In recent years, cannabis, or marijuana, has been assessed in amyotrophic lateral sclerosis (ALS) and has shown some beneficial effects for patients. As many as 30,000 Americans may be affected by ALS. If you are one of them and are looking at CBD oil as a treatment, this is what you need to know! Amyotrophic Lateral Sclerosis ALS , also known as Lou Gehrig’s Disease, affects the motor neurons of the spinal cord, which causes progressive weakness and atrophy of muscles. ALS &
Amyotrophic lateral sclerosis (ALS) is a disease characterized by extensive damage over time to motor neurons in the brain and spinal cord. Motor neurons are nerve cells that are responsible for the communication, the signals, taking place between the brain and the muscles.
Due to this damage, the brain is increasingly unable to control muscle movement, and patients progressively loses the ability to easily do activities that most people take for granted, like walk, swallow, or speak. There is currently no cure for ALS, but treatments can help manage its symptoms.
One potential treatment is cannabis sativa, otherwise known as marijuana. Cannabis, as medical marijuana, is being assessed in its various forms for its potential in easing ALS symptoms.
How cannabis works
The active ingredients in cannabis — tetrahydrocannabinol (THC) and cannabidiol (CBD) — are called cannabinoids. They are believed to work as antioxidants and as anti-inflammatory and neuroprotective agents, and for these reason might slow or prevent further damage to nerve cells in ALS.
Both CBD and THC mainly function by binding to the cannabinoid receptor proteins CB1 and CB2 of the endocannabinoid system. The endocannabinoid system is responsible for regulating brain function, hormone secretion, and the immune system. CB1 receptors are present on the surface of nerve cells in the brain and spinal cord, and regulate neurodevelopmental activities; CB2 receptors are predominantly present in immune cells, and modulate inflammation and immune cell function.
Binding of THC to the CB1 receptor activates the receptor’s anti-glutamatergic action, meaning it inhibits the release of excess glutamate by nerve cells. Glutamate is a neurotransmitter, and in excess can cause nerve cell damage or excitotoxicity. In ALS, excitotoxicity is thought to compound nerve cell damage and increase neurodegeneration.
Since THC prevents excitotoxicity via the CB1 receptors, treatment with THC may be neuroprotective for ALS patients. A study showed that neuronal cells obtained from the spinal cord of ALS mouse models and treated with THC were protected from induced excitotoxicity.
The cannabinoids exert an anti-inflammatory effect through the CB2 receptors, which regulate immune cells and the production of inflammatory proteins. In this way, they might slow further tissue damage.
Cannabinoids also function as an antioxidant, but in a CB receptor-independent manner. Other receptors, such as the transient receptor potential vanilloid receptor 1, have been found to be involved, but how they work in ALS is still unclear.
Medical marijuana in clinical trials
Cannabis-derived products are being, or were, evaluated for their potential in treating ALS in various clinical trials.
Sativex (nabiximols), being developed by GW Pharmaceuticals, is an oral spray containing the two active components of cannabis. A Phase 2 trial (NCT01776970) in Italy, called CANALS, evaluated the safety, efficacy, and tolerability of Sativex in ALS patients affected by spasticity, or muscle stiffness. A total of 59 patients, ages 18 to 80, were included in the study. Patients were randomly assigned to receive either Sativex (29 patients) or placebo (30 patients). The study’s findings showed that Sativex was well-tolerated with no serious side effects. Spasticity was significantly reduced in treated patients compared to those given the placebo, whose symptoms continued to worsen.
An earlier single-site study (NCT00812851) tested the efficacy of oral THC in alleviating cramps in ALS patients. This was a crossover study, meaning that all 27 patients enrolled, (mean age 57; with moderate to severe cramps) were given THC at some point during the trial. They were randomly divided into two groups, one receiving 5 mg THC twice daily for two weeks, followed by a placebo; and the other receiving placebo first followed by THC for two weeks. A two-week treatment-free, or washout, period preceded changes in treatment status, and patients were evaluated two weeks after their treatment period.
This trial’s primary goal was changes in cramp intensity. The number of cramps per day, the intensity of muscle twitches, change in appetite, depression, and patient’s quality of life and sleep were measured as secondary goals. Study findings failed to show effectiveness in these measures; THC at 5 mg did did not alleviate cramps in ALS patients, and no significant changes were observed in the secondary outcomes, its researchers reported.
An ongoing Phase 3 study (NCT03690791) is testing the effects of CBD oil capsules by CannTrust on slowing disease progression in ALS patients. The study aims to enroll 30 patients, ages 25 to 75, who will be randomly grouped to receive either the CBD oil capsules or a placebo. In this six-month study, changes in a patient’s motor abilities, lung function, pain and spasticity levels, and quality of life will be assessed to evaluate the efficacy of CBD capsules. Enrollment at this trial’s single site, the Gold Coast Hospital and Health Service in Australia, may still be underway; contact information is available here.
In an observational study (NCT03886753), researchers at Children’s Hospital of Philadelphia are evaluating the effects of four formulations of cannabis-based products — the medical marijuana products Dream, Soothe, Shine, and Ease — by Ilera Healthcare used as standard therapy by people with multiple diseases, including ALS. How this therapeutic moves within the body (its pharmacokinetics) and its chemical interaction in the body (pharmacodynamics) will be monitored, and reports of relief of symptoms collected. The study is enrolling patients, ages 2 and older.
Another large and observational study (NCT03944447) in people with multiple diseases, including ALS, aim to assess the safety and efficacy of cannabis use by up to 10,000 people in the more than 38 states that have legalized medical marijuana. As an observational study, medical cannabis as part of person’s standard therapy — regular use — is being evaluated through patient reporting of perceived relief and findings of side effects.
Called OMNI-Can, the study and its investigators will use an anonymous online questionnaire to assess the potential benefits and side effects of medical cannabis on participants, most of whom are expected to be current users. A separate cannabis-naive group, defined as no use in the past year, will also be enrolled. Participants will first be given the survey at a visit with a physician to establish their baseline (start of the study) characteristics. Subsequent surveys will be given follow-up visits every three months for up to five years.
The study’s primary goal is the perceived benefits of cannabis in treating chronic pain, and the safety of its use via reporting of adverse events. Its impact on patients’ quality of life will be also be recorded, as will preferences such as favored type for use (route of administration, like vaping or eating as a candy) and its formulation (THC/CBD ratio). Contact information is available here.
Cannabis use should be in consultation with a treating physician, who can monitor patients for behaviors that may indicate dependence.
CBD, one of the more than 100 pharmacologically active compounds (cannabinoids) that can be retrieved from the cannabis plant, is thought to hold the greatest therapeutic potential. This is largely because it does not have the psychoactive properties common to other cannabis-related compounds. psychoactive properties
In addition to dependence, side effects attributed to medical marijuana use include lung irritation (smoking or vaping), low or elevated blood pressure, anxiety, dry mouth, changes in appetite, and nausea.
ALS News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
CBD Oil for ALS (Lou Gehrig’s Disease)
ALS, also known as Lou Gehrig’s disease, is a degenerative disorder. Researchers named this disorder after the famous baseball legend Lou Gehrig, who was the first to be formally diagnosed with the condition. Characteristics of this disorder include gradually worsening muscle control and strength, which can eventually involve the inability to speak or swallow.
Most modern treatments for ALS focus on palliative care rather than curative solutions. Medical experts help patients to deal with chronic pain and discomfort, while also striving to extend life expectancy.
However, new research concerning ALS is underway. In recent years, there has been a focus on using cannabinoids, such as cannabidiol, to address ALS’s symptoms. This article addresses burgeoning research regarding possible uses of CBD in managing ALS symptoms. Various ways in which ALS can affect patients will also be discussed and examined.
What Is ALS?
ALS, or Amyotrophic Lateral Sclerosis, is a degenerative disease that causes the muscles in the body to weaken and atrophy. This makes it challenging to move the limbs, but it also adversely affects many functions within the body, including respiration and swallowing. With no known cure, ALS eventually leads to death by respiratory failure, as the body becomes incapable of even breathing properly without aid.
Common ALS Treatment Options
Unfortunately, despite the best efforts of scientists everywhere, there are currently no useful medical treatments that work to prevent or treat ALS. Instead, most medical professionals attempt to delay the onset of worsening symptoms.
Doctors often recommend ALS support group plans that work to improve the mental health of sufferers. It is also beneficial for patients as they can connect to others with the same diagnosis.
Since its approval in 1995, Riluzole, under the brand name Rilutek, has been the primary ALS treatment option. The drug works to slow the progression of ALS, all while prolonging the sufferer’s life expectancy after diagnosis.
The main problem is that these drugs are prohibitively expensive, at least in the USA, and they also tend to create extremely unpleasant side effects.
For example, patients commonly report excessive nausea, stomach pain, and general flu-like symptoms after regularly taking Riluzole, forcing them to choose between long-term health and short term pain.
However, CBD may address the side effects of drugs such as Riluzole, allowing patients to have less stress and discomfort. CBD may assist in making patients’ lives easier, allowing doctors and specialists to concentrate on long-range options and care.
What Is CBD & What Can It Do?
CBD is a chemical compound that works with the body to produce a variety of beneficial effects, many of which can mitigate symptoms.
It works because the body already has an endocannabinoid system (ECS), a health system designed to work with cannabinoids naturally. It is responsible for many different responses within the body, such as the release of helpful neurochemicals and even the body’s inflammatory response.
Most conditions that CBD may mitigate are related to these bodily responses – a reduction in anxiety as a result of interaction with the serotonin receptor, or controlling the pain of arthritis by helping diminish the inflammation. These are just two widespread uses of CBD.
What Do the Studies Say?
Over the years, more and more researchers have conducted studies to show CBD’s efficacy as a way to help those with ALS.
One example is a report by Sabrina Giacoppo and Emanuela Mazzon for the Journal of Neural Regenerative Research. It investigated the effects of various cannabinoid compounds on ALS progression and mortality.
The researchers found that delta-9-tetrahydrocannabinol (THC), cannabinol (CBN), Sativex (a 1:1 mixture of THC and CBD), and other compounds had positive effects. They included reducing oxidative stress, protecting the nervous system, and slowing disease progression.
Most of these findings were based on animal studies, meaning further research is warranted. However, the authors concluded: “…there is a valid rationale to propose the use of cannabinoid compounds in the pharmacological management of ALS patients. Cannabinoids indeed are able to delay ALS progression and prolong survival.”
Despite the lack of human clinical trials, a case report by Gerhard Nahler discussed the effects of co-medication with cannabidiol on ALS symptoms.
Co-medication works by pairing CBD with another conventionally used drug, as certain medications seem to work together and produce an increased efficacy rate. Experts observe this in those who have epilepsy, where they note a reduction in seizures when patients take a mixture of CBD and the conventional epilepsy drug, Clobazam.
The report demonstrated that CBD and Riluzole delayed the progression of the disease in a patient recently diagnosed with ALS. It improved symptoms such as muscle weakness and difficulties with speech and swallowing for approximately 12 months.
Finally, a 2019 study investigated the effects of CBD with THC on spasticity in 32 ALS patients. It found that there was a high level of satisfaction with the treatment, especially among those with moderate to severe symptoms. The researchers state that “THC:CBD may serve as a valuable addition in the spectrum of symptomatic therapy in ALS.” However, they also suggest that further research is necessary.
So Is CBD Oil Only Useful as a Co-Medication?
All this might lead some to believe that the only use CBD oil has is in conjunction with conventional drugs used to treat ALS.
However, while CBD oil can be useful when combined with other drugs, the fact remains that those taking CBD oil still enjoy the various potential benefits that this unique oil would provide. For example, CBD users have stated that this substance reduces stress, increases relaxation, and eases pain, and it is known to have pain-relieving and anti-anxiety properties.
Another potential benefit of CBD for ALS patients is its ability to regulate the immune system and quell inflammation. Experts have suggested that immune dysfunction may contribute to the development of ALS and research has shown that people with the condition often have excessive levels of inflammation.
Although there is currently no evidence that CBD can reduce inflammation in ALS, specifically, it may well have positive effects. While CBD seems to be a worthwhile option, some might be wondering why patients use CBD oil rather than whole-plant, medical marijuana. , In fact, there are a few reasons why some experts don’t recommend regular cannabis for treating ALS.
Why Not Just Smoke Regular Marijuana?
While there are many people who smoke cannabis regularly to manage many of the underlying symptoms of ALS, there are a few significant drawbacks that make taking CBD oil a preferable option.
For starters, THC’s psychogenic effects can potentially be a problem for those with ALS. While some people may find the high pleasant, others may not enjoy the sensation. Furthermore, THC can cause various side effects, including dizziness, confusion, or increased anxiety levels.
Furthermore, marijuana sales are not currently allowed in a variety of jurisdictions in the USA, making it all the more difficult for doctors to recommend it as a useful option to assist with ALS symptoms.
There is also a more practical issue with smoking cannabis – the ability to smoke it at all. As ALS develops, the ability to breathe independently can be impaired, making it challenging to attempt to smoke marijuana. This is often one of the main reasons why CBD oil is preferable, as it is far easier to take for someone with reduced motility.
Final Verdict About CBD Oil for ALS
ALS patients may now use CBD oil to mitigate or reduce their symptoms as it is readily available in many places. Studies show that there is great promise in how people can benefit from CBD.
Although there is still plenty of research to be done, CBD oil seems to be a compelling choice for those looking to lessen the effects of many ALS symptoms.
Amyotrophic Lateral Sclerosis
ALS , also known as Lou Gehrig’s Disease, affects the motor neurons of the spinal cord, which causes progressive weakness and atrophy of muscles.
ALS & Cannabinoids
Cannabis Patient with ALS Outlives Her Doctors
Cathy Jordan she was diagnosed with ALS in 1986. Decades later she is still alive thanks to cannabis.
Science abstracts on CBD and Amyotrophic Lateral Sclerosis
- Cannabis and amyotrophic lateral sclerosis
- Self-medication with cannabidiol oil in a patient with primary lateral sclerosis
- Neurological aspects of medical use of CBD
These links are from third-party sites and are provided as a courtesy to the reader.