Stabbing pain, intense pressure, sensitivity to light and sound, and nausea. These are some of the common symptoms of a migraine.
Everyone experiences migraines differently. But everyone would agree migraines have a unique ability to completely ruin your day.
You can go from happy and active one moment to curled up on a bed in the dark the next.
Migraine is said to be the third most prevalent illness in the world, affecting about 12% of the population.
Conventional treatments include painkillers, triptans, and antiemetics for vomiting and nausea.
Research is finding that medicinal cannabis may also provide significant relief from migraine symptoms, helping to reduce severity and frequency.
The use of cannabis to treat headaches dates back hundreds to thousands of years.
As medicinal cannabis becomes more accessible in New Zealand and around the world, it’s likely to become a popular option for people who suffer from migraines and severe headaches.
What are migraines? More than a headache
It’s important to make it clear that a migraine is not just a bad headache.
While not completely understood, migraine is said to be a neurological condition that’s linked to genetic mutations in the brain.
It might present as a severe headache, but it’s more complex than that.
There are many different things that can trigger migraine, including stress, tiredness, dehydration, hormonal changes, and some medicines such as the contraceptive pill.
Symptoms can include fatigue, irritability, anxiety, sensitivity to light or sound, problems with vision, and debilitating pain.
The most common treatments for migraine are over-the-counter pain medications and nonsteroidal anti-inflammatory drugs (NSAIDs), which help to relieve symptoms.
Patients can also get prescriptions for triptans, a group of painkillers used for migraines and cluster headaches. Triptans promote the release of serotonin, which causes blood vessels around the brain to contract, helping to stop the headache or migraine.
Second-line preventative treatments for migraine include beta-blockers, SSRIs, antidepressants, anticonvulsants, calcium channel blockers and more.
While many people find that these treatments can help with migraine, many of these medications can cause adverse side effects, especially when overused.
Side effects can range from weight gain and depression to digestive system and cardiovascular issues.
People who don’t respond well to conventional migraine medications may be interested in exploring the potential of medicinal cannabis.
Medical cannabis and migraine: What does the research say?
Research is finding that medicinal cannabis may be an effective treatment for migraine and headache disorders.
Studies have reported that cannabis helps to decrease migraine frequency and severity.
While there’s currently a lack of clinical data to support the use of medicinal cannabis for migraine, there’s a growing body of anecdotal, preclinical and scientific evidence.
Given the strong evidence for the pain-relieving and anti-nausea effects of cannabis for other health conditions, it stands to reason it may also prove to help with migraine.
‘Superior to ibuprofen’
One of the few clinical trials in this space looked at the effects of medical cannabis on medication overuse headache (MOH).
MOH is a chronic headache that develops from primary headaches such as migraine. It develops as a result of the overuse of medication.
The study compared nabilone, a synthetic cannabinoid that mimics THC, and ibuprofen, a common NSAID for treating pain and inflammation.
The 30 patients had all had MOH for at least five years and were taking pain medication daily.
During the study, they were treated with both medications for eight weeks at a time, with a one week break in between.
The study found that nabilone was more effective than ibuprofen in reducing pain intensity and daily painkiller use.
Nabilone reduced pain intensity by 27.9 % compared to 17.8% for ibuprofen.
Nabilone was also the only drug to reduce the level of medication dependence and improve quality of life.
Any adverse effects of medicinal cannabis were mild and disappeared once patients stopped using the medication.
Migraine severity cut in half
A 2019 study published in the Journal of Pain found that inhaled cannabis (flower and concentrate) helped to reduce headache and migraine pain ratings by close to 50%.
The study analysed data from a medical cannabis tracking app, which patients used to anonymously record their experiences.
The final sample comprised 1306 medical cannabis users who used the app 12,293 times to track changes in headache and 653 medical cannabis users who used the app 7441 times to track changes in migraine severity.
The data showed a 47.3% decrease in self-reported headache severity and a 49.6% decrease in migraine severity following cannabis use.
The authors also said that cannabis does not appear to lead to the medication overuse headache associated with other conventional treatments “meaning that use of cannabis does not make headaches or migraines worse over time”.
While the findings of this study warrant further investigation in controlled clinical trials, the sample size (close to 2000 people) is significant and the findings support anecdotal evidence.
Reduced migraine frequency
A retrospective study of 121 adults diagnosed with migraine found that medical cannabis more than halved the frequency of migraines.
The 2016 study found that migraine headache frequency decreased from 10.4 to 4.6 headaches per month with the use of medical cannabis.
The most common effects of medicinal cannabis were migraine prevention and reduced frequency.
A cross-sectional questionnaire-based study, published in 2020, also investigated associations between medicinal cannabis treatment and migraine frequency.
It found that medical cannabis use resulted in long-term reduction of migraine frequency in over 60% of treated patients.
In both of these studies, patients were treated with a range of cannabis cultivars that were both THC- and CBD-dominant or contained equal amounts of both cannabinoids.
How does cannabis help with migraines?
Science doesn’t completely understand how medicinal cannabis works to help with migraine.
It’s highly likely that it has something to do with the body’s Endocannabinoid System (ECS).
CB1 receptors have been located in brain regions associated with migraine pain.
It’s possible that endocannabinoids (the body’s own cannabinoids) interact with and modulate several pathways related to migraine.
Clinical observations have shown that levels of anandamide — one of the body’s two known endocannabinoids — are reduced in the fluid found in the brain and spinal cord of patients with chronic migraine.
Anandamide helps to inhibit two of the many mechanisms that are known to contribute to migraine.
It’s also been suggested that reduced levels of anandamide could result in lowered pain threshold in migraine patients.
Given that THC likely acts similarly to anandamide in the body, it may be that medicinal cannabis helps to make up for the deficiency in people who experience migraines.
Research has also found that CBD enhances anandamide signalling, which may have benefits for migraine patients.
Using medical cannabis for migraine
The early research into medicinal cannabis and migraine is promising for patients and caregivers.
Studies are showing that medical cannabis may help to reduce migraine severity and frequency
While more clinical trials are needed (there are several underway at the time of writing), there’s a growing body of evidence that suggests medicinal cannabis is an effective treatment for migraine.
Research suggests around 36% of medicinal cannabis users are using it to treat migraines and headaches.
If you’re finding that conventional treatments aren’t working, you’re experiencing adverse side effects, or you simply want to try a more natural alternative to over-the-counter medications, you may want to consider talking to your doctor about using medicinal cannabis.
You can read our guide to getting a medicinal cannabis prescription in New Zealand here.