Muscular Dystrophy – Medical Marijuana Research Overview
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Muscular dystrophies are a group of genetic diseases characterized by progressive muscle weakness and degeneration that primarily affect young boys. Studies have shown that marijuana helps reduce the pain and involuntary muscle contractions associated with the disease.
Overview of Muscular Dystrophy
Muscular dystrophy is a collection of genetic diseases that progressive degeneration of the skeletal muscles. The cause of muscular dystrophy is a defective gene, which is sometimes inherited, that causes damaged muscle fibers and muscle weakness.
There are many types of muscular dystrophy. The most common one is Duchenne muscular dystrophy, which accounts for about half of muscular dystrophy cases and typically affects boys, with symptoms of frequent falling, muscle pain and stiffness and waddling gait commonly appearing between the ages of 2 and 3. Myotonic is the most common type of muscular dystrophy that affects adults, and it is characterized by an inability to relax muscles after they contract. Other types of muscular dystrophy include Becker, Fascioscapulohumeral, Congenital, Emery-Dreifuss and Limb-girdle.
With muscular degeneration come additional complications like the inability to walk, contractions, breathing problems, scoliosis, and heart problems and swallowing problems.
While there is no cure for muscular dystrophy, treatment can help to manage the disease’s associated symptoms and slow its progression. Corticosteroid medications and exercising helps to improve muscle strength and slow the disease’s progression.
Findings: Effects of Cannabis on Muscular Dystrophy
Cannabis can help those with muscular dystrophy to manage the pain and involuntary muscle tightness commonly associated with the disease.
Two major cannabinoids found in cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD), effectively lower pain because they activate the two main cannabinoid receptors (CB1 and CB2) of the endocannabinoid system within the body. These receptors regulate the release of neurotransmitter and central nervous system immune cells to manage pain levels (Woodhams, Sagar, Burston & Chapman, 2015). Cannabis has even been found to significantly improve neuropathic pain in patients who had previously attempted to treat their discomfort with more conventional methods (Wilsey, et al., 2013). One study found that smoking cannabis three times daily for five days reduced the intensity of chronic pain and improved sleep (Ware, et al., 2010).
Along with pain, muscle spasm (involuntary muscle tightness) is the most common reason that medical cannabis is recommended and prescribed by medical professionals (Borgelt, Franson, Nussbaum & Wang, 2013). Evidence suggests that, like pain, cannabinoid-induced reductions in muscle tremors and spasticity are due to the activation of the CB1 and CB2 receptors (Pertwee, 2002). Studies have demonstrated that medical cannabis offers significant improvements in muscle spasticity, both in mice trials and in human subjects (Borgelt, Franson, Nussbaum & Wang, 2013) (Baker, et al., 2000).
States That Have Approved Medical Marijuana for Muscular Dystrophy
Currently, just Illinois, Louisiana, New Hampshire and New Jersey have approved medical marijuana specifically for the treatment of muscular dystrophy.
A number of other states, however, will consider allowing medical marijuana to be used for the treatment of muscular dystrophy with the recommendation of a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
In addition, 16 states have approved medical marijuana for the treatment of spasms (contractions/tightness), which can be a symptom associated with Myotonic and Emery-Dreifuss muscular dystrophies. These states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Maryland, Michigan, Minnesota, Montana, Nevada, New Hampshire, Oregon, Rhode Island and Washington. Several states have approved medical marijuana specifically to treat “chronic pain.” These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island and Vermont. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have approved cannabis for the treatment of “intractable pain.”
Recent Studies on Cannabis’ Effect on Muscular Dystrophy
- Cannabis significantly improved neuropathic pain that had resisted previous conventional treatments.
Low-dose vaporized cannabis significantly improves neuropathic pain.
- THC treatments reduced muscle tremors and spasms experienced in mice.
Cannabinoids control spasticity and tremor in a multiple sclerosis model.
Baker, D., Pryce, G., Croxford, J.L., Brown, P., Pertwee, R.G., Huffman, J.W., and Layward, L. (2000, March 2). Cannabinoids control spasticity and tremor in a multiple sclerosis model. Nature, 404(6773), 84-7.
Borgelt, L.M., Franson, K.L., Nussbaum, A.M., and Wang, G.S. (2013, February). The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy, 33(2), 195-209.
Muscular dystrophy. (2014, November 27). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/muscular-dystrophy/basics/definition/con-20021240.
NINDS Muscular Dystrophy Information Page (2015, September 24). National Institute of Neurological Disorders and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/md/md.htm.
Pertwee, R.G. (2002, August). Cannabinoids and multiple sclerosis. Pharmacology & Therapeutics, 95(2), 165-74.
Ware, M.A., Wang, T., Shapiro, S., Robinson, A., Ducruet, T., Huynh, T., Gamsa, A., Bennett, G.J., and Collet, J.P. (2010, October 5). Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. Canadian Medical Association Journal, 182(14), E694-701.
Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., and Donaghe, H. (2013, February). Low-dose vaporized cannabis significantly improves neuropathic pain. Journal of Pain, 14(2), 136-48.
Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role of the endocannabinoid system in pain. Handbook of Experimental Pharmacology, 227, 119-43.
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