Chronic prednisone use vs medical marijuana

Question:
My daughter has been on chronic prednisone for over 14 years. As we are trying to wean her off, I worry about the permanent damage left behind. What is your opinion about using medical marijuana as a way to reduce inflammation caused her MS instead of prednisone? 

Answer:
I think you are mixing apples and oranges in your comparison of steroids and marijuana as anti-inflammatory treatments.

Prednisone has broad ranging, often dangerous effects on the immune system. The receptors and gene pathways associated with these effects are well known. Marijuana or it’s component cannabinoids are purported to exert effects on immune function dependent on the eye of the beholder; older studies claimed damaging immune suppressant effects whereas more recent studies in AIDs patients suggest no immune suppressant effects. Whether Marijuana exerts any clinical meaningful beneficial or harmful effects on immune cell function is still highly debated.

It is rare for MS specialist to keep patients on chronic prednisone for such a long time (over 14 years in the case of your daughter). It is quite likely she has a very unusual case of the disease or a rare variant condition if she has stayed on prednisone this long.  Getting her off prednisone could take well over a year but could improve many of the problems associated with chronic prednisone use. You should work closely with an MS specialist to help in this process. Good luck

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego