To describe cannabis use in subjects with MS and spasticity.

Spasticity affects over 80% of people with MS, impacting activity, participation and quality of life. 2014 AAN systematic reviews found pharmaceutical cannabinoids (oral or oral-mucosal spray containing tetrahydrocannabinol [THC] with or without cannabidiol [CBD]) have strong (Level 1) evidence for reducing patient-reported spasticity. These products are not available in the US, but marijuana is medically (1998) and recreationally (2014) legal in Oregon. Here we describe cannabis use in subjects in Portland, Oregon, with MS and self-reported spasticity enrolling in a randomized controlled trial of education and exercise for spasticity.

At baseline subjects report cannabis use, the route of administration, frequency of use and perceived benefits. They also reported use of prescribed medications for spasticity. Here we report data from the first 29 subjects, with an additional 40-50 subjects to be reported at the meeting.

31% (9/29) reported using cannabis. Of these, 11% (1/9) reported topical use only, all others used multiple routes of administration including topical 78% (7/9), edibles 67% (6/9), or smoking, vaping and/or tinctures 33% (3/9). All subjects reported using cannabis at least once per week: 56% (5/9) used once per day or less and 44% (4/9) used more than once per day. All subjects reported cannabis being somewhat or very helpful for pain and 78% (7/9) reported similar benefit for spasticity. 89% (8/9) reported also using a prescribed medication for spasticity, with 67% (6/9) using 10-60 mg of baclofen per day.

Where both medical and recreational marijuana are legal, but pharmaceutical cannabinoids are not available and cannot be prescribed, approximately 1/3 of people with MS and spasticity report using cannabis. Most use cannabis by multiple routes of administration, find cannabis somewhat to very helpful for both spasticity and pain and are also using prescribed antispasticity medications.