Real world" experience of medical marijuana in symptomatic management of multiple sclerosis and transverse myelitis

Objective: Investigate the use and effects of medical marijuana (MM) in symptomatic management of multiple sclerosis (MS) and transverse myelitis (TM). Background: The effects of cannabis derivatives on neurologic symptoms have been investigated with variable outcomes. The New York State Medical Marijuana Program (NYSMMP) was created in December 2015, allowing registered practitioners to certify patients for MM that is neither covered by insurance nor subsidized. Qualifying symptoms and conditions include pain and spasticity secondary to MS and spinal cord damage. Limited information exists to guide certifying physicians regarding the “real world” utilization and effects of MM. Design/Methods: We conducted a cross sectional study among patients from the University of Rochester MS Center diagnosed with MS or TM enrolled in the NYSMMP. Subjects completed a survey reporting their experience with MM certification, usage, and effects. Results: Fourteen subjects (13 with MS, 1 with TM) completed the survey. Nearly all certified subjects (93%) tried MM; 77% continued it and 62% used it daily or more. Formulations used included oil (85%), pills (46%) and vapor pens (15%) with a relatively even distribution in tetrahydrocannabinol/cannabidiol (THC/CBD) concentrations. The majority of subjects (77%) found MM helpful in managing symptoms, primarily spasticity and pain, and reported no side effects. More than half (70%) felt their quality of life improved with MM, and some patients reduced other symptomatic medications. Most subjects estimated a monthly cost of $100–300. Cost was reported as a factor for discontinuation or less frequent use. Conclusions: MM appears to have a role in symptomatic management of MS and TM through both direct symptom relief and reduction in other medications. The variability in effectiveness of MM formulations and concentrations suggests the need for physician and patient flexibility to achieve desired responses. Improving affordability may increase patient benefit. Additional survey responses will likely decrease bias and expand preliminary findings. Disclosure: Dr. Gyang has nothing to disclose. Dr. Hyland has nothing to disclose. Dr. Samkoff has nothing to disclose. Dr. Goodman has nothing to disclose.