Amytrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a rapidly progressive, invariably fatal neurological disease that attacks the nerve cells (neurons) responsible for controlling voluntary muscles (muscle action we are able to control, such as those in the arms, legs, and face). The disease belongs to a group of disorders known as motor neuron diseases, which are characterized by the gradual degeneration and death of motor neurons.

What are motor neurons?

Motor neurons are nerve cells located in the brain, brain stem, and spinal cord that serve as controlling units and vital communication links between the nervous system and the voluntary muscles of the body. Messages from motor neurons in the brain (called upper motor neurons) are transmitted to motor neurons in the spinal cord (called lower motor neurons) and from them to particular muscles. In ALS, both the upper motor neurons and the lower motor neurons degenerate or die, and stop sending messages to muscles. Unable to function, the muscles gradually weaken, waste away (atrophy), and have very fine twitches (called fasciculations). Eventually, the ability of the brain to start and control voluntary movement is lost.

ALS causes weakness with a wide range of disabilities. Eventually, all muscles under voluntary control are affected, and individuals lose their strength and the ability to move their arms, legs, and body. When muscles in the diaphragm and chest wall fail, people lose the ability to breathe without ventilatory support. Most people with ALS die from respiratory failure, usually within 3 to 5 years from the onset of symptoms. However, about 10 percent of those with ALS survive for 10 or more years.

Although the disease usually does not impair a person’s mind or intelligence, several recent studies suggest that some persons with ALS may have depression or alterations in cognitive functions involving decision-making and memory.

ALS does not affect a person’s ability to see, smell, taste, hear, or recognize touch.

Medication for ALS

There is no cure cure for ALS. The only FDA-approved pharmaceutical treatment for ALS is Riluzole, and is not effective in all patients. Side effects include gastrointestinal difficulty and impaired liver function, often leading to a host of other pharmaceuticals needed to treat the side effects.

Riluzole is a benzothiazole. Exactly how riluzole works is not known. It may prevent further damage to certain brain cells (motor neurons) responsible for controlling muscle function. It is used for treating patients with amyotrophic lateral sclerosis to prolong survival and/or to delay the need for surgery to help breathing (tracheostomy). On average, with use of Riluzole, life is prolonged by 5 months.

Medical Marijuana and ALS

Preclinical trials show that cannabinoids may be effective in treating both the progression of ALS and associated symptoms of pain and appetite loss.

The Process

Clinical trials are necessary to determine methodology associated with the cannabinoid treatment of ALS.

Human clinical studies on THC-only Cannabis are limited by sample size. Research regulations for clinical use of THC also make it difficult to recruit ALS patients in a timely manner for a controlled study. Despite these significant obstacles, two human studies have been conducted.

One of the studies, was a pilot study investigating the safety and tolerability of THC in ALS patients (Gelinas/ABood 2002). This clinical study confirmed symptomatic benefits for appetite, insomnia, and spasticity.

The seconds research study was conducted as an anonymous survey in 80 countries, 131 surveys were completed, and the mean age 54. Participants reported that Cannabis helped provide relief from drooling, speech and swallowing difficulty, appetite loss, weakness, shortness of breath, spasticity, depression, and pain (Amtmann D 2004).

In animals with ALS, THC administered either before or after the onset of the disease delayed motor impairment and prolonged survival. Furthermore, THC potently reduced oxidative and excite-toxic damage in spinal cord cultures in vitro (Raman et al. 2004). The protective effects of cannabinoids and their anti-spastic effects in MS are well known (Carter 2001). Furthermore, cannabinoid receptors are up-regulated in human tissue during disease progression, making them an abundant target for treatment.

The benefits of Cannabis to treat ALS is prevalent in anecdotal evidence, but basic laboratory and animal research suggests that THC may be the first naturally occurring, non-toxic, anti-oxidant to slow the progressions of the disease significantly. In addition to delaying the progression of disease and increasing life-span cannabinoids treatments may offer other benefits include sleep induction, appetite stimulation, saliva reduction, bronchodilation, analgesia, and muscle relaxation (Carter).

The Patient

The American Journal of Hospice and Pallative Medicine has been making the case for clinical trials studying ALS and cannabis, but these have yet to see the light of day.

With respect to the treatment of ALS, from both a disease modifying and symptom management viewpoint, clinical trials with cannabis are the next logical step. Based on the currently available scientific data, it is reasonable to think that cannabis might significantly slow the progression of ALS, potentially extending the life expectancy and substantially reducing the overall burden of the disease.

Researchers from the California Pacific Medical Center released findings in 2004 that displayed successful administration of THC in animals before and after the onset of ALS symptoms, showing a decrease in both disease progression and associated symptoms. Other studies have shown blocking the CB1 cannabinoid receptor to extend the life span of animal models with ALS.

Bob Strider began experiencing the symptoms of ALS in 1998, specifically the loss of function in his right arm and problems swallowing. An avid cannabis enthusiast, he had used cannabis heavily for decades, which he believes has kept the progression of his disease slow but steady. In 2012, Strider began manufacturing his own cannabis oils, dosing himself with approximately a gram a day for 60 days. Within 10 days of his regimen, he regained control of his right arm and was able to stop using opiates to manage his pain.

Cathy Jordan, a woman with ALS, has used cannabis to relieve numerous symptoms and has now been alive for more than 25 years since her diagnosis.

In 1985 a vibrant woman by the name of Cathy Jordan was busy painting a trailer and getting ready for the Kentucky Derby, when her finger locked up so tight her husband couldn’t pry it open from her hand. She was a hair dresser who was used to using her hands, and was forced to retire. In 1986 she was diagnosed with ALS, also known as Lou Gehrig’s disease at the age of only 36 years old. In 1989 while vacationing in Florida she happened to use cannabis. While using cannabis she realized her disease had stopped. When she told her Doctors that her disease had stopped, they thought she had a form of dementia, and was not handling her demise from ALS very well. Since then, she has been using cannabis and wants people to know that people are dying from Lou Gehrig’s disease, yet there is a natural plant that is non-toxic, and it works. That plant is cannabis, also known as marijuana. The marijuana plant eases the symptoms of Lou Gehrig’s disease, and for Cathy Jordan it stopped the progression of ALS.

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