Multiple Sclerosis
Multiple sclerosis is one of the best-supported indications for medical cannabis in Europe, with Nabiximols (Sativex) specifically approved for MS-related spasticity in multiple EU countries.
Quick Reference
Nabiximols (Sativex) — The EU Approval
Nabiximols (brand name Sativex) is a 1:1 THC:CBD oromucosal spray derived from cannabis plant extract. It is specifically approved in the UK, Germany, Spain, Denmark, Sweden, Czech Republic, and several other EU countries for the treatment of spasticity in multiple sclerosis patients who have not responded adequately to other treatments. This regulatory approval represents the most clear-cut validation of cannabis-based medicine in the European context, with multiple clinical trials demonstrating significant spasticity reduction.
MS Spasticity — What the Evidence Shows
Clinical trials of Nabiximols in MS spasticity have consistently shown significant improvements. The MOVE 2 trial found 40% of patients who responded to initial Nabiximols treatment showed clinically significant improvements in spasticity NRS scores after 12 weeks. Patient-reported outcomes consistently show improvements in spasm frequency, pain, sleep disturbance and quality of life. The combination of THC and CBD appears to be more effective than either alone for spasticity, supporting the entourage effect hypothesis.
Neuropathic Pain in MS
Central neuropathic pain is a debilitating symptom affecting up to 50% of people with MS. Cannabis-based medicines have demonstrated effectiveness for MS-related neuropathic pain in multiple clinical trials. A systematic review of cannabis and MS pain found significant reductions in pain intensity and improved sleep quality. The mechanism involves THC and CBD modulating overactive pain signalling in damaged CNS pathways — the hallmark of central neuropathic pain.
Other MS Symptoms
Beyond spasticity and pain, cannabis may benefit several other MS symptoms. Bladder dysfunction: a clinical trial showed Nabiximols reduced urinary urgency and incontinence episodes. Tremor: some patients report improvement though clinical trial results are mixed. Fatigue: CBD-dominant preparations have shown benefit in some studies. Cognitive symptoms: current evidence does not support cannabis for MS-related cognitive impairment — THC may worsen some cognitive functions.
Accessing Medical Cannabis for MS in Europe
If you have MS and are interested in cannabis-based medicine, speak to your neurologist. Sativex is available on prescription in multiple EU countries for qualifying patients. In Germany, medical cannabis has been prescribable since 2017 and MS is a common indication. In Malta, medical cannabis is available through the AREC programme. The NHS in the UK covers Sativex for MS in specific circumstances. Private prescriptions and medical cannabis clinics are available in most EU countries.