BY HADLEY HENRIETTE DOCTOR REVIEWED
It's not your imagination. Marijuana really does help migraines and headaches of all stripes. Habitual marijuana users have known this for decades, but researchers and migraine sufferers are just getting hip to this fact.
In fact, it seems LACK of marijuana might be a factor for some types of migraines. "Migraines are now actually theorized to be an endocanabinoid deficiency," explains Ann-Marie Wong M.D., a pediatrician and lead marijuana doctor at Medverde based in Miami, FL.
If you haven't heard of the body's cannabinoid system that is because the first endogenous cannabinoid, anandamide, wasn't identified until the 1990s. By 2001, it was hypothesized that an endocannabinoid deficiency was potentially behind migraines, as well as fibromyalgia, IBS, and PTSD—conditions that have all been considered treatment resistant.
In 2007, a study showed reduced levels of the endocannabinoid anandamide in the cerebrospinal fluid of chronic migraine sufferers as well as those with increased activation of the trigeminovasular system (TVS). This fact, coupled with THC and CBD's known analgesic properties, makes a compelling case for migraineurs to try marijuana.
Dr Wong says, “In my experience, marijuana just makes migraines easier to treat overall and seem to lessen severity. For the occasional migraine, it can be used once it begins, but for people with chronic migraines, daily use of cannabis is better as it reduces the total number and intensity of attacks. " The research supports this.
For those wary of psychoactive effects of TCH, she has seen success with CBD both alone and combined with THC. "Cannabis can be used on its own or alongside other classic migraine medications, although the goal would be to try to reduce or eliminate the pharmaceuticals. I had a patient who came in on four different medications for migraine pain and we were able to eliminate all of them and just manage his migraines with 30 mg full-spectrum CBD a few times a day. It vastly improved his quality of life,” says the doctor with a smile.
While migraine isn't listed as one of the official qualifications for a medical marijuana license in the state of Florida, Dr. Wong says she often helps patients with this problem as it falls under chronic pain. There are a wide array of triggers that include stress, hormones, food sensitivities, changes in sleep or weather. Another is high CSF pressure, which is why medications like Topamax are sometimes tried with terrible side effects. Interestingly, marijuana can reduce CSF pressure making it a better option with much less side effects.
Migraine medications usually work by either constricting blood flow or blocking pain receptors. THC is a little different. It is vasodilator that lowers intracranial pressure, relaxes arteries and increases blood flow to tissues.1 It also works on body's endocannabinoid system, which regulates pain processing and many of our most critical bodily functions like memory, emotional processing and immune response.
As a long-time migraine sufferer, I managed my migraines with caffeine and NSAIDs until they evolved into three-day pain marathons complete with vomiting, diarrhea and not a small amount of tears. Triptophans didn't agree with me, I was becoming sensitive to the fluoride in Ubrelvy. I was out of options. I was on day three of a particularly stubborn migraine when it finally came to me to try marijuana. I retrieved a long-forgotten container of “Pineapple Haze” and took two puffs.
Within 90 seconds my migraine all but disappeared. And, perhaps due to the age of the buds, I was not high either, which I was grateful for because I was dizzy enough already. It was perfect and I applied for my Florida Medical Marijuana license very shortly after.
WHAT TO WATCH OUT FOR
One drawback of marijuana for migraines is that the relief lasts only as long as the drug itself does, which is about two hours. As a result, you may find yourself inhaling (via smoking or vaping) many times over the course of a long migraine, which can have its own health consequences that need to be weighed against the benefit. While oral THC products are safer and last much longer, but seem to take longer to work. Goldilocks Wellness plans to do a deep dive into the safest ways to smoke, but for now it seems solventless "live rosin" or vaporizing dry herb will do the least damage.
If you are a migraine sufferer, discuss marijuana for migraines with your doctors. Even if you live in a state with legal recreational marijuana, it is important to check for any contraindications before starting a new medication or supplement. These with heart and cardiovascular conditions or a history of or family history of mental illness or addiction should avoid marijuana. If you are already cleared for marijuana use by your doctor and are shopping for cannabis, remember to check THC levels. Starting with the lowest effective percentages and the lowest dosages is advised to mitigate any side effects as well as the possibility of medication overuse rebound headaches, which can occur with all currently available headache medications.
"Can marijuana help migraines?"
Sarchielli, Paola; Pini, Luigi; Coppola, Francesca; Rossi, Christiana; Baldi, Antonio; Mancini, Maria; Calabresi (2007) Endocannabinoids in chronic migraine: CSF findings suggest a system failure. Neuropsychopharmacology.
1 Filbey, Francesca; Aslan, Sina; Lu Hanzhang; Peng, Shin-Lei. (2018). Residual Effects of THC va Novel Measures of Brain Perfusion in Metabolism in a Large Group of Chronic Cannabis Users. Neruopsychopharmacology
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