Amyotrophic Lateral Sclerosis (ALS)
Progressive neurodegenerative disease affecting motor neurons. Cannabis has limited evidence for managing spasticity, sleep, pain, and appetite loss in ALS patients; no evidence to date demonstrates disease-modifying effects.
- 35 states
- QUALIFYING IN
- Limited
- EVIDENCE
- G12.21
- ICD-10
Reviewed by Laura H. Meyer
Qualifying states
- Arizona
- Arkansas
- California
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Illinois
- Iowa
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Dakota
- Ohio
- Oklahoma
- Pennsylvania
- Rhode Island
- South Dakota
- Texas
- Vermont
- Virginia
- West Virginia
What it is
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that destroys motor neurons in the brain and spinal cord, leading to loss of voluntary muscle control. Symptoms typically include muscle weakness, spasticity, fasciculations, dysphagia, and respiratory compromise. Most patients survive 2–5 years from diagnosis.
There is no cure. FDA-approved treatments (riluzole, edaravone) modestly slow progression.
Cannabis and cannabis-derived therapies
The 2017 NASEM consensus report did not separately classify ALS evidence beyond the general spasticity and pain categories. Small clinical studies and patient-reported surveys describe cannabis use for symptomatic management of:
- Spasticity and muscle cramping
- Sialorrhea (excess saliva)
- Sleep disturbance
- Pain
- Appetite loss / cachexia
ALS is a qualifying condition under most US medical cannabis programs. Cannabis is not a disease-modifying treatment for ALS and should be coordinated with the patient's neurology and palliative care teams.
Frequently asked questions
Does cannabis slow ALS disease progression?
No. There is no clinical evidence that cannabis or cannabinoids slow ALS progression. The role of cannabis in ALS is symptomatic (managing spasticity, sleep disturbance, pain, and appetite loss) not disease-modifying.
Which ALS symptoms have the strongest cannabis evidence?
Muscle spasticity has the most consistent evidence base, paralleling the stronger evidence for MS spasticity. Sleep disturbance, pain, and appetite stimulation have limited but suggestive evidence. Cannabis is most commonly used as adjunct symptomatic therapy alongside standard ALS medications.
Are there risks of cannabis specifically for ALS patients?
Yes. ALS patients with respiratory compromise should avoid inhaled cannabis. Cannabis can interact with riluzole and other ALS medications. Sedating effects can compound disease-related fatigue.
Is ALS a qualifying condition in most state medical-cannabis programs?
Yes. ALS is one of the most consistently enumerated qualifying conditions in US state medical-cannabis statutes, typically alongside terminal illnesses and severe neurodegenerative diseases.
Sources
- NASEM: The Health Effects of Cannabis and Cannabinoids (2017)accessed May 15, 2026
- ALS Association: Cannabis and ALSaccessed May 15, 2026