Journal of Neurology

, Volume 265, Issue 2, pp 417–423 | Cite as

Attitudes, perceptions, and use of marijuana in youth with multiple sclerosis

  • J. Nicholas BrentonEmail author
  • Teri Schreiner
  • Krystle Karoscik
  • Meg Richter
  • Samantha Ferrante
  • Amy Waldman
  • Brenda Banwell
Original Communication



Studies have shown a negative impact on cognition and brain volume in marijuana-using adult multiple sclerosis (MS) patients and healthy adolescents. Given that onset of MS during childhood and adolescence negatively impacts brain growth and the normal maturation of neuronal networks, the addition of marijuana exposure in these youth may be even more harmful.


Determine attitudes toward and prevalence of recreational marijuana use in MS youth.


We surveyed 52 consecutive pediatric-onset MS patients from three pediatric MS centers in the United States. Participants answered a structured questionnaire to capture attitudes toward marijuana and personal use habits, if present.


Nearly half reported use of marijuana, with the majority beginning to use in mid-to-late adolescence. The most popular reasons for using marijuana were relaxation (72%), improvement of medical problems (64%), and stress reduction (52%). Over half (64%) of marijuana users perceived it to have negative effects on memory and focus. Cost and access were not barriers to use, despite all respondents being less than age 21.


Youth with MS endorse recreational marijuana as safe, and many use marijuana frequently despite appreciating a negative impact on memory. More detailed understanding of the long-term impact of marijuana use in youth with MS is needed.


Cannabis Marijuana Multiple sclerosis Pediatric Adolescent 



The authors thank Amy Lavery, Gerry Liu, and Brooke Henry for assistance in study initiation and recruitment. We would also like to thank Isabella Dumitrescu for her assistance in creating the questionnaire employed in this study.

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standard

This study was approved by the appropriate ethics committees and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

Supplementary material

415_2017_8715_MOESM1_ESM.docx (691 kb)
Supplementary material 1 (DOCX 22 kb)


  1. 1.
    Johnston LD, O’Malley PM, Miech RA, Bachman JG, Schulenberg JE (2014) Monitoring the future national survey results on drug use, 1975–2014: overview, key findings on adolescent drug use. Accessed 12 June 2017
  2. 2.
    Johnston LD, O’Malley PM, Miech RA, Bachman JG, Schulenberg JE (2017) Monitoring the future national survey results on drug use, 1975–2016: overview, key findings on adolescent drug use. Institute for Social Research, The University of Michigan, Ann Arbor. Accessed 2017
  3. 3.
    Hill KP (2015) Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: a clinical review. JAMA 313(24):2474–2483CrossRefPubMedGoogle Scholar
  4. 4.
    Koppel BS, Brust JC, Fife T, Bronstein J, Youssof S, Gronseth G et al (2014) Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the guideline development subcommittee of the American Academy of Neurology. Neurology 82(17):1556–1563CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Flachenecker P, Henze T, Zettl UK (2014) Nabiximols (THC/CBD oromucosal spray, Sativex(R)) in clinical practice—results of a multicenter, non-interventional study (MOVE 2) in patients with multiple sclerosis spasticity. Eur Neurol 71(5–6):271–279CrossRefPubMedGoogle Scholar
  6. 6.
    Novotna A, Mares J, Ratcliffe S, Novakova I, Vachova M, Zapletalova O et al (2011) A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex((R))), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis. Eur J Neurol 18(9):1122–1131CrossRefPubMedGoogle Scholar
  7. 7.
    Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A et al (2003) Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. Lancet 362(9395):1517–1526CrossRefPubMedGoogle Scholar
  8. 8.
    Vaney C, Heinzel-Gutenbrunner M, Jobin P, Tschopp F, Gattlen B, Hagen U et al (2004) Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study. Mult Scler 10(4):417–424CrossRefPubMedGoogle Scholar
  9. 9.
    Zajicek JP, Hobart JC, Slade A, Barnes D, Mattison PG, MUSEC Research Group (2012) Multiple sclerosis and extract of cannabis: results of the MUSEC trial. J Neurol Neurosurg Psychiatry 83(11):1125–1132CrossRefPubMedGoogle Scholar
  10. 10.
    Rog DJ, Nurmikko TJ, Friede T, Young CA (2005) Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology 65(6):812–819CrossRefPubMedGoogle Scholar
  11. 11.
    Kavia RB, De Ridder D, Constantinescu CS, Stott CG, Fowler CJ (2010) Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosis. Mult Scler 16(11):1349–1359CrossRefPubMedGoogle Scholar
  12. 12.
    Honarmand K, Tierney MC, O’Connor P, Feinstein A (2011) Effects of cannabis on cognitive function in patients with multiple sclerosis. Neurology 76(13):1153–1160CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Pavisian B, MacIntosh BJ, Szilagyi G, Staines RW, O’Connor P, Feinstein A (2014) Effects of cannabis on cognition in patients with MS: a psychometric and MRI study. Neurology 82(21):1879–1887CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M et al (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69(2):292–302CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Krupp LB, Tardieu M, Amato MP, Banwell B, Chitnis T, Dale RC et al (2013) International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler 19(10):1261–1267CrossRefPubMedGoogle Scholar
  16. 16.
    National Health and Nutrition Examination Survey (2008) Drug use questionnaire. Accessed 2015
  17. 17.
    Pew Research Centre (2014) America’s New drug policy landscape. Accessed 2015
  18. 18.
    Charvet LE, O’Donnell EH, Belman AL, Chitnis T, Ness JM, Parrish J et al (2014) Longitudinal evaluation of cognitive functioning in pediatric multiple sclerosis: report from the US Pediatric Multiple Sclerosis Network. Mult Scler 20(11):1502–1510CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Amato MP, Goretti B, Ghezzi A, Lori S, Zipoli V, Portaccio E et al (2008) Cognitive and psychosocial features of childhood and juvenile MS. Neurology 70(20):1891–1897CrossRefPubMedGoogle Scholar
  20. 20.
    Till C, Ghassemi R, Aubert-Broche B, Kerbrat A, Collins DL, Narayanan S et al (2011) MRI correlates of cognitive impairment in childhood-onset multiple sclerosis. Neuropsychology 25(3):319–332CrossRefPubMedGoogle Scholar
  21. 21.
    MacAllister WS, Belman AL, Milazzo M, Weisbrot DM, Christodoulou C, Scherl WF et al (2005) Cognitive functioning in children and adolescents with multiple sclerosis. Neurology 64(8):1422–1425CrossRefPubMedGoogle Scholar
  22. 22.
    Aubert-Broche B, Fonov V, Ghassemi R, Narayanan S, Arnold DL, Banwell B et al (2011) Regional brain atrophy in children with multiple sclerosis. Neuroimage 58(2):409–415CrossRefPubMedGoogle Scholar
  23. 23.
    Aubert-Broche B, Fonov V, Narayanan S, Arnold DL, Araujo D, Fetco D et al (2014) Onset of multiple sclerosis before adulthood leads to failure of age-expected brain growth. Neurology 83(23):2140–2146CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Longoni G, Brown RA, MomayyezSiahkal P, Elliott C, Narayanan S, Bar-Or A et al (2017) White matter changes in paediatric multiple sclerosis and monophasic demyelinating disorders. Brain 140:1300–1315CrossRefPubMedGoogle Scholar
  25. 25.
    Romero K, Pavisian B, Staines WR, Feinstein A (2015) Multiple sclerosis, cannabis, and cognition: a structural MRI study. Neuroimage Clin 9(8):140–147CrossRefGoogle Scholar
  26. 26.
    Orr JM, Paschall CJ, Banich MT (2016) Recreational marijuana use impacts white matter integrity and subcortical (but not cortical) morphometry. Neuroimage Clin 8(12):47–56CrossRefGoogle Scholar
  27. 27.
    Gilman JM, Kuster JK, Lee S, Lee MJ, Kim BW, Makris N et al (2014) Cannabis use is quantitatively associated with nucleus accumbens and amygdala abnormalities in young adult recreational users. J Neurosci 34(16):5529–5538CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Meier MH, Caspi A, Ambler A, Harrington H, Houts R, Keefe RS et al (2012) Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci USA 109(40):E2657–E2664CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Solowij N, Jones KA, Rozman ME, Davis SM, Ciarrochi J, Heaven PC et al (2011) Verbal learning and memory in adolescent cannabis users, alcohol users and non-users. Psychopharmacology 216(1):131–144CrossRefPubMedGoogle Scholar
  30. 30.
    Dougherty DM, Mathias CW, Dawes MA, Furr RM, Charles NE, Liguori A et al (2013) Impulsivity, attention, memory, and decision-making among adolescent marijuana users. Psychopharmacology 226(2):307–319CrossRefPubMedGoogle Scholar
  31. 31.
    Jacobus J, Squeglia LM, Infante MA, Castro N, Brumback T, Meruelo AD et al (2015) Neuropsychological performance in adolescent marijuana users with co-occurring alcohol use: a three-year longitudinal study. Neuropsychology 29(6):829–843CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Hanson KL, Winward JL, Schweinsburg AD, Medina KL, Brown SA, Tapert SF (2010) Longitudinal study of cognition among adolescent marijuana users over three weeks of abstinence. Addict Behav 35(11):970–976CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Paus T, Collins DL, Evans AC, Leonard G, Pike B, Zijdenbos A (2001) Maturation of white matter in the human brain: a review of magnetic resonance studies. Brain Res Bull 54(3):255–266CrossRefPubMedGoogle Scholar
  34. 34.
    Satterthwaite TD, Wolf DH, Erus G, Ruparel K, Elliott MA, Gennatas ED et al (2013) Functional maturation of the executive system during adolescence. J Neurosci 33(41):16249–16261CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Division of Pediatric Neurology, Department of NeurologyUniversity of VirginiaCharlottesvilleUSA
  2. 2.Department of Pediatric NeurologyUniversity of Colorado/Children’s Hospital ColoradoAuroraUSA
  3. 3.Department of Pediatric NeurologyUniversity of Pennsylvania/Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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