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Multiple Sclerosis

Medical Marijuana for Multiple Sclerosis: Research, Evidence & How to Qualify

Medical disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making changes to your treatment plan. Medical marijuana laws vary by state — verify the rules in your jurisdiction before proceeding.

Introduction

Of all the neurological conditions for which medical cannabis is used, multiple sclerosis (MS) has one of the strongest and most consistent bodies of clinical evidence. Unlike many areas of cannabis medicine where the research is still catching up to patient experience, MS has been studied in properly designed randomised controlled trials, systematic reviews, and meta-analyses involving thousands of patients — and has produced an approved cannabis-based pharmaceutical that is prescribed in over 30 countries.

That drug — nabiximols (Sativex), a standardised oromucosal spray containing THC and CBD in a 1:1 ratio — is approved across Europe, the UK, Canada, and numerous other countries for the treatment of moderate-to-severe MS spasticity that has not responded adequately to conventional treatment. While nabiximols does not yet carry FDA approval in the United States, its evidence base directly informs how American MS patients and physicians approach medical cannabis.

For the more than 1 million Americans living with MS — and the 60–84% of them who experience spasticity or pain at some point in their disease — medical cannabis represents one of the most evidence-supported symptomatic treatment options available outside of disease-modifying therapies (DMTs).

This article explains what MS is, how the endocannabinoid system is specifically altered in MS, what the clinical trials and real-world studies show, which symptoms respond best to cannabinoid treatment, and how MS patients can legally access medical marijuana in the United States.

What Is Multiple Sclerosis?

Multiple sclerosis is a chronic, immune-mediated inflammatory disease of the central nervous system (CNS) characterised by demyelination — the destruction of the myelin sheath that insulates nerve fibres and enables rapid, efficient electrical signal transmission. When myelin is damaged or destroyed, nerve signals slow, distort, or fail to transmit at all, producing the wide range of neurological symptoms that characterise MS.

The disease is not limited to demyelination. Progressive axonal damage — the loss of the nerve fibres themselves — underlies the irreversible disability that accumulates in many patients over time and is now recognised as central to disease progression, even in early stages.

Types of MS

MS presents in several distinct patterns:

  • Relapsing-Remitting MS (RRMS) — the most common form, affecting approximately 85% of newly diagnosed patients. Characterised by clearly defined relapses (also called flares or attacks) with periods of partial or complete recovery between them.
  • Secondary Progressive MS (SPMS) — follows an initial relapsing-remitting course in many patients, transitioning to a phase of gradual worsening with or without relapses.
  • Primary Progressive MS (PPMS) — characterised by gradual, continuous worsening from disease onset, with no distinct relapses. Affects approximately 10–15% of MS patients and has been historically more difficult to treat.
  • Clinically Isolated Syndrome (CIS) — a first episode of neurological symptoms suggesting demyelination; may or may not progress to MS.

Who it affects and the scale of the condition

  • MS affects approximately 2.3 million people worldwide and over 1 million Americans (ASRA Pain Medicine News, 2024)
  • It is the most common neurological disorder in young adults, with diagnosis typically occurring between ages 20 and 50
  • Women are affected at a ratio of approximately 3:1 compared to men
  • MS is the leading cause of non-traumatic neurological disability in young adults in North America and Europe
  • There is currently no cure for MS; treatment focuses on modifying disease progression and managing symptoms

Symptoms

MS produces a remarkably broad and variable spectrum of symptoms, depending on which areas of the CNS are affected by lesions. Common symptoms include:

  • Spasticity and muscle stiffness — one of the most prevalent and disabling symptoms, affecting 54–84% of patients
  • Chronic pain — neuropathic, musculoskeletal, and spasm-related pain affects 60–84% of MS patients and significantly reduces quality of life
  • Fatigue — described by many patients as their most disabling symptom
  • Bladder and bowel dysfunction
  • Tremor and coordination problems (ataxia)
  • Cognitive difficulties — affecting memory, processing speed, and attention
  • Depression and anxiety — occurring at significantly higher rates than in the general population
  • Visual disturbances — including optic neuritis
  • Sleep disturbance

The Endocannabinoid System in Multiple Sclerosis

The connection between the endocannabinoid system (ECS) and MS is one of the most thoroughly investigated in the field of cannabis medicine. It operates on multiple levels — symptom management, anti-inflammatory activity, and potential neuroprotection — making it uniquely relevant compared to most other conditions.

ECS dysregulation in MS

Research published in key neuroscience journals has demonstrated that the ECS is specifically dysregulated in MS patients. A landmark study measuring endocannabinoid levels in MS patients and healthy controls found that anandamide (AEA) — a primary endocannabinoid — was elevated in the cerebrospinal fluid of patients with relapsing MS, suggesting the ECS is actively upregulated in response to neuroinflammation as a compensatory mechanism (Maccarrone et al., 2004).

Further work examining post-mortem brain tissue from MS patients found CB1 receptors expressed by cortical neurons, oligodendrocytes (the cells that produce myelin), oligodendrocyte precursors, macrophages, and T lymphocytes, while CB2 receptors were present in T cells, astrocytes, and microglial cells within active lesions. This distribution is not incidental — it places cannabinoid receptors precisely where MS pathology occurs (reviewed in Biomedicines, 2022).

Critically, endocannabinoid levels in cerebrospinal fluid were found to be lower in RRMS and SPMS patients compared to controls, and lowest in SPMS — the more advanced, progressive form of the disease. This suggests that as MS progresses, the ECS becomes increasingly unable to mount its compensatory anti-inflammatory response, providing a compelling rationale for exogenous cannabinoid supplementation.

Three ways cannabinoids may benefit MS patients

1. Symptomatic relief — spasticity and pain CB1 receptors are expressed abundantly in the spinal cord’s motor circuits and in brain regions controlling muscle tone. Activation of these receptors reduces the excessive excitatory drive that produces spasticity — the involuntary muscle stiffness, spasms, and cramping that are among MS’s most disabling features. Cannabinoids limit the release of neurotransmitters from presynaptic terminals, reducing the hyperexcitable neuronal state that drives spasticity and neuropathic pain (PMC, 2024).

2. Anti-inflammatory activity CB2 receptors are expressed on immune cells — T lymphocytes, macrophages, and microglia — that drive the neuroinflammatory cascade in MS. Activation of CB2 receptors modulates cytokine production, reduces inflammatory signalling, and influences immune cell migration into the CNS. Both THC and CBD have demonstrated anti-inflammatory properties in preclinical MS models. The concept of cannabinoids as disease-modifying symptomatic treatments (DMSTs) — agents that simultaneously address symptoms and the underlying inflammatory mechanisms — has been formally proposed by a group of Italian MS specialists (PMC, 2025).

3. Neuroprotective potential Perhaps most intriguing is the emerging evidence that cannabinoids may protect neurons and oligodendrocytes from the damage that drives irreversible disability in MS. Preclinical studies in experimental autoimmune encephalomyelitis (EAE) — the standard animal model of MS — have demonstrated that cannabinoids reduce axonal damage, support myelin integrity, and exert anti-apoptotic effects on oligodendrocytes. While these neuroprotective effects have not yet been definitively demonstrated in large-scale human clinical trials, they represent a compelling area of ongoing research.

The Clinical Evidence: What the Research Shows

The CAMS trial — landmark UK study

The Cannabinoids in Multiple Sclerosis (CAMS) study, published in The Lancet (Zajicek et al., 2003), was the first large-scale randomised controlled trial examining cannabis for MS. The study enrolled 657 patients across the UK and compared oral THC (dronabinol), whole-plant cannabis extract (CBD + THC), and placebo over 15 weeks.

While the primary outcome — measured spasticity using the Ashworth scale — did not reach statistical significance, patients in the active treatment groups reported significantly greater subjective improvements in spasticity, pain, sleep, and muscle spasms. Crucially, objective mobility also improved significantly in both treatment groups. The trial prompted substantial further research and highlighted the importance of patient-reported outcomes in MS spasticity assessment — the Ashworth scale, a clinician-rated measure, is now recognised as less sensitive to the aspects of spasticity that cannabinoids most effectively address.

Nabiximols (Sativex) — the most extensively studied cannabinoid medicine in MS

Nabiximols is a standardised whole-plant cannabis extract delivered as an oromucosal spray, containing THC and CBD in a 1:1 ratio. It has been subjected to more rigorously designed clinical trials than any other cannabinoid medicine in MS.

Meta-analysis of RCTs (Kleiner et al., Current Neuropharmacology, 2023): A systematic review and meta-analysis published in Current Neuropharmacology examined all randomised, placebo-controlled trials of nabiximols for MS-related refractory spasticity. The analysis concluded that nabiximols significantly outperforms placebo on responder rates — the proportion of patients achieving clinically meaningful spasticity improvement. The review supported nabiximols as an effective add-on therapy for patients with moderate-to-severe MS spasticity that has not responded to conventional first-line treatments.

Meta-analysis of three pivotal trials (Wade et al.): A combined analysis of 666 MS patients across three placebo-controlled RCTs found nabiximols produced a statistically significant reduction in spasticity scores (adjusted mean NRS reduction of −1.30 versus −0.97 for placebo; treatment difference −0.32, 95% CI −0.61 to −0.04, p = 0.026). Patients defined as “responders” — achieving ≥30% improvement from baseline — were significantly more common in the nabiximols group.

Real-world German study (Haupts et al., Neurodegenerative Disease Management, 2024): A prospective, multicenter, open-label 12-week study of 51 adult MS patients prescribed nabiximols in real-world clinical practice in Germany found that the mean goal attainment scale score — a patient-centred outcome measuring achievement of individualised treatment goals — increased by 46% from baseline to week 12 (35.2 vs 51.4; p < 0.001). Mean gait speed improved by 23% at both 4 and 12 weeks. Clinically meaningful improvements were recorded in spasticity, pain, sleep quality, and urinary bladder dysfunction. Notably, 90.7% of patients showed clinically significant spasticity improvement (≥20% NRS improvement) after just 4 weeks.

Real-world e-registry analysis (spasticity-plus syndrome): A real-world analysis examining nabiximols through the lens of the newly described “spasticity-plus syndrome” — the concept that spasticity in MS often presents in clusters with pain, bladder dysfunction, sleep disturbance, and mood disorders through shared pathophysiology — found that nabiximols reduced the baseline mean spasticity score by 24.6% at week 4 and 33.9% at 18 months in treatment continuers, while also resolving a range of associated symptoms.

Long-term safety (Martinez-Paz et al., 2023): Observational studies suggest that the spasticity benefits of nabiximols may persist for at least 12 months of continuous treatment, addressing concerns about long-term tolerability.

Broader cannabis for MS spasticity — systematic review and meta-analysis (Clinical Therapeutics, 2025)

A comprehensive systematic review and meta-analysis published in Clinical Therapeutics in 2025 evaluated nine clinical trials involving 2,544 MS patients and examining cannabis-based therapies for MS-related spasticity. Cannabinoid therapies studied included whole-plant extracts, oils, and smoked cannabis containing THC and/or CBD. The analysis found consistent evidence supporting cannabis-based therapies for MS spasticity reduction across the included trials.

Retrospective real-world review (PMC, 2023)

A retrospective review of 141 MS patients receiving medical cannabis for symptom management at a neurology outpatient clinic, published in PMC (2023), found that patients experienced extensive MS symptom improvement after initiating medical cannabis:

  • 72% of patients reported alleviation of pain
  • 48% of patients reported alleviation of spasticity
  • Improvements in sleep quality were also documented

The study also recorded changes in concurrent medications, adverse events, and changes in cognition and mobility, providing a comprehensive real-world profile of cannabis use in clinical MS practice.

The Utah Center for Medical Cannabis guidance

The Utah Center for Medical Cannabis, which produces evidence-based guidance for state-licensed prescribers, assigns “substantial evidence” to the conclusion that cannabis and cannabinoids are effective in improving patient-reported MS spasticity symptoms via oral cannabinoids — the highest evidence rating in its framework. For neuropathic pain in MS patients, the center assigns “moderate evidence” of efficacy.

The CANSEP trial — ongoing

The CANSEP trial (Efficacy of cannabinoids compared to the current standard treatments on symptom relief in persons with MS) is an active, five-year randomised clinical trial that began enrolling patients in November 2022 and had randomised 41 of a target 50 participants by May 2024. The trial will compare cannabinoids directly to standard MS symptom treatments, generating the head-to-head comparative data currently missing from the evidence base.

The “Spasticity-Plus Syndrome” — A New Clinical Concept

One of the most clinically important developments in MS cannabinoid research is the formal recognition of what Italian MS specialists have termed the “spasticity-plus syndrome” (SPS) — the observation that spasticity in MS patients almost never occurs in isolation.

Patients with MS spasticity consistently present with clusters of associated symptoms: spasms and cramps, neuropathic pain, bladder dysfunction, sleep disturbance, fatigue, and mood disorders. These symptoms appear to share a common underlying pathophysiology and frequently trigger and worsen each other.

The clinical significance of this concept is that cannabinoids — which act on CB1 and CB2 receptors distributed across the nervous system, immune system, and urogenital system — may be particularly well-suited to addressing this symptom cluster simultaneously, whereas conventional single-target medications can only address individual components. A 2025 publication by the Italian DMST in MS Study Group formally proposed nabiximols as a disease-modifying symptomatic treatment — an agent that bridges the traditional distinction between symptom management and disease modification.

Which Symptoms Respond Best to Medical Cannabis?

Based on the cumulative evidence, the MS symptoms with the strongest support for cannabinoid treatment are:

Spasticity: The best-evidenced application. Multiple RCTs, systematic reviews, and meta-analyses consistently show meaningful reduction in patient-reported spasticity. Most effective in patients with moderate-to-severe spasticity who have not responded adequately to conventional antispastic medications (baclofen, tizanidine).

Neuropathic pain: Moderate-to-strong evidence. Cannabinoids modulate pain processing in the spinal cord and brain through CB1 receptor activation and other mechanisms. MS patients with central neuropathic pain — one of the most challenging pain conditions to treat — often report meaningful relief.

Sleep disturbance: Documented improvements in sleep quality across multiple real-world studies. The bidirectional relationship between spasticity/pain and sleep disruption means that addressing spasticity often secondarily improves sleep.

Bladder dysfunction: Emerging evidence. CB1 and CB2 receptors are expressed in the bladder wall and urinary tract. Multiple studies including the Haupts et al. (2024) real-world German analysis reported improvements in bladder function alongside spasticity reduction.

Tremor: More limited and inconsistent evidence compared to spasticity and pain. Some patients report meaningful tremor reduction; others do not respond. Research continues.

Fatigue: Patient-reported improvement in some studies, but evidence is less consistent. The relationship between fatigue, sleep quality, pain, and spasticity means that addressing the symptom cluster may have secondary benefits on fatigue.

Cannabinoids and Products for MS

Nabiximols (Sativex) — the gold standard

For MS patients, nabiximols represents the most clinically studied and standardised cannabinoid option. The 1:1 THC:CBD ratio delivered as an oromucosal spray allows flexible dose titration and avoids the variable absorption of oral preparations. While not FDA-approved in the United States, it is available in some states through compassionate use and is widely recognised by MS neurologists.

THC-dominant products

For spasticity and neuropathic pain, THC-containing products are the most relevant cannabinoid option. CB1 receptor activation in spinal motor circuits is the primary mechanism underlying anti-spastic effects. THC can be delivered via:

  • Oromucosal spray (closest to nabiximols)
  • Oral tinctures (slower onset, longer duration — better for sustained symptom management)
  • Vaporised flower (faster onset, shorter duration — useful for acute spasm relief)
  • Capsules/edibles (longest duration, most variable absorption)

CBD for inflammation, pain, and mood

CBD contributes to MS management primarily through anti-inflammatory and anxiolytic properties rather than direct antispastic effects. It is often used alongside THC in balanced formulations, where it may also moderate some of THC’s psychoactive effects and improve tolerability.

The 1:1 ratio principle

The clinical evidence for nabiximols — a 1:1 THC:CBD product — suggests this ratio offers a useful balance of efficacy and tolerability for most MS patients. Starting with a balanced product and adjusting the ratio based on individual response and tolerance is the recommended approach for most MS patients who do not have access to nabiximols specifically.

Dosing Considerations

Dosing for MS should always be guided by a physician. Key principles drawn from the clinical trial literature:

  • Nabiximols dosing in trials: Patients typically started at 1–2 sprays per day and titrated upward over 2 weeks to an effective dose, typically 4–12 sprays per day. The approved label allows up to 12 sprays per 24-hour period.
  • Start low, titrate slowly: For dispensary products, begin with the lowest available THC dose and add one increment every 3–5 days based on response and tolerability
  • Timing matters: Evening or nighttime dosing is particularly useful for sleep-related spasticity and nocturnal spasms. Daytime dosing requires careful balance to avoid impairing cognitive function or mobility
  • Different delivery for different needs: Consider a longer-acting oral product for sustained daytime spasticity management and a faster-acting inhalation or oromucosal product for breakthrough spasms

Side Effects and Drug Interactions

Cannabis is generally well tolerated in MS patients, but specific considerations apply:

  • THC-related effects: Dizziness, dry mouth, drowsiness, cognitive effects at higher doses. These are particularly relevant for MS patients who may already have balance, coordination, or cognitive challenges — starting at very low doses is essential
  • CBD interactions: CBD is metabolised by cytochrome P450 enzymes and may interact with medications commonly used in MS, including some DMTs and antiepileptics used for neuropathic pain. Discuss with your neurologist and pharmacist before starting
  • Cognitive effects: Some DMTs and cannabis can both affect cognitive function. MS patients with pre-existing cognitive symptoms should be especially cautious with THC dose escalation
  • Driving and safety: Cannabis-impaired driving is illegal in all states. MS patients should not drive or operate heavy machinery when initiating or adjusting cannabis treatment

Does Multiple Sclerosis Qualify for a Medical Marijuana Card?

Multiple sclerosis is one of the most broadly recognised qualifying conditions for medical marijuana programs across the United States. As of 2026, MS appears on the qualifying condition list in virtually every state with an active MMJ program — often explicitly by name.

This reflects both the strength of the clinical evidence and the historical advocacy of the MS patient community, which was among the first to push for access to medical cannabis based on patient-reported benefits in the 1990s.

Step-by-step qualification

Step 1: Confirm MS is a qualifying condition in your state. In almost all states with active MMJ programs, it is listed explicitly. Use our state-by-state guide to confirm specific requirements.

Step 2: Gather your medical documentation. Records from your neurologist confirming your MS diagnosis, type (RRMS, SPMS, PPMS), current symptoms, and treatment history. Documentation of inadequate symptom control with conventional medications (baclofen, tizanidine, gabapentin) strengthens your case considerably.

Step 3: Schedule a telehealth MMJ consultation. Services including NuggMD, Leafwell, and Veriheal connect patients with state-licensed MMJ physicians via video appointment. The consultation typically takes 15–20 minutes. Bring your neurology records and be prepared to describe your most disabling symptoms and their impact on daily function.

Step 4: Receive your recommendation and register if required. Upon approval, you will receive a written physician recommendation. Depending on your state, you may need to register with the state’s patient registry before dispensary access.

Step 5: Involve your neurologist. While your MMJ card can be obtained through a telehealth provider, it is strongly advisable to inform your MS neurologist about your intention to use medical cannabis — particularly regarding potential drug interactions with your DMT and other medications. Many MS neurologists are familiar with and supportive of cannabis for spasticity management.

Frequently Asked Questions

Is medical marijuana FDA-approved for MS? No cannabis-based product is currently FDA-approved specifically for MS in the United States. Nabiximols (Sativex) — the most extensively studied cannabinoid medicine for MS spasticity — is approved in over 30 countries but has not received FDA approval. However, MS is a recognised qualifying condition for medical marijuana programs in virtually all US states with active MMJ programs, allowing legal access to cannabis-based products.

Can cannabis slow MS progression? This is one of the most important open questions in MS cannabinoid research. Preclinical studies in animal models have demonstrated neuroprotective effects of cannabinoids — protection of axons and oligodendrocytes from the damage that drives irreversible disability. The ECS is dysregulated in MS, and cannabinoids’ anti-inflammatory and CB2-mediated immunomodulatory effects are relevant to disease pathophysiology. However, definitive evidence from large randomised controlled trials demonstrating disease-modifying effects in humans does not yet exist. This is an active area of investigation.

Will cannabis interact with my MS disease-modifying therapy? This depends on your specific DMT. CBD in particular can interact with medications metabolised by cytochrome P450 enzymes. Some DMTs share these metabolic pathways. Always discuss with your neurologist and pharmacist before beginning cannabis treatment.

Is smoked cannabis appropriate for MS? Most MS specialists and cannabis medicine physicians recommend against smoking cannabis. Vaporisation of dried flower is a safer alternative if inhalation is preferred, as it avoids combustion byproducts. For most MS patients, oromucosal sprays, tinctures, or capsules provide more consistent dosing and longer duration of action than inhalation.

Can cannabis help with MS fatigue? The evidence for cannabis specifically addressing MS fatigue is less robust than for spasticity and pain. Some patients report improved energy, possibly related to better sleep quality from spasticity reduction. However, higher doses of THC can themselves cause fatigue. If fatigue is your primary symptom, discuss with your physician whether a low-THC, CBD-dominant product might be more appropriate than a high-THC formulation.

Key Takeaways

  • Multiple sclerosis has one of the strongest evidence bases for medical cannabis of any neurological condition, supported by multiple RCTs, systematic reviews involving over 2,500 patients, and a cannabis-based pharmaceutical (nabiximols) approved in over 30 countries
  • The ECS is specifically dysregulated in MS — with cannabinoid receptors expressed on the exact cell types involved in MS pathology — providing a strong biological rationale for treatment
  • Spasticity and neuropathic pain are the symptoms with the strongest clinical evidence for cannabinoid benefit; sleep, bladder function, and mood also show improvement in real-world studies
  • The “spasticity-plus syndrome” concept explains why cannabinoids — with their broad, multi-system activity — may be particularly effective for MS compared to single-target conventional medications
  • MS qualifies for medical marijuana in virtually every US state with an active MMJ program
  • All MS patients should involve their neurologist in cannabis treatment decisions, given potential drug interactions with DMTs and the importance of coordinated care

Sources and Further Reading

  1. Kleiner, D., Horváth, I.L., Bunduc, S., et al. (2023). Nabiximols is Efficient as Add-On Treatment for Patients with Multiple Sclerosis Spasticity Refractory to Standard Treatment: A Systematic Review and Meta-Analysis of Randomised Clinical Trials. Current Neuropharmacology, 21(12), 2505–2515. https://doi.org/10.2174/1570159X21666230727094431
  2. Haupts, M.R., Essner, U., & Mäurer, M. (2024). Patient-reported benefits from nabiximols treatment in multiple sclerosis-related spasticity exceed conventional measures. Neurodegenerative Disease Management, 14(1), 11–20. https://doi.org/10.2217/nmt-2023-0040
  3. Garde, N. & Heibel, M. (2024). Effect of nabiximols oromucosal spray (Sativex®) on symptoms associated with multiple sclerosis-related spasticity: a case series. Drugs in Context, 13, 2023-10-1. https://pmc.ncbi.nlm.nih.gov/articles/PMC10881112/
  4. Howard, R., Varlotta, C., & Lynn, R.R. (2024). Cannabis in the management of multiple sclerosis-related pain and spasticity. ASRA Pain Medicine News, 49. https://doi.org/10.52211/asra110124.012
  5. Clinical Therapeutics (2025). Assessing the Role of Cannabis in Managing Spasticity in Multiple Sclerosis: A Systematic Review and Meta-Analysis. https://doi.org/10.1016/j.clinthera.2025.07.009
  6. PMC (2025). Disease-Modifying Symptomatic Treatment (DMST) Potential of Cannabinoids in Patients with Multiple Sclerosis. https://pmc.ncbi.nlm.nih.gov/articles/PMC12163502/
  7. PMC (2023). Multiple Sclerosis and Use of Medical Cannabis: A Retrospective Review of a Neurology Outpatient Population. https://pmc.ncbi.nlm.nih.gov/articles/PMC10211357/
  8. Utah Center for Medical Cannabis. Evidence-Based Guidelines: Multiple Sclerosis (reviewed 10/10/2023). https://medicalcannabis.utah.gov/evidence-based-guidelines/multiple-sclerosis/
  9. PMC (2024). Unveiling the Potential of Cannabinoids in Multiple Sclerosis and the Dawn of Nano-Cannabinoid Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC10891830/
  10. Zajicek, J.P., Fox, P., Sanders, H., et al. (2003). Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. The Lancet, 362(9395), 1517–1526. https://doi.org/10.1016/S0140-6736(03)14738-1
  11. Maccarrone, M., et al. (2004). The endocannabinoid system is dysregulated in multiple sclerosis and in experimental autoimmune encephalomyelitis. Brain, 127(11), 2436–2447. https://pubmed.ncbi.nlm.nih.gov/17626034/
  12. PMC (2022). Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination. Biomedicines, 10(3), 539. https://doi.org/10.3390/biomedicines10030539
  13. CANSEP Trial Protocol (2024). Efficacy of cannabinoids compared to the current standard treatments on symptom relief in persons with multiple sclerosis. https://pmc.ncbi.nlm.nih.gov/articles/PMC11303178/

This article was written and medically reviewed in March 2026. It will be updated as new research becomes available. For state-specific qualifying condition information, see our How to Get Your MMJ Card guide.