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Caring for people with multiple sclerosis who use cannabis for symptom control

02 June 2019
Volume 24 · Issue 6



Research suggests that a large proportion of people living with multiple sclerosis (PwMS) are using cannabis to self-manage symptoms, or at least believe there are potential benefits in using this drug. Since community nurses are frontline caregivers, they are likely to encounter PwMS who use cannabis within the home setting. The literature base surrounding this topic is largely driven by quantitative research examining the effectiveness of cannabis as a medicine. This review found that qualitative research exploring the experiences of PwMS who use cannabis is lacking worldwide and is completely absent within UK nursing literature. PwMS using cannabis may not feel safe discussing this with health professionals, as they might fear being judged. This literature review discusses how people perceive the effectiveness of cannabis in helping symptoms associated with MS, while also considering the stigma and legal concerns people face. This review may help community nurses inform their practice and enhance person-centred relationships between them and PwMS.

Around 100 000 people in the UK live with multiple sclerosis (MS) (MS Society, 2017). MS is a neurodegenerative condition wherein the immune system attacks and breaks down the protective myelin sheath surrounding the nerve fibres (Goldenberg, 2012). This can result in varying degrees of disability. Nerve signals can become distorted, or neurotransmission may not occur at all. With increased survivorship for long-term conditions, people can live with MS symptoms for many years, and, in some cases, this results in a decreased quality of life (Kesselring, 2005; George and Martin, 2016).

Conventional treatments for MS usually include steroids and disease-modifying therapies (Chong et al, 2006; Minagar, 2013), to decrease the number and/or severity of relapses (Fox and Rhoades, 2012). The use of complementary and alternative therapies for MS is on the rise within the UK and other countries worldwide (Skovgaard et al, 2012). In a survey conducted by the MS Society, it was reported that one in five people who have MS use cannabis as a complementary therapy and as a means of self-management (MS Society, 2017). However, Sativex, a cannabis-based medication for the management of symptoms related to MS, was discontinued in the UK in 2014. The National Institute for Health and Care Excellence (NICE) recommended that doctors not offer this medication, because it is deemed not to be cost-effective. However, research does show it is effective in treating MS symptoms, such as spasticity (Serpell et al, 2013) and neuropathic pain (Russo et al, 2016).

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