The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies.
        Psychol Med. 2014; 44: 797-810
        • Degenhardt L
        • Hall W
        • Lynskey M.
        Exploring the association between cannabis use and depression.
        Addiction. 2003; 98: 1493-1504
        • Crippa JA
        • Zuardi AW
        • Martín-Santos R
        • et al.
        Cannabis and anxiety: a critical review of the evidence.
        Hum Psychopharmacol. 2009; 24: 515-523
        • Meier MH
        • Caspi A
        • Ambler A
        • et al.
        Persistent cannabis users show neuropsychological decline from childhood to midlife.
        Proc Natl AcadSci U S A. 2012; 109
        • Gilman JM
        • Kuster JK
        • Lee S
        • et al.
        Cannabis use is quantitatively associated with nucleus accumbens and amygdala abnormalities in young adult recreational users.
        J Neurosci. 2014; 34: 5529-5538
        • Brenton JN
        • Schreiner T
        • Karoscik K
        • et al.
        Attitudes, perceptions, and use of marijuana in youth with multiple sclerosis.
        J Neurol. 2018; 265: 417-423
        • Cofield SS
        • Salter A
        • Tyry T
        • et al.
        Perspectives on marijuana use and effectiveness: A survey of NARCOMS participants.
        NeurolClinPract. 2017; 7 ( -Marijuana-Statistics): 333-343
      2. Anon 2020 -Marijuana-Statistics.