A short article on two Canadian surveys (self-reporting by users) showing that many epilepsy and multiple sclerosis patients self-medicate with marijuana. The author states that social and legal obstacles have hampered clinical advances in the study of cannabis sativa for medical treatment of a variety of neurological symptoms.
“Cannabis use may be occurring in these settings but there is little scientific evidence of its effectiveness for neurological symptoms. No controlled data lend support to its use for epilepsy. Small studies in multiple sclerosis have shown variable results against spasticity and no effect for tremor. A large [660 subjects] randomized trial comparing oral THC, oral cannabis extract, and placebo showed no effect on spasticity (measured by the Ashworth scale), despite participants reporting fewer spasms and less pain.
“Some of the many variables facing clinical investigators include different drug formulations (cannabis extracts, synthetic cannabinoids), uncertain dose, and multiple methods of delivery (some patients insist cannabis is effective only when smoked). Difficulties in trial design include a strong placebo effect and maintenance of double-blind status. A recurrent theme in multiple sclerosis trials is no effect on an objective primary outcome despite subjective improvement. Valid, reliable, and responsible objective measures are needed.
The Canadian survey data, Wingerchuk states, “suggest that people with recreational drug experiences are more likely to use cannabis for neurological symptom relief, and are at greater risk of becoming active or dependent users than the general population.”
Although Wingerchuk indicates that “hazards of regular cannabis use, such as persistent mood disorders and cognitive dysfunction, should be considered,” no mention is made of the many social, economic and criminal hazards associated with marijuana use.
Scottsdale, AZ. Reported in the Lancet, July 24,