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Cannabis and ALS: What You Need to Know

Remember when you couldn’t log onto social media without seeing someone dump a bucket of ice water over their heads for a good cause? The famous Ice Bucket Challenge helped raise awareness and research funds for the devastating disease called ALS. We hope some of those funds go to further investigate the relationship between cannabis and ALS.

ALS is also known as “Lou Gehrig’s disease,” named after the famous baseball player who built a heroic reputation for playing through his physical limitation. This neurodegenerative condition causes the muscles to waste away and has no cure — but there is hope. In this article, we will cover ALS and how cannabis can relieve symptoms and help stop the disease from progressing.

What Exactly is ALS?

Amyotrophic lateral sclerosis (ALS) is a degenerative neurological disease that involves the neurons (nerve cells) that control voluntary muscle movement. These voluntary muscles are responsible for actions like talking, walking, and chewing. ALS is a progressive disease that gets worse with time. There is no cure for ALS, and there aren’t any proven treatments to reverse or slow its progression.

ALS is part of a group of disorders called motor neuron diseases, which are characterized by the deterioration and death of these neurons. Nerve cells connect the brain and spinal cord to muscles all over the body, providing communication links between the brain and all the voluntary muscles. When motor neurons start to degenerate and die over time, messages aren’t sent to the muscles. Without the ability to function, the muscles begin to weaken, twitch, become paralyzed, and waste away. The brain eventually loses the ability to control voluntary movements, and the muscles deteriorate, which can lead to many debilitating symptoms including respiratory failure.

The most common symptoms of ALS are muscle stiffness and weakness. As the disease progresses, patients lose the ability to move, eat, speak, and sometimes even breath. Many ASL patients also suffer from depression that develops from a reduced quality of life.

Over 30,000 Americans are affected by ALS, but we still don’t know exactly how it is caused.

While there is no cure for ALS, there are medications used to reduce nerve damage and to try and slow the decline of function. Other drugs are used to treat the symptoms of ALS like stiffness, drooling, depression, sleep problems, constipation, and uncontrolled episodes of crying or laughing. The effectiveness of these medications can vary, and they often cause uncomfortable side effects.

Can Cannabis Treat ALS?

Cannabis has been used to bring relief from the symptoms of ALS for a long time, and researchers are finding it may even slow the progression of the diseases. The nerve damage associated with ALS happens through a combination of excitotoxicity and oxidative stress. Cannabis has the potential to address both of these issues.

Cannabis has been a known antioxidant for a long time and can help decrease the nerve damage caused by too many free radicals within the body. Along with being a powerful antioxidant, cannabis also provides neuroprotection that can spare the neurons from the excitotoxicity caused by injured nerve tissue. The neuroprotection cannabis offers may be able to slow the damage that leads to cell death.

A 2004 animal study found that cannabinoids were able to slow the motor impairment and prolong survival in individuals with motor neuron cell damage. Researchers concluded that the cannabinoid treatment reduced both oxidative damage and excitotoxicity. Other studies have looked at the neuroprotection benefits of cannabis for ALS patients, with promising results. Researchers are currently studying how CB2 receptors can play a role in ALS progression and are working to understand how the endocannabinoid system is involved in reducing oxidative cell damage and neuroinflammation.

Cannabis and ALS: Managing Symptoms

While we are still learning how cannabis can help slow the progression of ALS, we do know that it can provide much-needed relief to many of its uncomfortable symptoms. Marijuana can help with issues like chronic pain, muscle spasticity, appetite, and sleep problems. A 2001 literature review in the American Journal of Hospice & Palliative Care found that many symptoms of ALS are treatable with cannabis and summarized their findings in this table:

Not only can cannabis help relieve physical symptoms, but it can also improve a patient’s psychological state. ALS can take a massive toll on mental health, and cannabis can help boost mood, reduce anxiety, and alleviate depression.

A 2012 survey of 48 ALS patients who used cannabis to alleviate symptoms found many positive benefits. Patients reported improvements in appetite, sleep, swallowing, mood, and better speech. These patients only reported a few side effects like a sore throat and red eyes, which can be avoided by other methods of cannabis use like edibles and topicals, rather than smoking.

With continued research on medical cannabis as a treatment for ALS, we will see a future with more options for patients and alternatives to prescription drugs without the side effects. If you have questions about whether medical cannabis may help you manage your condition, be sure to schedule an appointment.

Wondering if cannabis can treat ALS? Learn everything you need to know about how cannabis can help people with ALS find relief.

What Can Cannabis Do for Patients with ALS?

Part of a group of rare degenerative neurological conditions, amyotrophic lateral sclerosis (ALS) causes muscle stiffness and cramping that can be extreme. Difficulty swallowing, slurred speech, and muscle twitching are also markers of this progressive disease, often named for New York Yankees baseball player Lou Gehrig, who infamously had his career cut short in 1939 following his diagnosis. The condition also is known as motor neuron disease (MND) for the way it kills neurons that control voluntary muscle movement

Fifteen people each day are diagnosed with the incurable disease, according to the ALS Association . Treatments include prescription medications as well as holistic options, such as speech therapy, breathing exercises, and medical marijuana.

The prognosis for ALS is poor and few patients live beyond five years with the disease, although there are notable exceptions. Physicist Stephen Hawking lived for more than half a century with ALS, but his case was an anomaly.

What has current research told us about how cannabis may be able to improve the quality, or even the quantity, of life for patients with ALS?

Research Overview

Research has been encouraging in the treatment of ALS with cannabis with a number of studies and clinical trials leading the way.

(Photo via Andrei_R/Shutterstock)

The Studies

A 2010 study published in the American Journal of Hospice and Palliative Care found that cannabis was effective in addressing issues associated with ALS. Researchers described the powerful antioxidative, anti-inflammatory, analgesic, appetite-stimulating, muscle relaxing, and neuroprotective properties of cannabis. All of these properties could pertain to symptom management of ALS, according to the authors of the study. In addition, delayed onset and slower disease progression were observed in mice with ALS. Based on all these findings, researchers made a strong recommendation for clinical trials of cannabis to treat ALS.

In 2016, a literature review published in the journal Neural Regeneration Research expanded on the claims of the 2010 study. The authors of the review concluded that “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.” However, they did note the need for studies performed on humans and targeted clinical trials.

One such clinical trial is presently under way at the Gold Coast Hospital and Health Service in Queensland, Australia. The trial involves 30 participants with ALS or MND. The patients will alternately be treated with CBD oil or a placebo and the study is estimated to wrap up in January 2021.

These research studies and trials have paved the way for some ALS patients to integrate cannabis into their therapeutic treatments.

Patient Perspectives

Just before his 40th birthday, Sam Jundef of Marlboro, New Jersey, was diagnosed with ALS. In the four years since his diagnosis, the once-athletic father of two cannot move, speak, or breathe without assistance. Sam has gained some relief from vaping marijuana, but the process is arduous and involves disconnecting his ventilator.

Because of these challenges, Sam and his wife, Jessica, have been fighting for access to transdermal medical marijuana patches in New Jersey. Jessica lamented to New York City’s WPIX-TV in 2018 that, “He’s 43 years old. He can’t walk. He can’t talk. He can’t eat. He can’t breathe on his own and, like, why can’t we provide things for him that are going to make his life easier? Why should my husband, who has ALS, who’s dying, whose every day is precious, why should he have to suffer a minute?”

There may be good reason why ALS patients and their loved ones are battling for legal access to cannabis medicine. Cathy Jordan, a retired resident of Parrish, Florida, has been living with ALS since 1986. With an average survival rate for ALS patients falling between two and five years, Cathy’s longevity is exceptional. She credits medical marijuana with stopping ALS in its tracks. Cathy chronicled her journey in Florida Food & Farm in 2017: “I turned 36 on New Year’s Day 1986. But during that first week, I knew I had ALS. I was hoping beyond hope I didn’t have ALS. I started choking on my own saliva. I didn’t want to end my life like that.”

Then, in 1989, Jordan turned to medical marijuana and her life changed: “I smoked my first Myakka Gold. I’m convinced that whatever was in that pot stopped my disease.”

Jordan’s survival story is an unusual one but may provide hope to some ALS patients who have tried other treatments that have failed. What do the experts have to say about cannabis as a treatment for ALS?

(Photo via bubutu/Shuttershock)

What the Experts Say

Dr. Dale J. Lange, Chairman of Neurology, Neurologist-in-Chief, and Professor of Neurology at Weill Medical College of Cornell University in New York, has initiated a clinical trial to test the effects of cannabis on ALS. Lange told HuffPost in 2015: “I am very interested in looking into the effects of high CBD/low THC in patients with ALS and UMN predominant motor system disease.”

That eminent professionals in the field such as Lange are probing the possibilities is a hopeful sign, but there is much more work to be done to ensure legal access for patients in need.

The Bottom Line

A burgeoning body of evidence indicates that cannabis could work as part of a comprehensive treatment plan for patients with ALS.

Featured Image illustrated by Allena Braithwaite/Weedmaps

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