Cannabis
Cannabis contains chemicals which provide relief for many people with MS. The main constituents of cannabis are tetrahydrocannabinol (THC), which is the molecule that produces a psychoactive effect (‘high’) when cannabis is smoked or consumed, and cannabidiol (CBD), which has the potential for the treatment of spasticity.
In the UK, cannabis is currently categorised as a class B drug but the Government recently decided that cannabis-based health products can be available on prescription to patients in England, Wales and Scotland. The Advisory Council on the Misuse of Drugs (ACMD) is to conduct a long-term review of cannabis and NICE has been commissioned to provide advice for clinicians by October next year. Once a product is licensed by the MHRA, it will be available on prescription in the same way as any other Schedule 2 drug.
One product already available is Sativex – a cannabis-based medication licensed in the UK for treatment of moderate to severe spasticity for people where other medications have been ineffective or intolerable. Containing both THC and CBD, Sativex is thought unlikely to cause dependency but it is not routinely offered on the NHS as NICE says it is not cost-effective.
Many CBD-containing products are sold legally in health food stores, as CBD is not a controlled substance under the Misuse of Drugs Act, and thus strains of the cannabis plant that contain very little or no THC can be grown under license in the UK. This includes plants for making industrial hemp that is used for products such as clothing, plastic and body lotions. The oil that is sold legally in UK stores is extracted from these plants, providing that the THC content is less than 0.2 per cent and cannot be easily separated from the oil. There have been anecdotal reports that CBD oil is beneficial in relieving anxiety, sensory symptoms and pain relief.