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Cannabis and Multiple Sclerosis (MS) Treatment

September 1, 2016
The Multiple Sclerosis Foundation estimates that every week in the U.S., 200 people will learn they have multiple sclerosis (or as it’s more commonly called, MS). People like Jabe Couch, a father and husband from the Pacific Northwest. Few conditions are as long-lasting and progressively debilitating as MS, which causes damage to the brain, spinal cord, and affects the body’s immune system. A diagnosis can be devastating.

“Running. I loved to run,” recounts Couch. But after he was diagnosed with MS at the age of 23, Couch’s previously active lifestyle appeared to be coming to an end. “Not only could I no longer run. I’d be confined to a wheelchair for probably the rest of my life.” He recalls the day when doctors put him through an MRI and told him his immune system had gone into attack mode.

While MS is universally recognized by states as a qualifying condition for medical marijuana, Couch had no desire to use a drug that he’d long associated with “lazy stoners.” Eventually, however, he had a change of heart.

What Causes Multiple Sclerosis and are There Treatment Options?

Prescription Drugs are the Most Common MS Treatment Option

MS is neither contagious nor directly inheritable. Although scientists are getting better at identifying the various factors they hope will be able to help doctors diagnose MS earlier and treat more effectively, available treatments are poor.

Doctors prescribed Couch, a native of Bend, Oregon, 16 different drugs, none of which were developed specifically for MS. “They gave me a massive cocktail of drugs,” he recalls. “Valium for anxiety. Percocet and OxyContin for pain. Ritalin [a stimulant] to keep me from nodding off.” Couch continues, “Steroids. Antidepressants. Drugs for spasms and digestive issues. And, drugs to treat drug interactions!”

I asked Coach why he didn’t consider cannabis, which by then was legal in Oregon.

“No way! I grew up with all the propaganda,” Couch says. “Cannabis was dangerous. Was the government lying? Cannabis was a Schedule I drug — just like heroin!”

But, Couch’s drugs weren’t very effective, and caused severe side effects like seizures. And they were expensive – “Ten grand per month,” he says. And even though insurance paid its share, he adds, “The co-pays still felt like a second mortgage.”

It wasn’t long before the once active, drug-free Oregonian became what he describes as, “a full-fledged boozer and pill popper.” Addicted, he’d wash down his pills with a couple of cold ones. Despite being confined to a wheelchair, “I felt like I was traveling down the freeway at 150 miles per hour destined for a really bad place. Life was spiraling out of control.”

The depression got worse. Along came suicidal ideation. It got so bad, Couch remembers his wife making sure there were no firearms in the house.

Couch’s story is not unique. More than 400,000 people in the United States (and 2.5 million people worldwide) currently live with MS. Over half will suffer depression and become twice as likely to commit suicide as the general population.

Can Medical Cannabis be Used as Multiple Sclerosis Treatment?

Medical Cannabis as an MS Treatment Option

Because multiple sclerosis is a progressive illness, things weren’t getting better for Couch. So one day after work a friend offered him a drag off a joint. He was reluctant until his dad said, “What do you have to lose?” The cannabis helped immediately. It didn’t fix everything at one time, but as he recalls, “I felt like a huge weight had been lifted.”

A significant amount of evidence suggests THC and CBD-based medications can be used for treating muscle spasticity associated with multiple sclerosis, but most studies have focused on synthetic derivatives. Few have examined whole-plant cannabis or many of the other MS associated symptoms. Nonetheless, cannabis seems to help the following symptoms:

  • Pain and sleep disturbances: According to a 2005 ”gold-standard” trial of whole-plant cannabis-based extract (oromucosal spray containing 1:1 THC:CBD), cannabis-based medication was twice as effective as placebo to treat pain, and three times more effective for sleep.
  • Inflammatory-related issues: Neural tissue inflammation is common as the body’s immune cells attack the central nervous system. The (well established) anti-inflammatory effects of cannabis can help MS sufferers.
  • Muscle spasms: A 2014 systematic review provided high-quality evidence that cannabis-based medicines were highly effective in treating muscle spasms.
  • Abdominal complaints: Many scientists believe cannabinoids help control gut response and modulate gastrointestinal issues. According to a survey conducted by Scottish researcher Roger Pertwee, 51-60% of respondents reported a decrease in defecation urgency, a 44% decrease in incontinence, and 30% had less constipation.
  • Mood issues: Most MS patients will experience depression or at least persistent mood issues. Pertwee’s survey found that more than 90% of the MS sufferers reported botanical cannabis as improving mood.

Cannabis, MS, and The Comeback Kid

Jabe Couch, Medical Marijuana MS Patient

It’s been a long road for Couch, but today he couldn’t be happier. Since introducing cannabis into his MS treatment protocol, he’s gradually weaned himself off all the pharmaceutical drugs except for one. Couch spends time in his garden, not only growing his own cannabis (a Jack Herer strain), but also fruits and vegetables.

Couch uses a variety of methods to consume his medication. In the evening, he enjoys an indica-infused brownie to help him sleep. During the day, he’ll add a high-CBD infused butter to his omelet or vaporize strains that alleviate fatigue and give him energy. Even more remarkable, Couch claims that not only has his MS halted, MRIs show signs that it’s regressing.

But the best thing about cannabis? “For years, my face was so numb, I couldn’t feel anything,” recounts Couch. “One day the numbness started to subside. I was kissing my wife, and I could feel her soft face pressed against mine. Overjoyed, I started crying. It was one of the best days of my life.”

  • Think a little further

    CBD Crew ^_^ THC/CBD cannabis in every seed.

    • Jim Jackson

      Yes!!! CBD Crew has created many THC/CBD strains. I’m currently growing the Therapy strain for myself (peripheral neuropathy) and for a friend with MS.

  • Grampa Scott

    Excellent info.

  • BoscoBob

    I have MS and was reluctant to go the cannabis route. I was on some seriously #@%! up medications. The worst was Gabapentin®. It causes severe suicidal ideation 24/7. To convince my doctor to give me the “Okie-Dokie” for medical cannabis, I printed out the “adverse effects” for all of my medications (about 57 pages). I also printed out the “adverse effects” for cannabis (less than a page and few that were substantiated). In addition, I printed out the LD50’s. The latest LD50 for cannabis requires a person to consume 1,500 POUNDS of cannabis in 15 minutes to kill half of the people attempting this Herculean feat.

    In the end, she acquiesced and signed me up. Quality of life has improved and all of those horrific side effects of the drugs have gone. I am now a convert to cannabis!

    • Roy Turner

      I live in Florida,If you watch the news you understand.I’m 54 in a wheel chair .Don’t eat much at all ,Hard time swallowing ,no energy .My world has become my house .I wish the state would get it together.The way i am now is i have nothing to lose ,but a lot to be gained . If i could sit here longer i’d keep going .God Bless

  • Ferret Dancer

    Congress must act now to change the federal law. It is my belief that recreational users have made this all but impossible. While states may legalize marijuana, it not only remains illegal from a federal standpoint, but it is also classified as a Schedule I substance.

    “…The CSA has classified marijuana but it is up to the Drug Enforcement Administration (DEA) to carry out any law enforcement. Federal laws apply throughout the United States, not just on federal property. This means that even in states that have passed medical marijuana laws, federal law still overrules. Federally, there are sentencing guidelines and mandatory sentencing laws. The sentencing guidelines are enacted by the United States Sentencing Commission. The mandatory sentencing laws are enacted by Congress. The Sentencing Commission came into creation in 1987 to alleviate disproportionate differences in punishments…”

    • StriperQueen

      I have not gotten my MMJ card for fear that I will lose my LTC. I live in a state that has made marijuana legal but has dragged its heels on it becoming available to purchase safely. I have MS and now have a severely damaged femoral nerve due to back surgery. I woke up unable to walk. I find it strange that they say that the nerve is damaged yet at the same time it feels like it is more than awake and overly functioning as the pain and inflammation in that leg is over the top. I am currently just buying CBD oil with the amount of THC under the .3% via online sources. However, I have tried a brownie that was given to me by a family member seeing me in such pain. I had one small bite and it worked better than these pills they prescribe for me. So I cannot wait for my state to get its act together. oh. I love your name Ferret Dancer as I have myself quite a bunch of little furballs. They provide such joy for me.

  • Richard Gaylord

    this article is filled with factual errors about both MS and the usefulness of cannabis in dealing with its symptoms. i have CIDP, my younger sister has MS and my twin sister has Sjogren’s Syndrome. ALL of these diseases are autoimmune in nature and involve demyelination (damage to the protective covering (myelin sheath) that surrounds nerve fibers). MS affects the central nervous system and the other two affect the peripheral nervous system. All three of these conditions qualify for the use of medical cannabis in Illinois. other states may or may not permit the use of cannabis to treat these and other demyelinating diseases. cannabis relieves a number of symptoms in these diseases, including muscle spasms, inability to sleep, lack of willingness to eat, and psychological distress.

    • Jeremy Kossen

      Richard — Thank you for your comment, although it sounds like you missed the point of the article — which is to bring awareness to MS, and the demonstrated utility of cannabis to treat MS-related symptoms. You state, “this article is filled with factual errors about both MS and the usefulness of cannabis in dealing with its symptoms.” Yet, nothing that you cite did I contradict. I very clearly stated that most research on MS and how cannabis can potentially treat associated symptoms has focused on spasticity and spasms. This is just a fact. Go to PubMed and do a search of published studies. MS has been included in other studies focused on chronic pain, but in general, the research has been heavily focused on spasticity. However, there have been some surveys and observational studies on other symptoms, several of which I cited. Unfortunately, given the restraints of writing for the web, I’m limited in the length of my article. And I couldn’t go into nearly as much depth as I would have liked to, but that would also probably bore most readers — particularly as the focus of the article was not to cover every aspect of MS, but rather to illustrate through a “case study” how cannabis help those with MS.

      Although, you were perplexingly vague in terms of what inaccuracies there were, I’m presuming you are referring to the points that followed your initial statement, none of which I contradicted:

      1. “ALL of these diseases are autoimmune in nature and involve demyelination (damage to the protective covering (myelin sheath) that surrounds nerve fibers).”

      The precise antigen (the target that immune cells are sensitized to attack) of MS is not known. Consequently, the prevailing opinion is that it’s more accurate to characterize MS as immune-mediated rather than autoimmune. However, I never even made this distinction — in fact, I avoided characterizing it all (except as progressive), because I know some people disagree, and I didn’t want to take away from the primary purpose of the article: again, to bring awareness to MS and how cannabis can help.

      2. “MS affects the central nervous system.”

      Yes, you’re correct. I never said it didn’t.

      3. “All three of these conditions qualify for the use of medical cannabis in Illinois. other states may or may not permit the use of cannabis to treat these and other demyelinating diseases.”

      I stated that among medical marijuana states, MS is universally a qualifying condition. Perhaps, “near universally” would be more accurate. I don’t know of any MMJ states where a patient with MS cannot qualify for medical marijuana. Not all states specifically mention MS, but in nearly all the states that don’t, MS qualifies under associated symptoms.

      4. You stated that there were factual errors about “the usefulness of cannabis in dealing with its symptoms,” yet went on to say, “cannabis relieves a number of symptoms in these diseases, including muscle spasms, inability to sleep, lack of willingness to eat, and psychological distress.”

      Yes, I agree 100% that cannabis relieves these symptoms, and provided citations to support it.

      I’m sorry the article rubbed you the wrong way. If, in fact, there were any gross inaccuracies that you didn’t mention in your comment, please, do not hesitate to share.

      • Richard Gaylord

        sorry if i came across as harsh. i was having a very bad day of symptoms. the only gross inaccuracy is your statement that “multiple sclerosis is a progressive illness”. this is fundamentally wrong. MS comes in two versions – relapsing-remitting or progressive (and some ‘lucky’ people only experience a single episode). also, i know of no evidence that MS affects the immune system; rather; it’s the immune system that causes MS as indicated by the presence of certain antibodies found in a spinal tap. and as for MS not being ‘directly inheritable’, that is the conventional wisdom but i consider the fact that i and two of my siblings all have demyelinating diseases to direct contradict that (the odds of 3 siblings all having different demyelinating diseases without there being a genetic component is even less than the odds that O.J. was innocent) for other readers, a good FAQ on MS is at other than that, i don’t object to your other statements except that as a scientist, i don’t pay much attention to anecdotal evidence and i am very concerned with cannabis being promoted as a cure-all elixir for a hodgepodge of symptoms. i don’t think it’s a good idea to promote the legalization of MS for use as a medicine for a wide range of ailments because if medical studies subsequently find that not be the case, it would lead to it’s being made illegal again; rather, i view cannabis use as an expression of a fundamental right to put whatever we want into our own body.

        • Jeremy Kossen

          Hi Richard — I appreciate your response, and you make some valid points. Accuracy is highly important to me, and if I’d made a mistake, I’m happy to acknowledge it (if I know what the mistake is). I’ll make sure to correct the statement “MS is a progressive illness” to it being “progressive” or “relapsing-remitting.” As to your second point, about “no evidence that MS affects the immune system; rather; it’s the immune system that causes MS as indicated by the presence of certain antibodies found in a spinal tap.” I don’t disagree with that point, and I see where you’re coming from. Perhaps I should have worded it differently. Something like “MS is an immune-mediated disease, as such, the body’s immune system attacks healthy nerve tissue, causing nerve damage, which in turn, affects the whole body.” On point three, that MS is not “directly inheritable,” that’s interesting. As you said, that’s the conventional wisdom and I read it in multiple studies, but given the odds of three siblings all having demyelinating diseases without there being a genetic component does seem statistically impossible. I’m going to do a bit more research on that point.

          You also stated concern about cannabis being promoted as a “cure-all elixir for a hodgepodge of symptoms.” I couldn’t agree with you more, and in fact, in most of my articles I try to state that anecdotal evidence is low on the hierarchy of evidence scale. In fact, my next article is on “cannabis and glaucoma,” and the evidence is pretty clear that cannabis is not a particularly effective treatment for glaucoma (primarily because patients would need to consume six to eight times per day and there are superior treatments and surgical procedures). So I state frankly that contrary to conventional wisdom, cannabis is not good for glaucoma. I’ve done the same for other conditions or in refuting anecdotal suggestions that “cannabis oil cures cancer.”

          I’ve written much longer research reviews which rely very little on anecdotes or one-off case studies, but unfortunately, most people don’t think like scientists, and when writing for a largely non-scientific audience, you have to tie in the human element to communicate a point. But, when I do, I cite what evidence supports the anecdotes. Often there is very little evidence, because “gold standard” double-blind placebo controlled trials are virtually non-existent thanks to the difficulty conducting research on botanical cannabis. Sometimes, there are surveys or observational studies, which I believe have merit in the absence of more rigorous studies, but are clearly not as desirable. It can be an awkward dance, because I speak to so many patients suffering from a range of different conditions, who’ve been helped by cannabis (particularly with respect to getting off of medicines we know to be bad e.g. opioids), but we also don’t have the data to support anecdotes and I follow all the science-based medicine arguments, as well. I find myself agreeing more often than not with SBM, while disagreeing more often than not with the “cannabis as a panacea” crowd. It’s an amazing plant, but certainly not a panacea.

          Again, I appreciate you following up the initial response with valid criticism that is actionable. Drives me nuts when people make blanket statements without citing what they’re referring to. With your follow-up I have something I can address accordingly.

        • Jeremy Kossen

          Hi Richard — Interesting explanation from the National MS Society on genetic factors and heritability/non-heritability of MS:

          “While MS is not hereditary, having a first-degree relative such as a parent or sibling with MS does significantly increase an individual’s risk of developing the disease. Studies have shown that there is a higher prevalence of certain genes in populations with higher rates of MS. Common genetic factors have also been found in some families where there is more than one person with MS. Some researchers theorize that MS develops because a person is born with a genetic predisposition to react to some environmental agent that, upon exposure, triggers an immune-mediated response. Sophisticated new techniques for identifying genes are helping to answer questions about the role of genes in the development of MS.”

          Also, they note environmental factors — such as Vitamin D — appear to influence risk of MS, specifically that MS occurs more frequently in areas farther from the equator (where people are exposed to less natural sunlight); and that when people born in an area with a high risk of MS who later move to an area of lower risk before the age of 15, they assume the risk of the new area. Unfortunately, they don’t cite any of the studies. In most of these complex diseases and disorders, explanations of underlying causes appear to be fluid, and highly debatable. Researchers love to try to explain a phenomenon with a unifying theory — e.g. depression is due to serotonin deficiency, addiction is caused by dopamine, etc. — but, these unifying theories seem to almost always get debunked. Given the complexity of so many diseases, so are the underlying causes, and there seems to be a confluence of multiple factors that affect risk.

          The National MS Society’s statement that some researchers hypothesize persons may be born with a “predisposition to react to some environmental agent that, upon exposure, triggers an immune-mediated response.” I find this possible explanation intriguing — not just for MS (and related conditions), but warrants further study for numerous conditions. I know there’s also been a lot of research into identifying specific genomic biomarkers for MS (to improve diagnoses and clinical outcomes), but thus far, few have proved clinically useful (an challenge hardly unique to MS). There was an interesting review on genetics studies from the Neurology and Immunobiology departments at Yale School of Medicine (unfortunately, the full study is behind a paywall):

          Biomarkers & MS:

          Likewise, the National MS Society provides some cursory information about the state of genetics research at:

          Searching for MS Genes:

          • Richard Gaylord

            doctors are lousy scientists (and not very good as doctors either based on my experiences with them) they use terms like ‘genetic predisposition’ which is the same as inheritabile (being inheritable does not mean that everybody in a family gets it. nor does it mean that environmental factors are not also important). they also use terms like ‘autoimmune-mediated’ when they haven’t found the antibodies that would confirm if a disease is an autoimmune disease. and they don’t understand that correlation does not mean causation. but none of this matters to me because the bottom line for me is that my body doesn’t tolerate corticosteroids and due to an IgA deficiency, i also can’t take IVIG treatment. so i have no treatments for the disease itself available to me (i’m not going to go the plasma exchange route) and so i only treat the various symptoms as they occur (e.g. with cannabis).

          • Jeremy Kossen

            All great points. And, I especially liked what you said: “‘genetic predisposition’ which is the same as inheritable (being inheritable does not mean that everybody in a family gets it. nor does it mean that environmental factors are not also important).” Genetic predisposition vs. inheritable? It is pretty much the same thing.

        • Maygrelle

          It is true that MS is not “directly inheritable,” that is, it’s not caused by the direct inheritance of one or two genes. Instead, what’s inherited is likely a combination of many genes that, when they encounter a specific (as yet unidentified) environmental agent, causes MS. It’s long been known that a person is more likely to get MS when another member of their family also has it. My sister and I both do. Although she has a benign form while I have a progressive form. And, while I have tried cannibis in several forms, I’ve not found it to be of any benefit in easing any of my symptoms. I don’t believe in anecdotal evidence; I believe in science. The science for some MS symptoms being relieved in some patients with MS is promising, but we are not their yet. And, as evidenced by me, there is a subset of patients for whom it will not work at all.

  • AlphaOmega

    I have an almost identical story so I’m not going into details. It’s very very sad but the majority of patients must be there own advocates and take back control of there live’s. And if there current course of treatment is not working or causing major consequences have the courage to speak up. Time is of the essence and in the end it’s really about the quality of life you can lead.

  • Neeski

    I was diagnosed with MS in 1991. I am lucky I have had a ‘mild’ course with several serious setbacks. Throughout, sleep has been my biggest enemy, robbing me of energy, clear mindset, and stamina. I have been prescribed prescription medication only to find out it greatly increases my chances of getting Alzeiheimers later in life. That made me say screw it and I moved to nighttime Indica use. It has made all the difference and given my life back. I am so grateful to my neurologist for being forward thinking and giving me a medical my license. I also wanted to take issue with your article NOONE has been able to get MS to regress. Symptoms subside, but the disease process continues 24/7. So Mr. Couch may have had improved sensation or physical control, but even the magic of marijuana is not a cure. Thanks for this article. Keep getting the word out!

    • Jeremy Kossen

      Thanks Neeski for sharing your story! I’m so happy hear that cannabis has helped. Regarding your “issue,” that no one has been able to get MS to regress, it’s funny you should mention that. Because after I submitted the article to my editor, I had second thoughts about using that term as I think it was imprecise. I think as you pointed out, more accurately, it should be described as having improved sensation and physical control, symptoms have subsided, etc. I wasn’t trying to suggest it was a “cure,” but that it has provided tremendous benefits in terms of improving quality of life and the overall debilitating symptoms. Thank you again for your comment. I’m glad that (aside from that) you liked the article.

      • Caddie Zoe

        I just have to jump in and say that I was diagnosed with MS IN 1986. I had already been smoking pot for years. Being illegal at the time, and I was a nurse, I couldn’t tell my doctors. Now, however many years later, still smoking and no MS. I have read many articles of people who have symptom relief with smoking, and I do believe that weed could be a cure. So I say ‘YES’ to weed and MS regression!

        • Jeremy Kossen

          Wow, Caddie — that’s amazing. Connect to me on FB if you can, because I’d love to hear more for future articles.

        • Jenni@Neb

          I am also a nurse living with MS since 2010. I live in a state that is not legal at this time but I would love to chat more with you on your journey with medicinal marijuana. maybe FB or email?!

        • cowgirl7

          Thank-you for sharing that and giving us hope. Were you also using the Jack Heror strain?

        • Gerald Braun

          Caddie. I am a RN using cannabis for another serious health condition. Can we connect? you can reach me @ or gershon braun on FB.

      • Torri Nolte

        Great article, Jeremy! Very encouraging. Any information we MS’ers can share with one another is so helpful. MS has different levels or severity. Benign and single-case exacerbation being the lowest. Primary progressive being the worst. I’ve had relapsing-remitting MS, the level in the middle, for 29 years. Most people don’t know I have MS.
        While it’s true that MS is not curable, I believe it can be greatly relieved or even put into remission with the right interventions. Five years ago I decided to eliminate all foods but meat, non-nightshade vegetables and water. Within a few weeks I felt better than I think I ever have in my life. Seriously. It was simply amazing! BUT a very hard diet to follow for sure. I lasted one month with those amazing results before I fell off the wagon and had a piece of pumpkin cheesecake at a Christmas party. It was all downhill from there.
        I think a lot of MS is related to the gut, the “second brain” as it’s called. That might just be my own experience and opinion.
        MS has no cure, but I know it can regress. I’ve experienced it. And I’ve read testimonials about people who used diet, marijuana, stem cell replacement, and perhaps other methods, to relieve the inflammation of the lesions on the brain and spinal cord and put themselves into remission, or in my case, it sure felt like regression. Remission or regression. Close enough.
        I’m fairly new to MMJ, and, like Jabe, I never ever thought I’d use marijuana, but I’m almost ready to start making my own cannabis oil and growing my own plants. Still researching and trying out different strains and researching various medicating methods.
        I very much appreciated reading about what steps Jabe Couch is taking. Thank you so much for including that information.

      • Gerald Braun

        @jeremykossen:disqus Great article..I wish there was more to report on cannabis effectuating a clear and observable improvement in the underlying pathophysiology of MS…anything new?

  • Jessica

    Jabe (the man featured in this story) is my brother. We are fundraising for him to receive a freedom chair! Please consider donating! Jabe is fundraising for a mobility chair. Once we hit 5% of our goal we can get more help with sharing socially from #GRIT

  • Sandi Specht

    Thank you for this very helpful article. I was wondering what you (or others reading this) actually take for MS in regards to the type cannabis and ratio of CBD/THC? What strains? Tincture, capsules, edibles?

  • Rory Gordon

    So I was diagnosed with MS at age 19 (in 2002), and much like the writer of this article, my active days ground to a halt. I taught myself how to walk again because I utterly loathe the idea of living in a seat my entire life. I wound up going from 6’4, 207lbs. to 148 within three months of starting my first Rx treatment for MS. Over the course of years and running the gamut of MS therapies, I nearly lost my liver, kidneys, skin, heart, and gallbladder to reactions to these awful drugs.

    I moved to Montana about eight years ago, and fell in love with the location and climate (humidity is not a friend when you have MS). I also switched over to MMJ and adopted a more naturopathic lifestyle. The difference in feeling was profound and immediate. This plant put me somewhere close to normal again, when all the Rx drugs did was steal half of my life due to side effects.

    My original doctors in NY said I’d be wheelchair bound by 25 and dead by 40, given the speed with which my condition was progression. Here I am at 35 and still walking. Running is out of the question for the near future… but I plan on at least being able to do a 5k on an elliptical or treadmill by the end of this decade.

  • Gerald Braun

    Great article..I wish there was more to report on cannabis effectuating a clear and observable improvement in the underlying pathophysiology of MS…anything new?