By Venice Care · Last updated [September 29, 2026.]
The short answer
There is no cure for amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease), but treatment can slow progression and make daily life more comfortable. Three FDA-approved drugs are available: riluzole, edaravone and, for people with an SOD1 gene mutation, tofersen. Coordinated care from a team of specialists (neurology, therapy, breathing, nutrition and emotional support) is the foundation of treatment.
Medical cannabis does not slow ALS. In Florida, ALS is a qualifying condition, and some patients use cannabis alongside standard care for symptoms such as cramps, pain, sleep problems or poor appetite. This guide explains each option, what the evidence shows, and how to find ALS speciality care near Venice.
What Venice Care does and doesn’t do. Venice Care provides medical cannabis evaluations and certification for Florida patients in our Venice office and by telehealth. We are not an ALS multidisciplinary clinic and do not replace your neurologist. If you haven’t yet been seen by an ALS speciality centre, see Finding ALS speciality care near Venice below.
What is ALS?
ALS is a progressive disease of the motor neurones, the nerve cells in the brain and spinal cord that send movement signals to your muscles. As those cells are lost, muscles weaken and waste away. Over time this can affect walking, using the hands, speaking, swallowing and breathing.
ALS is one of the motor neurone diseases. Its ICD-10-CM code is G12.21. Most cases are sporadic, with no family history. A minority are inherited (familial ALS), often linked to genes such as SOD1, C9orf72, TARDBP and FUS. Genetic testing is increasingly recommended after diagnosis because a result can open the door to gene-targeted treatment and trials.
Early symptoms
ALS often starts subtly, in one part of the body, and symptoms vary from person to person.
- Limb onset (the most common pattern): weakness in a hand, arm, foot or leg. Examples are dropping objects, trouble gripping, tripping or foot drop.
- Bulbar onset: slurred or slowed speech, a hoarse or nasal voice, or trouble swallowing. Choking or coughing at meals can be an early sign.
- Other common features: muscle twitching (fasciculations), cramps, stiffness, and muscle wasting.
- Breathing: shortness of breath, trouble breathing when lying flat, morning headaches or daytime tiredness can appear as breathing muscles weaken.
- Emotional changes: some people develop pseudobulbar affect, sudden episodes of uncontrollable laughing or crying. A smaller group develop changes in thinking or behaviour related to frontotemporal dementia.
These symptoms can have many causes other than ALS. If you have progressive weakness, twitching, or speech or swallowing changes, see a neurologist promptly. Diagnosis often takes many months because early ALS resembles other conditions.
How ALS is diagnosed
There is no single test for ALS. A neurologist diagnoses it from symptoms, a physical and neurological exam, and tests that rule out other conditions. Mayo Clinic lists the common ones: electromyography (EMG) and nerve conduction studies, MRI of the brain and spinal cord, blood and urine tests, and sometimes a spinal tap. The MRI is used mainly to exclude other causes, though it can show changes suggesting ALS. A blood test for neurofilament light chain can help support an early diagnosis.
Before your first neurology visit, keep a symptom diary noting when and how you notice changes in walking, hand coordination, speech and swallowing. The pattern can help your neurologist.
Stages of ALS and how it progresses
ALS affects everyone differently. The ALS Association notes that there is no single timeline. What varies most is how fast symptoms progress and which appear first, and progression isn’t always steady, since some people have weeks or months with little change.
Clinicians track progression with two kinds of tools:
- ALSFRS-R, a questionnaire scoring everyday function (speech, swallowing, handwriting, walking, breathing and more), usually repeated every few months.
- Staging systems such as King’s and MiToS, which group progression by how many body regions are affected and by loss of function.
Survival varies widely. The ALS Association reports an average survival of about three years after diagnosis. About 20% of people live five years or more, about 10% live ten years or more, and about 5% live twenty years or longer.
ALS treatment options
Treatments can’t reverse damage already done, but they can slow the progression of symptoms, help prevent complications, and keep you more comfortable and independent.
FDA-approved medicines
| Medicine | How it’s given | What to know |
|---|---|---|
| Riluzole (Rilutek, Tiglutik) | By mouth | Can add about three months of life on average. Possible side effects include dizziness, digestive problems and liver effects, so liver function and blood counts are usually monitored. |
| Edaravone (Radicava) | Into a vein, or as an oral liquid | May slow the decline in daily function. The effect on lifespan is not yet known. Given daily for two weeks each month. Side effects can include bruising, headache and trouble walking. |
| Tofersen (Qalsody) | Injected into spinal fluid | For people with an SOD1 mutation only. Side effects can include headache, fatigue, joint pain and injection-site pain. |
Treating symptoms
Symptom care is a large part of ALS treatment. Your team can treat muscle cramps and spasms, pain, excess saliva and phlegm, trouble sleeping, fatigue, depression and anxiety, constipation, and pseudobulbar affect. Medicines are available for each of these, and your neurologist will choose what suits you.
Therapies and equipment
- Breathing care: regular breathing tests and noninvasive ventilation (BiPAP) to help at night as muscles weaken. Some people later choose a tracheostomy with a ventilator, which is a personal decision worth discussing with your team well in advance.
- Physical therapy: low-impact exercise, stretching, bracing, and mobility equipment such as walkers, wheelchairs and ramps.
- Occupational therapy: adaptive tools for dressing, eating and bathing, and home modification.
- Speech therapy: techniques for clearer speech, communication devices, and voice banking (recording your own voice for text-to-speech).
- Nutrition: softer or easier-to-swallow foods, and a feeding tube when swallowing becomes too difficult. It’s best to talk about feeding tubes early, before breathing has declined significantly.
- Emotional and practical support: social workers can help with insurance, equipment and costs, and counsellors can support you and your family.
Clinical trials and emerging treatments
Gene-targeted therapy is the most promising direction. Tofersen showed that treating a specific genetic cause is possible, and researchers are studying similar approaches for other genes. Stem cell therapies have been tested in trials, but none is an approved ALS treatment. Search ClinicalTrials.gov for “amyotrophic lateral sclerosis” and filter by “recruiting”, or ask your ALS centre about trials near you. Mayo Clinic also encourages joining the National ALS Registry.
Medical cannabis and ALS: what we know
Medical cannabis is a symptom-management option, not a disease-modifying treatment. It has not been shown to slow ALS.
What the evidence looks like. Research specific to ALS is limited. A small randomised crossover trial has tested THC for ALS cramps, and much of what’s known about cannabis for muscle stiffness comes from other conditions. In multiple sclerosis, a recent large review found modest benefit for spasticity from THC:CBD extracts, with low certainty of evidence. A Danish randomised trial found no effect versus placebo on neuropathic pain or spasticity in people with MS or spinal cord injury. Claims that cannabis protects motor neurones come from animal and lab studies only.
Why do some patients try it? Patients and carers sometimes report help with cramps, pain, sleep and appetite. Individual responses vary widely, and we can’t promise results.
Safety points specific to ALS:
- Cannabis can add to the drowsiness caused by muscle relaxants such as baclofen and by benzodiazepines.
- Cannabinoids are processed by the liver and can interact with other medicines, so review your full medication list, including riluzole, with your physician.
- Smoking or inhaling is not advisable if your breathing or swallowing is weak. Oral and other non-inhaled forms are usually considered first. [Dr Gordon: Describe your approach.]
- ALS can affect thinking and judgement in some people. THC can worsen confusion or impair decision-making.
- Always tell your neurologist about any cannabis use.
Getting certified in Florida
ALS is a qualifying condition under Florida’s medical marijuana programme. [Dr Gordon: describe your process step by step, for example, what to bring, whether your neurologist’s records are needed, what the visit covers, how telehealth works, recertification timing and cost.] After certification, you can buy products from state-licensed dispensaries.
Supporting a family member with ALS
Care needs change as ALS progresses, from help with daily tasks early on to round-the-clock support later.
- Plan early. Advance care planning, including your wishes about ventilation, feeding tubes and resuscitation, works best while the person can take part in decisions. Palliative care is a layer of support alongside treatment, and it isn’t the same as hospice.
- Use available help. Programmes include ALS Association equipment and navigation services, respite care, and benefits through Medicare, Medicaid and the VA for eligible veterans. Veterans have a higher risk of ALS.
- Look after the carer. Carer burnout is common. Support groups through the ALS Association can help.
Conclusion
ALS has no cure, but medications, team-based care and symptom management can help people live more comfortably. If you’re considering medical cannabis as part of your plan, Venice Care can evaluate you in Venice or by telehealth: book an appointment or call (941) 586-2426.
Frequently asked questions
Is there a cure for ALS?
No. Riluzole, edaravone and tofersen (for SOD1 ALS) can slow progression, and team-based supportive care improves comfort and independence.
What’s the difference between ALS and MS?
Both are neurological diseases, but they work differently. MS is an autoimmune condition in which the immune system attacks nerve insulation, and it often follows a relapsing course. ALS destroys motor neurons directly and is progressive. Sensory symptoms are common in MS and rare in ALS.
Can an MRI diagnose ALS?
Not by itself. MRI mainly rules out other causes, such as spinal cord tumors or herniated discs, though it may show changes suggesting ALS. EMG testing is central to confirming nerve and muscle involvement.
How fast does ALS progress?
It varies a great deal. The ALS Association reports average survival of about three years after diagnosis, with about 10% living ten years or more. Bulbar-onset ALS often progresses faster than limb-onset.
Is ALS painful?
Pain isn’t a prominent early feature, though cramps, stiffness and joint pain from immobility are common and treatable. Palliative and hospice teams are experienced at managing comfort, including breathlessness, at every stage.
Is ALS a qualifying condition for medical marijuana in Florida?
Yes. A licensed, qualified physician can certify eligible patients, who can then buy from state-licensed dispensaries.
Where can I find ALS clinical trials?
Search ClinicalTrials.gov for “amyotrophic lateral sclerosis” filtered by “recruiting” and your state, use the ALS Association’s clinical trial resources, or ask your ALS center.
Medical Disclaimer: This article is for informational and educational purposes only. It does not constitute medical advice and should not substitute for consultation with a licensed physician. Amyotrophic lateral sclerosis is a complex disease; diagnosis and treatment decisions must be made by qualified medical professionals. Venice Care provides medical cannabis evaluations within the scope of Florida law. For ALS emergencies, contact your neurologist or call 911.