How common is cannabis use among people with multiple sclerosis? | Research

The takeaway

A survey of 1,000 MS patients in Oregon and Washington found 30% currently used cannabis, with most reporting multiple routes of administration and 64-78% perceiving it as beneficial; use was more common among younger, lower-income, and more disabled patients.

MS patients considering cannabis, neurologists treating MS, and researchers studying complementary medicine use in chronic neurological conditions.

30% use cannabis; 64-78% perceive benefit

What the researchers found

30% currently used cannabis, 21% had used in the past, and 49% never used. Most current users (59%) used multiple administration routes (smoking, vaping, topicals, tinctures, edibles all at 35-46%). 64-78% of current/past users reported cannabis as beneficial for MS. Use was higher among younger patients (OR 2.24 for ages 18-40 vs >60), lower-income (OR 3.94 for <$25K vs >$100K), secondary progressive MS (OR 1.77), and greater disability.

Why it matters

With nearly a third of MS patients using cannabis and most perceiving benefit, clinicians need to proactively discuss cannabis use. The association with lower income and greater disability suggests patients with fewer resources and more severe disease are turning to cannabis, possibly due to gaps in conventional treatment access.

The numbers in context

1,000 respondents; 30% current users; 21% past users; 59% used multiple routes; 64-78% perceived benefit; use higher in younger (OR 2.24), lower-income (OR 3.94), progressive MS (OR 1.77), more disabled (OR 2.05); perceived benefit highest in most disabled (OR 17.96)

How the study worked

Cross-sectional survey of MS patients in Oregon and Southwest Washington (states with legal medical and recreational cannabis). 1,188 surveys returned, 1,000 with sufficient completion included in analysis.

What this study cannot tell us

Cross-sectional survey in two legal-cannabis states; rates may differ elsewhere. Self-reported use and perceived benefit. Selection bias: patients interested in cannabis may be more likely to complete the survey. No objective outcome measures.

How to read the evidence

Large survey with robust sample size, but cross-sectional, self-reported, and from legal-cannabis states only.

When this study was published

Published in 2021; cannabis use among MS patients likely continues to evolve with changing access and attitudes.

The bigger picture

The finding that patients not using disease-modifying therapies were more likely to perceive cannabis as beneficial raises a concern: are some patients substituting cannabis for evidence-based treatments? Alternatively, patients for whom conventional treatments failed may be more motivated to try cannabis.

Questions still open

Are MS patients using cannabis as a complement or replacement for disease-modifying therapies? Does the relationship between disability and cannabis benefit reflect genuine therapeutic effect or desperation? How do specific cannabis formulations map to specific MS symptoms?

Common questions

How many MS patients use cannabis?

In this survey from Oregon and Washington (where cannabis is legal), 30% of MS patients reported current cannabis use, 21% past use, and 49% never use.

Do MS patients find cannabis helpful?

Between 64% and 78% of current and past users reported cannabis as beneficial for their MS. The highest perceived benefit was among patients with the greatest disability (OR 17.96).

Who is most likely to use cannabis for MS?

Younger patients, those with lower income, those with progressive MS, and those with more disability were more likely to use cannabis and perceive it as beneficial.

Read the original research

A cross-sectional survey of cannabis use by people with MS in Oregon and Southwest Washington.

Multiple sclerosis and related disorders, 55, 103172

View on PubMed ↗Publisher’s paper ↗

Citation

Rice, Jessica; Hildebrand, Andrea; Spain, Rebecca; Senders, Angela; Silbermann, Elizabeth; Wooliscroft, Lindsey; Yadav, Vijayshree; Bourdette, Dennis; Cameron, Michelle. (2021). A cross-sectional survey of cannabis use by people with MS in Oregon and Southwest Washington.. Multiple sclerosis and related disorders, 55, 103172. https://doi.org/10.1016/j.msard.2021.103172