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AAN releases new CAM guidelines on MS; marijuana beneficial, other remedies fail

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  • AAN releases new CAM guidelines on MS; marijuana beneficial, other remedies fail

    This is bound to shake things up in the field of complimentary alternative medicine (CAM). The American Academy of Neurology has just released new guidelines on alternative therapies for MS and, surprise, they found most don't work or do little. Except for one: marijuana. There is evidence that the plant helps with spasticity and decreases urinary frequency. Living in New Mexico, I might need to make trips up to Colorado more frequently! Below are a few links to reports on CNN, in the LA Times, and Businessweek. I also included a link to CNN's Dr. Sanjay Gupta's article on him "doubling down" on marijuana ... and his apology for initially dismissing the plant as an effective treatment. - Dave

    Medical marijuana might be the most effective complementary or alternative medicine to provide relief of symptoms caused by multiple sclerosis (MS) according to new guidelines from the American Academy of Neurology (AAN) released Monday.

    Complementary and alternative medicines (CAM) are nontraditional therapies often used in addition to (and sometimes instead of) doctor recommended treatments.

    The guidelines are based on recommendations made by a panel of nine physicians chosen by the AAN who are experts in the field of CAM. They identified and reviewed 291 studies and literature from the last 43 years. Of those, 115 made the cut; most were short, lasting between six and 15 weeks.
    LA Times
    There is strong evidence that medical marijuana pills may reduce symptoms of spasticity and pain reported by multiple sclerosis patients, but little proof that smoking pot offers the same benefit, according to new alternative treatment guidelines released by the American Academy of Neurology.

    The guidelines on complementary and alternative medicine, or CAM, treatments for MS were published Monday in the journal Neurology and are among the first from a national medical organization to suggest that doctors might offer cannabis treatment to patients.

    Though advocates of medical marijuana use said the guidelines appeared to be part of a recent national trend in which doctors were seriously evaluating the use of cannabis, they argued that the federal government had stymied marijuana research.,2596095.story
    Marijuana, taken in pill or spray form, helps ease certain multiple sclerosis symptoms, while about a dozen other alternative remedies offer no benefit, according to a report by U.S. neurologists.

    Not enough research exists to say if smoking the drug helps in MS, according to the report.

    The pill or oral spray form of marijuana may help reduce stiffness and involuntary spasms, pain from those symptoms and frequent urination, though it doesn’t help reduce tremors, the study published today in the journal Neurology found. The results form the basis of new guidelines from the American Academy of Neurology on use of alternative therapies in MS.
    Dr. Sanjay Gupta
    (CNN) -- It's been eight months since I last wrote about medical marijuana, apologizing for having not dug deeply into the beneficial effects of this plant and for writing articles dismissing its potential. I apologized for my own role in previously misleading people, and I feel very badly that people have suffered for too long, unable to obtain the legitimate medicine that may have helped them.

    I have been reminded that a true and productive scientific journey involves a willingness to let go of established notions and get at the truth, even if it is uncomfortable and even it means having to say "sorry."

    It is not easy to apologize and take your lumps, but this was never about me.

    This scientific journey is about a growing number of patients who want the cannabis plant as a genuine medicine, not to get high.

    It is about emerging science that not only shows and proves what marijuana can do for the body but provides better insights into the mechanisms of marijuana in the brain, helping us better understand a plant whose benefits have been documented for thousands of years. This journey is also about a Draconian system where politics override science and patients are caught in the middle.

    Since our documentary "Weed" aired in August, I have continued to travel the world, investigating and asking tough questions about marijuana.

    I have met with hundreds of patients, dozens of scientists and the curious majority who simply want a deeper understanding of this ancient plant. I have sat in labs and personally analyzed the molecules in marijuana that have such potential but are also a source of intense controversy. I have seen those molecules turned into medicine that has quelled epilepsy in a child and pain in a grown adult. I've seen it help a woman at the peak of her life to overcome the ravages of multiple sclerosis.

    I am more convinced than ever that it is irresponsible to not provide the best care we can, care that often may involve marijuana.

    I am not backing down on medical marijuana; I am doubling down.
    Dave Bexfield

  • #2
    Here is the AAN report:

    Summary of evidence-based guideline: Complementary and alternative medicine in multiple sclerosis

    Report of the Guideline Development Subcommittee of the American Academy of Neurology

    Vijayshree Yadav, MD, MCR,
    Christopher Bever Jr, MD, MBA, FAAN,
    James Bowen, MD,
    Allen Bowling, MD, PhD,
    Bianca Weinstock-Guttman, MD,
    Michelle Cameron, MD, PT,
    Dennis Bourdette, MD, FAAN,
    Gary S. Gronseth, MD, FAAN and
    Pushpa Narayanaswami, MBBS, DM, FAAN

    doi: 10.1212/WNL.0000000000000250
    Neurology March 25, 2014 vol. 82 no. 12 1083-1092


    Objective: To develop evidence-based recommendations for complementary and alternative medicine (CAM) in multiple sclerosis (MS).

    Methods: We searched the literature (1970–March 2011; March 2011−September 2013 MEDLINE search), classified articles, and linked recommendations to evidence.

    Results and recommendations: Clinicians might offer oral cannabis extract for spasticity symptoms and pain (excluding central neuropathic pain) (Level A). Clinicians might offer tetrahydrocannabinol for spasticity symptoms and pain (excluding central neuropathic pain) (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity (short-term)/tremor (Level B) and possibly effective for spasticity and pain (long-term) (Level C). Clinicians might offer Sativex oromucosal cannabinoid spray (nabiximols) for spasticity symptoms, pain, and urinary frequency (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity/urinary incontinence (Level B). Clinicians might choose not to offer these agents for tremor (Level C). Clinicians might counsel patients that magnetic therapy is probably effective for fatigue and probably ineffective for depression (Level B); fish oil is probably ineffective for relapses, disability, fatigue, MRI lesions, and quality of life (QOL) (Level B); ginkgo biloba is ineffective for cognition (Level A) and possibly effective for fatigue (Level C); reflexology is possibly effective for paresthesia (Level C); Cari Loder regimen is possibly ineffective for disability, symptoms, depression, and fatigue (Level C); and bee sting therapy is possibly ineffective for relapses, disability, fatigue, lesion burden/volume, and health-related QOL (Level C). Cannabinoids may cause adverse effects. Clinicians should exercise caution regarding standardized vs nonstandardized cannabis extracts and overall CAM quality control/nonregulation. Safety/efficacy of other CAM/CAM interaction with MS disease-modifying therapies is unknown.

    Dave Bexfield


    • #3
      More on Marijuana from the AAN

      As with any drug, there are side effects, sometimes very serious. Marijuana is no different. Be informed! This from the AAN:


      • #4
        Interesting. Thanks for sharing. I live in a Washington state so this is very much a hot topic here.


        • #5
          It actually does help

          I was diagnosed 10 years ago, and my doctor believes I was born with MS. I have dealt with muscle spacticity and bladder control more as I get older. Recently, I started smoking pot again. Not a lot, and not often, and no where near the levels I did in college (didn't we all). I'm not often near a toilet while working, and have peed in many parking lots and behind many dumpsters. I've always believed if it's okay for the dudes I can do it too. This winter, however, the urgency and frequency was getting ridiculous. I smoked a little with a neighbor one night, and the urine retention and urgency have gone. When I say a little, I mean one hit, once a month.

          Many years ago I asked my neurologist if I quit drinking could I switch only to marijuana. He was very emphatic that I not resume my former ways. This was just a month before the study of cannabis on neurological disorders was published, and he was an adviser on the paper.

          If you have no qualms with occasional use, as a better alternative than the bladder control drugs on the market, many have serious side effects; and don't mind eating Doritos while high, go for it. But pot is not a cure-all, no matter what my brother-in-law says.


          • #6
            Thanks for the first person feedback, RPerry. It's likely something I'll talk to my doc about.
            Dave Bexfield


            • #7
              I'm an Indica girl!

              I live in CA and got my medical marijuana card about 1 1/2 months ago, really as a last resort to calm MS head tremors resulting from social anxiety & stress...and it is working wonders for me! I tried a bunch of different strains of marijuana (some made symptoms worse) until I found one that made me feel "normal" again! Even my friends have noticed a change for the better! Of course I have other symptoms that I'm battling, but they aren't nearly as obvious as this godawful head tremor. I was dx'd w RRMS almost 14 years ago, when I was 20...and the journey continues...good luck to everyone!