After five years of clinical use, THC/CBD oromucosal spray has confirmed efficacy for MS spasticity, while cannabinoid research has expanded into Alzheimer's, Parkinson's, Huntington's, and epilepsy.
Read this if you want to understand the current state of approved cannabinoid medicines and where the field is heading.
THC/CBD spray confirmed effective for MS spasticity after 5 years of clinical use
What the researchers found
This expert review assessed the state of cannabinoid therapeutics roughly five years after THC/CBD oromucosal spray (Sativex) entered clinical practice for multiple sclerosis spasticity.
For MS spasticity, clinical trials confirmed the spray's efficacy and tolerability, establishing it as the most widely used prescription cannabinoid medicine internationally. The review noted that the complexity of the endocannabinoid system is becoming better understood, with new signaling mechanisms emerging.
Beyond MS spasticity, the review cataloged active research into cannabinoids for various pain states, Alzheimer's disease, Parkinson's disease, Huntington's disease, and epilepsy. The authors emphasized that herbal cannabis contains many active ingredients, and individual cannabinoids have quite distinct biological activities requiring independent investigation.
The review called for continued characterization of individual cannabinoids in different diseases, noting that the therapeutic landscape is broader than any single cannabinoid product.
Why it matters
This review provides a practical checkpoint on cannabinoid medicine after real-world clinical experience. The confirmed efficacy of THC/CBD spray for MS spasticity validates the therapeutic approach, while the expanding research pipeline suggests many more applications may follow.
The numbers in context
THC/CBD oromucosal spray: THC:CBD ratio of 1.08:1.00. Approximately five years of clinical use across numerous countries at time of publication. Active research in pain, Alzheimer's, Parkinson's, Huntington's, and epilepsy.
How the study worked
Expert review of current data on the endocannabinoid system in relation to human diseases, focused on THC/CBD oromucosal spray as the primary clinical reference point and expanding to discuss potential future cannabinoid applications.
What this study cannot tell us
Expert review rather than systematic analysis. The neurodegenerative disease applications are still investigational. The review focuses primarily on one product (Sativex) and may not fully represent the broader cannabinoid therapeutic landscape.
How to read the evidence
Expert review drawing on clinical trial data and real-world experience. Moderate because it provides authoritative perspective but without systematic methodology.
When this study was published
Published in 2017.
The bigger picture
The success of THC/CBD spray for MS spasticity serves as a proof of concept for cannabinoid-based medicine. The expansion into neurodegenerative diseases represents a potentially transformative shift, as these conditions currently have limited treatment options.
Questions still open
- Will cannabinoid therapies for neurodegenerative diseases prove as effective as the MS spasticity application? Are combination cannabinoid products (like THC/CBD) generally superior to single-molecule approaches? How should different cannabinoids be matched to different diseases?
Common questions
What cannabinoid medicines are currently approved?
What diseases are being studied for cannabinoid treatment?
Read the original research
Cannabinoids therapeutic use: what is our current understanding following the introduction of THC, THC:CBD oromucosal spray and others?
Expert review of clinical pharmacology, 10(4), 443-455
Citation
Maccarrone, Mauro; Maldonado, Rafael; Casas, Miguel; Henze, Thomas; Centonze, Diego. (2017). Cannabinoids therapeutic use: what is our current understanding following the introduction of THC, THC:CBD oromucosal spray and others?. Expert review of clinical pharmacology, 10(4), 443-455. https://doi.org/10.1080/17512433.2017.1292849
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