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canadians with m.s. smoke cannabis despite negative side effects
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file: multiple sclerosis is a painful disease of the central nervous system in which the body’s immune system mistakenly attacks the myelin sheath that surrounds and protects nerve cells. /
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the inability of people with multiple sclerosis (ms) to accurately appraise their memory and executive function partly explains why they continue to smoke cannabis “despite objective evidence of the deleterious cognitive side effects of this behaviour,” suggests a canadian study.
supported in part by the multiple sclerosis society of canada, the study followed 40 people with m.s. for 28 days who reported smoking cannabis almost daily. with only cognitively impaired individuals taking part in the review, participants were assigned to a cannabis continuation (cc) or cannabis withdrawal (cw) group.
all subjects underwent neuropsychological tests for processing speed, memory and executive function both at baseline and day 28, as well as self-reported cognitive functioning.
investigators found no significant baseline differences between the two groups for either neuropsychological tests or self-reported cognitive functioning. on day 28, improvement was seen on all neuropsychological test measures, but only in the cw group for all indices.
even so, “all 19 participants in the cw group reverted to using cannabis on study completion despite being informed individually of their cognitive improvement.”
the reasons that participants provided for restarting use “were the same as those given for using it in the first place, namely pain, spasticity, depression, insomnia, bladder dysfunction, migraine and recreational,” authors write.
the researchers point out that cannabis use is very common among people with m.s. citing a 2017 survey hosted by the national m.s. society and the michael j. fox foundation, the results show two-thirds of respondents with m.s. were currently using cannabis, almost double the figure for those with parkinson’s disease. m.s. patients who use neurology and neuropsychiatry clinics in canada also report a high frequency of use, the study adds.
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the authors write, however, that “emerging m.s.-related data show that cannabis can cause or exacerbate cognitive dysfunction.”
people with m.s. report using cannabis to combat symptoms such as managing pain, spasticity, depression, anxiety, insomnia and fatigue, as well as to help reduce the use of prescription medications. “however, there is another factor that might explain, in part, this disconnect between the absence of objective therapeutic benefits and a subjective conviction that smoking, vaping, or ingesting cannabis is symptomatically beneficial. self-awareness may be inaccurate,” study authors note.
the findings, however, indicate “cognitive improvement was not accompanied by a self-awareness of this positive cognitive change.”
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