Cannabis Treatment for ALS

Amyotrophic Lateral Sclerosis, informally known as ALS or Lou Gehrig’s Disease, is a neurodegenerative disease that affects the nerve cells in the spinal cord, brain, and motor cortex that control voluntary muscles. Patients suffering from ALS can eventually lose their ability to eat, move, speak, and breathe. There is currently no known cure and, according to the National Institute of Neurological Disorders and Stroke, the majority of people developing ALS will die from respiratory failure within three to five years (ninds.nih.gov). The progression of ALS is extremely rapid and patients are left with little time to find the most effective treatment options. What treatment options are available are limited, however, and at best can attempt to lessen the severity of the symptoms. Pharmaceutical interventions cannot undo the effects of ALS and do include many unwanted side effects. Fortunately, research is suggesting that medical cannabis, (medical marijuana) can lend a hand in reducing some ALS symptoms, slow the progression of the disease, and possibly extend the ALS patient’s life.

Doctors do not fully understand why Amyotrophic Lateral Sclerosis begins to occur, but they do have a fairly good understanding of why ALS causes its’ symptoms; that is, the nerve and brain cells are being devastated. Some of the symptoms are manageable during the onset period and the progression is gradual at first. These symptoms include physical unsteadiness, weakness in the extremities, stooped posture, difficulty lifting one’s head, cognitive changes, chronic pain, fatigue, speech difficulties, excessive saliva or mucus, and difficulty breathing or swallowing (alsworldwide.org). Not every patient experiences each of these symptoms and the symptoms may progress differently depending on the patient but every patient will, at some point, deal with weakened muscles and paralysis. The only pharmaceutical drug that has been shown to extend the life of ALS patients is Riluzole and the extension is only by about 2 or 3 months. Side effects of Riluzole and the other commonly prescribed medication, Radicava, include excess bruising, fatigue, muscle weakness, digestive issues, nausea, rashes, appetite loss, and headaches.

The cannabis plant already has a long history of helping patients dealing with other neurological disorders such as Parkinson’s, Alzheimer’s,multiple sclerosis, and epilepsy and recent studies support a growth of evidence that cannabis is successful in treating the symptoms associated with Amyotrophic Lateral Sclerosis as well and without harmful side effects. Medical scientists have found that medical cannabis is particularly effective at treating ALS symptoms such as pain, spasticity, appetite loss, drooling, and depression (Amtmann, et al). In a 2010 paper published in the American Journal of Hospice and Palliative Care, researchers stated that, “Cannabis…has properties applicable to symptom management of ALS, including analgesia [i.e. pain control], muscle relaxation, bronchodilation [i.e. relaxation/widening of the airways], saliva reduction, appetite stimulation, and sleep induction” (Carter, et al.).

A study published in 2004 found that the cannabinoid delta-9-tetrahydrocannabinol (THC) was useful in preventing the the progression of ALS by reducing oxidative damage, or the damage caused to the body’s cells and tissues by free radicals. THC further helps to reduce cellular excitotoxicity which is where a neuron is excessively stimulated, leading to neurological damage. Both oxidative damage and cellular excitotoxicity are dangerous because they lead to the damage and eventual death of motor neuron cells. Additionally, medical researchers studying the effects of plant-derived cannabis extracts also documented delays of ALS progression during early stages of the disease (Moreno-Martet, et al.). As a result of these encouraging findings, experts are calling for more clinical trials to further understand how cannabis can aid the treatment of ALS progression. Publishing their results in the American Journal of Hospice & Palliative Medicine in 2010, the team of scientists concluded, “Based on the currently available scientific data, it is reasonable to think that cannabis might significantly slow the progression of ALS, potentially extending life expectancy and substantially reducing the overall burden of the disease.” They further asserted, “There is an overwhelming amount of preclinical and clinical evidence to warrant initiating a multicenter randomized, double-blind, placebo-controlled trial of cannabis as a disease-modifying compound in ALS” (Carter, et al.).

When considering the safety profile of whole-plant cannabis and the severely debilitating and crippling symptoms suffered by patients with ALS, medical cannabis is a safe and appropriate therapy for patients finding it difficult to control their symptoms, either with or without traditional medical intervention. Patients interested in medical cannabis treatment should begin a treatment protocol under the direction of a wellness expert. Proper dosing and strain-specific medications are crucial for patient success. For example, while a lot of the research into medical cannabis has shown that the cannabinoid THC is impressive in its treatment of ALS, strains high in the the cannabinoid cannabidiol (CBD) are also advantageous for their ability to work as a neuroprotectant. A medical cannabis expert can help patients to navigate the various strains of medications and methods of ingestion (such as vaping, topicals, and oils) available to them.

Written by: Mara Trivino ©KingHarvest.org

Sources:

“Amyotrophic Lateral Sclerosis (ALS) Fact Sheet.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Amyotrophic-Lateral-Sclerosis-ALS-Fact-Sheet.
Worldwide, By: ALS. “Early Symptoms of ALS/MND.” ALS Worldwide, alsworldwide.org/care-and-support/article/early-symptoms-of-als-mnd.
Amtmann, D, et al. “Survey of Cannabis Use in Patients with Amyotrophic Lateral Sclerosis.”The American Journal of Hospice & Palliative Care., U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/pubmed/15055508.
Carter, G T, et al. “Cannabis and Amyotrophic Lateral Sclerosis: Hypothetical and Practical Applications, and a Call for Clinical Trials.” The American Journal of Hospice & Palliative Care., U.S. National Library of Medicine, Aug. 2010, www.ncbi.nlm.nih.gov/pubmed/20439484.
Raman, C, et al. “Amyotrophic Lateral Sclerosis: Delayed Disease Progression in Mice by Treatment with a Cannabinoid.” Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders : Official Publication of the World Federation of Neurology, Research Group on Motor Neuron Diseases., U.S. National Library of Medicine, Mar. 2004, www.ncbi.nlm.nih.gov/pubmed/15204022.
Moreno-Martet, M, et al. “Changes in Endocannabinoid Receptors and Enzymes in the Spinal Cord of SOD1(G93A) Transgenic Mice and Evaluation of a Sativex(®) -like Combination of Phytocannabinoids: Interest for Future Therapies in Amyotrophic Lateral Sclerosis.”CNS Neuroscience & Therapeutics., U.S. National Library of Medicine, Sept. 2014, www.ncbi.nlm.nih.gov/pubmed/24703394. 
  

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