More than 40% of those with multiple sclerosis said they've used cannabis products in the past year, according to recently published results from a national survey on pain in people with MS.

And those who turned to products with some combination of compounds derived from the cannabis plant (CBD, or cannabidiol, and THC, or tetrahydrocannabinol) were most likely to try them for help with chronic pain and sleep—two symptoms that are common and often go together in this chronic neurological disease.

It represents an increase from previous studies of CBD/THC use in MS, as more states legalize marijuana use recreationally and/or medically. However, there's a wide gap between the proportion of people with MS who have used a cannabinoid in the past year (42%) and the proportion who have spoken with their physician about it (only 18%).  Furthermore, fewer than 1% of cannabinoid users received information from their provider about the type of cannabinoid product recommended for their symptoms.

"Reasons for the disconnect between respondent use and provider guidance in our sample requires further study, but reinforces a longstanding concern that research focused on the use of cannabinoids for MS symptoms has not caught up with consumer use of these products," says lead author Tiffany Braley, M.D., M.S., an associate professor of neurology and an MS specialist at Michigan Medicine.

The study included survey responses from more than 1,000 people with a diagnosis of multiple sclerosis from across the nation. 

When it comes to selecting a cannabinoid product, survey respondents who had a preference tended to use CBD products, which don't have the same psychoactive effects of THC and tend to be easy to find online or in stores in many different forms.

Senior author Anna Kratz, Ph.D., an associate professor in the department of Physical Medicine & Rehabilitation, said "patients are looking for guidance from their providers to make informed choices about whether cannabis compounds should be used at all, and if so, which formulations would be most beneficial."

However, providers still don't have a lot of good evidence to help them advise patients who plan to explore a cannabinoid for their chronic MS symptoms. It's frustrating, Braley says, because symptoms like chronic pain and some sleep disturbances in MS can be challenging to treat with existing options, and new, safe, more personalized approaches would be welcomed. "However, provider guidance for patients must be informed by research focused on the benefits and harms of both CBD and THC, and potential mechanisms that underlie the effects of cannabinoids on MS symptoms." she says.

Braley adds many publications about cannabis in MS, including this one, have had populations that skew female-identifying and white, highlighting a need for more diverse perspectives from racial and ethnic minorities that have been historically underrepresented in MS research.

Paper cited: "Cannabinoid use among Americans with MS: Current trends and gaps in knowledge." Multiple Sclerosis Journal – Experimental, Translational and Clinical. DOI: 10.1177/2055217320959816