Cannabis and Multiple Sclerosis: Therapeutic Frontiers in Neurological Treatment
Cannabis offers a promising, research-backed approach to managing multiple sclerosis symptoms, addressing pain, spasticity, inflammation, and fatigue where conventional treatments fall short
Multiple sclerosis represents the intersection of autoimmune dysfunction, neurological deterioration and therapeutic innovation. As conventional treatments often fall short of providing comprehensive relief, cannabis has emerged as a compelling complementary option for MS patients seeking alternative symptom management.
The growing body of evidence supporting cannabis for MS treatment reflects not just medical advancement but also the gradual dismantling of decades of stigma that have limited therapeutic options for patients with few alternatives. Research increasingly demonstrates that cannabinoids may address multiple aspects of MS, from spasticity and pain to inflammation and mood disorders, with mechanisms that uniquely target both symptoms and potentially underlying disease processes.
Understanding Multiple Sclerosis: An Autoimmune Assault on the Nervous System
Multiple sclerosis represents one of medicine's most perplexing challenges, an autoimmune condition where the body's defense system mistakenly attacks the protective sheath (myelin) that covers nerve fibers. This demyelination process disrupts communication between the brain and the rest of the body, leading to a progressive deterioration of neurological function.
The damage manifests through a constellation of symptoms including mobility issues, chronic pain, cognitive dysfunction and debilitating fatigue. Currently, an estimated 2.8 million people worldwide live with MS, each experiencing a unique progression and symptom profile that complicates treatment approaches.
The conventional treatment landscape for MS has centered around disease-modifying therapies designed to slow progression and reduce relapse frequency. These medications, including interferons, glatiramer acetate and more recently, monoclonal antibodies, aim to suppress or modulate immune system activity. Corticosteroids often serve as the front-line defense during acute flare-ups, temporarily reducing inflammation and shortening the duration of attacks.
However, these traditional approaches come with significant limitations, including serious side effects, limited efficacy for symptom management and prohibitive costs that create treatment disparities among patient populations.
Cannabis enters this therapeutic landscape not as a novel intervention but as a medicine with ancient roots now experiencing scientific revival. Historical records document cannabis use for neurological conditions dating back thousands of years across diverse cultures.
The plant's medicinal potential fell victim to 20th century prohibition policies that were more reflective of racial and cultural prejudices than scientific evidence. This historical suppression of cannabis research has only recently begun to reverse as legal barriers erode and scientific interest in the endocannabinoid system expands.
The growing interest in cannabis for MS specifically emerges from both laboratory findings and compelling patient testimonials suggesting benefits beyond what conventional therapies provide.
Cannabinoids and Symptom Management: Beyond Conventional Relief
Muscle spasticity represents one of the most common and debilitating aspects of MS, affecting approximately 80% of patients during their disease course. This manifestation goes beyond simple muscle stiffness, often involving painful spasms that interfere with basic movement, sleep and quality of life.
The impact extends beyond physical limitations, as spasticity contributes to secondary complications including contractures, pressure sores and increased dependence on caregivers. Cannabis, particularly formulations containing balanced THC and CBD ratios, has demonstrated remarkable efficacy in addressing this symptom complex that conventional treatments often fail to adequately control.
Clinical trials examining Sativex (nabiximols), an oromucosal spray containing standardized THC:CBD extracts, have consistently shown significant improvements in patient-reported spasticity measures. The landmark CAMS study (Cannabinoids in Multiple Sclerosis) demonstrated that cannabis extract significantly reduced patient-reported spasticity compared to placebo.
These findings have led to regulatory approval of Sativex for MS-related spasticity in numerous countries, though notably not yet in the United States despite compelling evidence. The mechanism appears to involve THC's action on CB1 receptors in the central nervous system, modulating the hyperexcitability that contributes to spastic movements and providing relief where conventional antispasmodics have proven inadequate.
Neuropathic pain represents another hallmark of MS that significantly impacts quality of life. This type of pain, resulting from damaged nerve fibers sending incorrect signals to pain centers, affects approximately 55% of MS patients and often proves resistant to traditional pain management approaches. The nature of this pain—burning, shooting or electric-like sensations—makes it particularly distressing and disruptive to daily functioning. Cannabinoids have demonstrated particular promise in addressing this challenging symptom through multiple mechanisms of action on the pain pathway.
Studies investigating cannabinoids for neuropathic pain have shown that THC and CBD work through complementary pathways to reduce pain signaling. THC directly activates CB1 receptors in the central nervous system, altering pain perception, while CBD enhances anandamide signaling and activates other receptors involved in pain modulation, including TRPV1.
A systematic review published in the Journal of Neurology found that cannabinoids produced a significant reduction in central pain compared to placebo, with numbers needed to treat comparable to or better than conventional neuropathic pain medications but with a more favorable side effect profile. This multi-modal approach to pain management represents a significant advantage over single-mechanism conventional analgesics.
The inflammatory component of MS drives both acute relapses and chronic progression, making anti-inflammatory interventions a cornerstone of disease management. Emerging research suggests cannabinoids, particularly CBD, possess potent anti-inflammatory and potentially neuroprotective properties that could address not just symptoms but underlying disease processes.
CBD has demonstrated ability to modulate microglial activation, reduce pro-inflammatory cytokine production and potentially limit oxidative stress damage to neurons. These properties suggest cannabinoids may offer disease-modifying potential beyond symptom management, though longer-term studies are needed to confirm these effects.
Fatigue affects up to 90% of MS patients and remains one of the most treatment-resistant aspects of the disease. Unlike normal tiredness, MS-related fatigue typically worsens with heat exposure and appears disproportionate to activity level, significantly impacting employment status and social functioning. Cannabis appears to address MS fatigue through multiple pathways, including improved sleep quality, reduced pain that otherwise disrupts rest and potentially direct effects on inflammatory mediators that contribute to central fatigue.
Patient surveys consistently rank fatigue reduction among the primary benefits of medical cannabis use in MS, though controlled studies specifically targeting this symptom remain limited.
Bladder dysfunction affects up to 80% of MS patients during their disease course, manifesting as urgency, frequency, nocturia and incontinence that significantly impact quality of life and increase risk of urinary tract infections. The endocannabinoid system is now known to play a role in normal bladder function, with CB1 receptors present throughout the bladder and urethral tissues.
Clinical studies, including work published in the European Urology journal, have demonstrated that cannabis extracts can reduce incontinence episodes by nearly 25% and significantly improve bladder control measures. These improvements appear mediated through modulation of detrusor muscle activity and sensory signaling pathways that regulate micturition reflexes.
The Biological Basis: How Cannabis Works in the MS Brain and Body
The endocannabinoid system represents one of the most widespread neuromodulatory networks in the human body, yet remained largely undiscovered until research on cannabis led to its identification in the early 1990s. This complex signaling system consists of cannabinoid receptors (primarily CB1 and CB2), endogenous ligands (anandamide and 2-AG) and the enzymes responsible for their synthesis and degradation.
The endocannabinoid system plays a critical role in maintaining homeostasis across multiple physiological processes including immune function, pain sensation, mood regulation and neuroplasticity—all systems disrupted in MS pathology.
CB1 receptors predominate in the central nervous system, with particularly high concentrations in areas relevant to MS symptomatology, including the cerebral cortex, basal ganglia, cerebellum and spinal cord. These receptors modulate neurotransmitter release and synaptic plasticity, explaining the effects of cannabinoids on pain, spasticity and tremor.
CB2 receptors, while present in the CNS at lower levels, are abundantly expressed on immune cells and upregulated during inflammatory states, making them particularly relevant to the immunomodulatory potential of cannabinoids in autoimmune conditions like MS.
THC, the primary psychoactive component of cannabis, functions as a partial agonist at both CB1 and CB2 receptors, though with higher affinity for CB1. This activation pattern explains its effectiveness against spasticity and pain, as CB1 receptor stimulation decreases excessive neuronal firing and neurotransmitter release in hyperexcitable circuits.
Simultaneously, activation of CB2 receptors by THC modulates immune cell migration and cytokine production, potentially dampening the inflammatory processes driving MS progression. This dual mechanism represents a significant advantage over conventional treatments that typically target either symptoms or immune function, but rarely both simultaneously.
CBD, the non-intoxicating cannabinoid gaining increasing attention for its therapeutic potential, operates through multiple mechanisms distinct from classical cannabinoid receptor activation. Rather than directly binding CB1 or CB2, CBD modulates the endocannabinoid system indirectly by inhibiting the enzyme that degrades anandamide (FAAH), thereby increasing levels of this endogenous cannabinoid.
Additionally, CBD interacts with numerous other targets including serotonin receptors (5-HT1A), vanilloid receptors (TRPV1), nuclear receptors (PPARγ) and adenosine receptors, explaining its broad spectrum of effects relevant to MS including anti-inflammation, neuroprotection and anxiolysis.
The neuroprotective potential of cannabinoids represents perhaps their most exciting yet least established benefit for MS patients. Preclinical studies suggest cannabinoids may protect neurons from damage through multiple mechanisms including reduction of excitotoxicity, modulation of microglial activation and promotion of remyelination processes.
A study published in Brain demonstrated that CB1 receptor activation protects against excitotoxic damage in animal models of MS, while CB2 activation promotes a shift from pro-inflammatory M1 microglial phenotype to anti-inflammatory M2 phenotype. Furthermore, evidence from experimental autoimmune encephalomyelitis models suggests cannabinoids may promote oligodendrocyte survival and myelin regeneration, offering hope for not just symptom management but actual disease modification.
Clinical Evidence: Translating Laboratory Promise to Patient Benefit
The past two decades have witnessed a significant expansion in clinical research examining cannabinoids for MS, though regulatory obstacles continue to limit study design and implementation. Among the most compelling evidence comes from a 2018 systematic review published in Frontiers in Neurology, which analyzed 32 randomized controlled trials involving 3,200 participants. The analysis found moderate-quality evidence supporting cannabinoids for spasticity, pain and bladder dysfunction, with more limited but promising evidence for sleep disturbances and quality of life improvements.
The review highlighted that combinations of THC and CBD typically produced better outcomes than isolated cannabinoids, suggesting an entourage effect where multiple cannabis compounds work synergistically.
The CAMS study (Cannabinoids in MS) represents one of the largest and most rigorous investigations of cannabis in MS to date. This multicenter, randomized, placebo-controlled trial enrolled 667 patients across the UK and found that cannabis extract significantly improved patient-reported spasticity, though objective measures showed less dramatic effects.
The follow-up CAMS extension study demonstrated sustained benefits over 12 months, addressing concerns about tolerance development. These findings led directly to the development and eventual approval of Sativex in numerous countries, though the disconnect between subjective improvement and objective measures highlights the challenges in assessing outcomes for symptoms with strong perceptual components.
Beyond symptom management, early evidence suggests cannabinoids may influence disease progression itself. The CUPID trial (Cannabinoid Use in Progressive Inflammatory brain Disease) examined whether dronabinol (synthetic THC) could slow disability progression in primary and secondary progressive MS. While the primary outcome was negative, post-hoc analyses revealed potential benefits in participants with lower disability scores at baseline, suggesting timing of intervention may be critical.
More recently, experimental models have demonstrated that CBD promotes remyelination and reduces axonal loss, effects that if translatable to humans could fundamentally alter the disease course rather than just managing symptoms.
Patient-reported outcomes consistently demonstrate improvements in quality of life measures that extend beyond specific symptom relief. A comprehensive survey published in the Journal of Neurology, Neurosurgery & Psychiatry found that MS patients using cannabis reported improvements in not just physical symptoms but also psychological well-being, social functioning and overall life satisfaction. These holistic benefits often exceed what's captured in traditional clinical outcome measures focused on specific symptoms or disability scales.
Particularly notable are reports of reduced medication burden, with many patients able to decrease their use of other medications, especially opioid analgesics, antispasmodics and sleep aids, potentially reducing polypharmacy complications.
Observational studies following patients using cannabis for MS over extended periods suggest favorable long-term safety profiles. A 5-year Italian observational study of nabiximols found sustained effectiveness without significant tolerance development for most patients, with side effects generally mild and diminishing over time as patients optimized their dosing regimens.
Notably, the often-feared cognitive effects appear minimal when patients use cannabis specifically for medical purposes under supervision, with appropriate dosing and formulation selection. These findings contribute to mounting evidence that therapeutic use differs substantially from recreational patterns in terms of risk profile.
Navigating Legal, Practical and Ethical Complexities
The legal status of medical cannabis creates a patchwork of accessibility that disadvantages many MS patients. In the United States, the contradictory situation where cannabis remains federally classified as a Schedule I substance while 37 states have legalized its medical use creates significant barriers to consistent access, research funding and physician comfort with recommendation.
This federal-state conflict forces patients into legal gray areas, impeding standardized care and creating geographic treatment disparities. Even in states with medical cannabis programs, MS often receives inconsistent recognition as a qualifying condition, with approval sometimes dependent on specific symptoms rather than the underlying diagnosis.
Internationally, approaches range from highly restrictive to relatively progressive, with countries like Canada, Germany and Israel emerging as leaders in cannabis-based medicine for conditions including MS. The UK approved Sativex specifically for MS spasticity in 2010, while maintaining otherwise strict cannabis prohibition until recent reforms. These inconsistencies reflect not scientific consensus but rather varying cultural attitudes, political pressures and historical approaches to drug policy.
For MS patients, these geographical disparities may determine whether cannabis represents a viable treatment option or an inaccessible alternative, creating fundamentally unequal treatment landscapes based on jurisdiction rather than medical need.
Access challenges extend beyond legal status to practical barriers including affordability, standardization and medical guidance. Unlike conventional pharmaceuticals, medical cannabis rarely receives insurance coverage, creating significant financial burdens for patients already facing the economic impacts of a chronic disease. A month's supply of Sativex can cost upwards of $500, while other cannabis preparations vary widely in price depending on formulation and market conditions.
This financial barrier disproportionately affects lower-income patients, creating treatment disparities that reflect socioeconomic status rather than medical appropriateness. The lack of standardization across products further complicates treatment, as patients must navigate varying THC:CBD ratios, terpene profiles and delivery methods with limited medical guidance.
The ethical considerations surrounding medical cannabis for MS reflect broader tensions in medicine regarding patient autonomy, evidence standards and risk assessment. Patient advocacy groups have consistently pressed for greater access, arguing that individuals living with a chronic, incurable condition should have maximal latitude in treatment choices, particularly when conventional options have failed.
Conversely, some medical organizations have maintained stricter standards of evidence, arguing that cannabis should clear the same regulatory hurdles as other medications before widespread recommendation. This tension reflects fundamental questions about who determines acceptable risk-benefit ratios—patients experiencing MS symptoms daily or regulatory bodies applying population-level standards.
Cultural attitudes toward cannabis continue to evolve, with decreasing stigma creating more space for nuanced discussion of medical applications. However, lingering stereotypes and misconceptions still influence both policy and medical practice. The conflation of therapeutic cannabis use with recreational consumption has historically impeded research funding, physician education and public health approaches.
For MS patients, this cultural baggage can complicate discussions with healthcare providers, family members and employers, adding unnecessary psychosocial burdens to treatment decisions. Progressive policies that clearly distinguish medical use from other consumption patterns remain essential for normalizing cannabis as a legitimate treatment option.
Optimizing Administration: Finding the Right Approach
The method of cannabis administration significantly impacts onset, duration, bioavailability and side effect profiles—considerations particularly important for MS patients balancing symptom relief with functional needs. Inhalation methods, including vaporization and traditional smoking, provide rapid onset (typically within minutes) and easier dose titration, making them suitable for acute symptom management such as breakthrough pain or sudden spasticity.
However, respiratory concerns, particularly with combustion methods, and shorter duration of effect (typically 2-4 hours) represent significant limitations. For MS patients with respiratory comorbidities or requiring consistent symptom control, inhalation may prove problematic despite its advantages in rapid onset and dose control.
Oral administration methods, including edibles, capsules, oils and tinctures, offer longer duration (typically 6-8 hours) and avoid respiratory risks but present challenges in dose consistency and delayed onset (30-90 minutes typically). This pharmacokinetic profile makes oral formulations better suited for managing chronic, persistent symptoms rather than acute flares.
Tinctures and oils administered sublingually offer a middle ground, with faster onset than traditional edibles but longer duration than inhalation. For many MS patients, a combination approach proves optimal—using longer-acting oral preparations for baseline symptom control with more rapid-onset methods available for breakthrough symptoms or particular activities requiring additional relief.
Topical applications represent an underexplored but promising administration route for localized symptoms common in MS. CBD-dominant creams, balms and transdermal preparations may help address focal pain, muscle tightness and sensory abnormalities without significant systemic effects.
The mechanism appears to involve both peripheral cannabinoid receptors and direct TRPV1 action on sensory neurons. While research specifically in MS populations remains limited, anecdotal reports and preliminary studies suggest benefit for localized symptom management without the cognitive effects or drug interactions associated with systemic administration.
Finding the optimal THC:CBD ratio represents one of the most crucial aspects of cannabis therapy for MS, as these cannabinoids offer different and sometimes complementary effects. Higher THC formulations typically provide greater symptom relief for pain and spasticity but carry increased risk of psychoactive effects, which may be problematic for patients who need to maintain cognitive clarity for work or driving.
CBD-dominant preparations offer anti-inflammatory benefits with minimal intoxication but may provide less immediate symptom relief. Many patients find balanced ratios (1:1 THC:CBD) provide optimal therapeutic benefit, as CBD appears to modulate some of THC's adverse effects while preserving or enhancing therapeutic action.
The highly individualized nature of cannabis response necessitates a personalized approach to dosing that contradicts conventional pharmaceutical paradigms. Factors influencing optimal dosing include individual endocannabinoid tone, concurrent medications, symptom severity, prior cannabis exposure and even genetic factors affecting cannabinoid metabolism.
The widely recommended "start low, go slow" approach allows patients to find their minimal effective dose while minimizing adverse effects. This gradual titration typically begins with 2.5mg THC equivalent doses, increasing incrementally while monitoring both therapeutic and adverse effects. This individualized approach, while more time-intensive than standardized dosing, ultimately yields better outcomes and fewer side effects.
Understanding Risks and Limitations
Cannabis therapy, like any medical intervention, carries potential adverse effects that require careful consideration. The most common side effects include dizziness, fatigue, dry mouth, altered cognition and in some cases, mood changes or heightened anxiety. These effects appear dose-dependent and often diminish with continued use as tolerance develops to these specific effects while therapeutic benefits persist. For MS patients, cognitive effects deserve particular attention, as approximately 40-65% already experience some degree of cognitive impairment from the disease itself.
Studies suggest that lower-dose, balanced THC:CBD formulations minimize cognitive impacts while maintaining therapeutic benefit, highlighting the importance of appropriate product selection and dosing.
Long-term risks of medical cannabis use differ significantly from patterns observed in recreational contexts, particularly regarding psychological effects and dependency concerns. A systematic review published in JAMA Psychiatry found that medical cannabis users showed lower rates of problematic use patterns compared to recreational users, with dependency rates comparable to those seen with other prescribed medications rather than recreational substances.
For MS specifically, longitudinal studies following patients using cannabinoids for up to 5 years have not demonstrated significant safety concerns, though more extended data would be valuable. The therapeutic benefit-to-risk ratio appears particularly favorable compared to alternative pharmacological approaches for symptoms like spasticity and neuropathic pain, which often involve medications with significant adverse effect profiles including opioids and benzodiazepines.
Certain populations may face heightened risks from cannabis therapy and require particular caution. Patients with personal or family history of psychosis, unstable cardiac conditions or severe hepatic impairment generally face exclusion from clinical trials and may experience greater risks from cannabis exposure.
Pregnancy represents another clear contraindication given evidence of potential developmental impacts. For MS patients with significant cardiovascular comorbidities, the transient tachycardia associated with THC may prove problematic, though this effect typically diminishes with regular use. These contraindications highlight the importance of individualized assessment rather than blanket recommendations for or against cannabis therapy.
Risk mitigation strategies can significantly improve the safety profile of medical cannabis while preserving therapeutic benefit. These include selecting products with known, standardized cannabinoid content; preferring CBD-dominant or balanced formulations over high-THC products; avoiding synthetic cannabinoids which have demonstrated less favorable safety profiles; using the lowest effective dose; and maintaining open communication with healthcare providers about all treatments including cannabis.
For MS patients specifically, timing cannabis use around activities requiring full cognitive function (e.g., work, driving) and monitoring for impacts on gait stability, particularly when initiating treatment, represent important precautions for maximizing benefit while minimizing risk.
The Horizon: Research Frontiers and Future Directions
Despite growing evidence supporting cannabinoids for MS symptom management, significant knowledge gaps persist that require dedicated research attention. Optimal formulations and dosing regimens remain poorly defined, with most patients still following trial-and-error approaches rather than evidence-based guidelines. Long-term effects on disease progression—whether beneficial through neuroprotective mechanisms or potentially detrimental through other pathways—remain inadequately characterized.
The role of minor cannabinoids and terpenes, increasingly recognized as contributing to the entourage effect, requires further investigation to develop truly optimized cannabis-based medicines rather than relying primarily on THC and CBD. These knowledge gaps reflect not lack of scientific interest but rather the persistent regulatory obstacles that have limited cannabis research for decades.
Exciting developments in cannabinoid pharmacology suggest future therapeutic approaches may extend beyond plant-derived compounds to include synthetic cannabinoids designed for enhanced targeting of specific symptoms. Pharmaceutical development programs are investigating selective CB2 agonists that may offer anti-inflammatory and neuroprotective benefits without the psychoactive effects associated with CB1 activation.
Other research focuses on inhibitors of endocannabinoid degrading enzymes (FAAH and MAGL inhibitors), which boost endogenous cannabinoid levels rather than introducing exogenous compounds. These approaches aim to retain the therapeutic benefits of cannabinoid signaling while minimizing adverse effects and improving dosing precision.
Novel delivery technologies offer promise for improving cannabinoid pharmacokinetics and patient experience. Nanotechnology-based formulations enhance bioavailability and allow more precise targeting, while extended-release preparations may provide more consistent symptom control without the peaks and troughs associated with current administration methods.
Transdermal delivery systems, currently under development by several pharmaceutical companies, could provide steady-state cannabinoid levels while avoiding first-pass metabolism and respiratory concerns. These technological advances aim to address current limitations in onset timing, duration and dose consistency that complicate current cannabis therapeutics.
The research landscape for cannabis in MS reflects broader shifts in funding priorities and regulatory approaches. Federal research funding in the United States has historically focused almost exclusively on cannabis harms rather than therapeutic applications, a pattern only recently beginning to change. Simultaneously, pharmaceutical companies have demonstrated increasing interest in cannabinoid drug development as legal barriers diminish and market potential becomes apparent.
Patient advocacy has played a crucial role in shifting research priorities, with organizations like the National Multiple Sclerosis Society evolving from cautious skepticism to actively funding cannabis research. These changing dynamics suggest a more robust evidence base may emerge in coming years, though regulatory hurdles persist in many jurisdictions.
Evolving Understanding of Cannabis in MS Treatment
To be sure, cannabis and cannabinoids have emerged as valuable therapeutic options for MS patients, particularly for symptom management aspects poorly addressed by conventional treatments. The strongest evidence supports their use for spasticity, neuropathic pain and sleep disturbances, with emerging data suggesting benefits for bladder dysfunction, mood disorders and potentially even disease modification.
The multi-modal action of cannabinoids on both central nervous system function and immunological processes uniquely positions them to address the complex symptom constellation and underlying pathology of MS. As research continues to clarify optimal approaches, cannabis increasingly appears not as an alternative to conventional medicine but as a complementary component of comprehensive MS care.
The rapidly evolving legal and cultural landscape surrounding cannabis creates both opportunities and challenges for patients and healthcare providers. Decreasing stigma has created space for more nuanced, evidence-based discussions of therapeutic cannabis, while legal reforms in many jurisdictions have improved access. However, persistent regulatory obstacles impede research, standardization and integration into mainstream healthcare systems.
Moving forward involves balancing patient access with appropriate safeguards, developing better educational resources for both patients and healthcare providers, and advocating for research funding proportionate to the potential therapeutic impact.
The individualized nature of both MS and cannabis response underscores the importance of personalized approaches to treatment. No single cannabinoid formulation, dosage or administration method will prove optimal for all patients or all symptoms. Finding the right approach requires collaborative decision-making between informed patients and knowledgeable healthcare providers willing to engage with cannabis as a legitimate therapeutic option.
This personalized medicine approach, while more complex than standardized prescribing patterns, ultimately offers the best chance for optimal symptom management and quality of life improvements.
Scientific understanding of cannabis in MS continues to evolve, with substantial progress in recent years despite persistent research barriers. Ongoing clinical trials and observational studies promise to fill critical knowledge gaps regarding long-term safety, disease modification potential and optimal therapeutic approaches. Patient advocacy remains crucial in driving both research priorities and policy reforms that affect access and affordability.
As evidence accumulates and legal barriers diminish, cannabis appears likely to assume an increasingly established role in comprehensive MS management—not as a panacea but as a valuable tool in the therapeutic arsenal against this complex neurological condition.
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