• Posted May 20, 2026

How Do Caffeine, Alcohol, Weed, Nicotine Affect MS Symptoms?

There are lots of legal substances people use regularly to alter their mood – alcohol, caffeine, nicotine and in some locales, weed.

But how do these substances affect people with multiple sclerosis (MS)?

Most have drawbacks that come along with their benefits, according to a study recently published in the Archives of Physical Medicine and Rehabilitation.

"Just as many people look to a cup of coffee in the afternoon for a pick me up, people with multiple sclerosis may seek caffeine to help with fatigue or alcohol to manage pain,” said senior researcher Anna Kratz, a professor of physical medicine and rehabilitation at the University of Michigan in Ann Arbor.

“Insights from studies like this could prompt a person with multiple sclerosis to reflect on what they are putting into their bodies and how it is impacting their symptoms,” she said in a news release.

For the study, researchers asked 258 people with MS to report their symptom severity and use of these substances four times a day for two weeks. Participants reported their levels of pain, stress, fatigue and depression.

Results showed that for every benefit, there came a drawback:

• Alcohol use showed a decrease in stress, but increased fatigue.

• Caffeine use showed a decrease in fatigue, but increased stress.

• Cannabis use showed benefits in pain management but was related to increased fatigue.

Only nicotine had nothing good to show for itself. It only increased fatigue, without producing any benefits.

Kratz encourages MS patients to talk with their doctor about the substances they regularly use, even ones as innocuous as caffeine.

“Having a better understanding of how these substances impact patients with multiple sclerosis will be beneficial for providers,” she said.

“Being able to understand the role these substances play and the pros and cons of each will allow providers to better advise their patients when it comes to use of these products,” Kratz said.

More information

The National Institutes of Health has more on multiple sclerosis.

SOURCES: University of Michigan, news release, May 18, 2026; Archives of Physical Medicine and Rehabilitation, April 2026