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Migraines are a type of intense throbbing and pulsating headache that commonly cause nausea, vomiting and sensitivity to light and sound. While migraines and their debilitating symptoms affect 10% of the world’s population, studies have shown marijuana is effective at inhibiting the system that causes migraine pain and therefore offers relief.
Overview of Migraines
A migraine is a type of headache that is characterized by pulsing or throbbing in an isolated area of the head8. The pain can be so intense that it causes nausea, vomiting and sensitivity to light and sound7. The International Headache Society distinguishes a migraine by the intensity of its pain and the frequency of attacks (at least five, lasting 4 to 72 hours if untreated)8. It’s not uncommon for those who suffer from migraines to first experience auras, which can include visual disturbances like flashes of light, the seeing of zig-zag lines, and vision loss. Migraines generally begin during childhood, adolescence, or early adulthood, with women suffering from migraines three times more often than men7.
While the pathophysiology of migraines is still not fully understood, research suggests they’re the result of fundamental neurological abnormalities caused by genetic mutations in the brain8. This fluctuation in neuronal activity likely activates the trigeminovascular system, which includes both the nerve and vascular system in the meninges, and the associated inflammatory response causes pain8. Genetics are also likely involved in the cause of migraines7.
Migraines are currently incurable and therefore the treatment focus is on preventing the attacks and relieving the symptoms once the attacks occur. The efforts to prevent migraines can include medications, stress management, exercise and nutritional adjustments, hydrating adequately, establishing consistent sleep schedules, and avoiding known behaviors that trigger attacks. Once a migraine hits, focus turns to the administration of pain relief medications7.
Findings: Effects of Cannabis on Migraines
Cannabis has been used to treat migraines for centuries. Between the years of 1874 and 1942, it was among the most prominent remedy used by physicians5.
Research suggests that cannabis’ effectiveness for migraine relief can be attributed to the cannabinoids contained in cannabis. Cannabinoids interact with the CB1 and CB2 receptors of the body’s endocannabinoid system, which in turn inhibits responses of the trigeminovascular system and restricts the inflammation that causes migraine pain1,3.
A January 2016 study found medical marijuana to be effective at decreasing the frequency of migraine headaches. In a first-of-its-kind study, because of previous federal regulations, the researchers found that 103 of 121 of participants diagnosed with migraines saw a decrease in migraine frequency. The average migraine frequency reduced from 10.4 a month to 4.6 per month8.
Further, studies suggest that cannabis is effective at providing analgesia effects caused by chronic neuropathic pain conditions that are otherwise resistant to other pain relief treatments11. The findings of one study even suggest that a dysfunction of the endocannabinoid system may contribute to the development of migraines. Researchers then came to a conclusion that the activation of the CB1 and CB2 receptors would correct this dysfunction and be useful in treating migraine pain4.
Because of the effectiveness of cannabinoids on migraines, there continues to be prominent marijuana use by migraine patients outside of physician recommendations and in locations where medical cannabis use continues to be illegal5.
States That Have Approved Medical Marijuana for Migraines
Currently just California, Illinois, and North Dakota have specifically approved medical marijuana for the treatment of migraines. Connecticut has approved medical marijuana for those diagnosed with intractable headache syndromes.
However, other states allow medical marijuana to treat nausea or chronic pain. These states include: Alaska (nausea, chronic pain), Arizona (nausea, chronic pain), Arkansas (nausea, intractable pain) Colorado (nausea, chronic pain), Delaware (nausea, chronic pain), Hawaii (nausea, chronic pain), Maine (nausea, chronic pain), Maryland (nausea, chronic pain), Michigan (nausea, chronic pain), Minnesota (intractable pain), Montana (severe nausea, severe pain), Nevada (severe nausea, pain), New Hampshire (nausea, severe pain), New Mexico (chronic pain), North Dakota (nausea, severe pain), Ohio (chronic pain, severe pain, intractable pain), Oregon (nausea, chronic pain), Pennsylvania (chronic pain, intractable pain), Rhode Island (nausea, chronic pain), Vermont (severe pain, severe nausea), Washington (nausea, intractable pain), and West Virginia (chronic or intractable pain).
In addition, other states allow medical marijuana for the treatment of migraines, but use must be first approved and accommodated with a recommendation by a physician. These states include: Connecticut (other medical conditions may be approved by the Department of Consumer Protection) and Massachusetts (other conditions as determined in writing by a qualifying patient’s physician. In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ Effect on Migraines
- Akerman, S., Holland, P.R., Lasalandra, M.P. and Goadsby, P.J. (2013, September). Endocannabinoids in the brainstem modulate dural trigeminovascular nociceptive traffic via CB1 and “triptan” receptors: implications in migraine. Journal of Neuroscience, 33(37), 14869-77. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771033/.
- Greco, R., Gasperi, V., Maccarrone, M., and Tassorelli, C. (2010, July). The endocannabinoid system and migraine. Experimental Neurology, 224(1), 85-91. Retrieved from http://www.sciencedirect.com/science/article/pii/S0014488610001159.
- Greco, R., Mangione, A.S., Sandrini, G., Nappi, G. and Tassorelli, C. (2014, March). Activation of CB2 receptors as a potential therapeutic target for migraine: evaluation in an animal model. The Journal of Headache and Pain, 15, 14. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995520/.
- Greco, R., Mangione, A.S., Sandrini, G., Maccarrone, M., Nappi, G. and Tassorelli, C. (2011). Effects of anandamide in migraine: data from an animal model. The Journal of Headache and Pain, 12(2), 177-83. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072518/.
- McGeeney, B.E. (2013). Cannabinoids and hallucinogens for headache. Headache, 53(3), 447-58. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1111/head.12025/full.
- Migraine (2013, June 4). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/definition/con-20026358.
- NINDS Migraine Information Page. (n.d.) National Institute of Neurological Disorders and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/migraine/migraine.htm.
- Rhyne, D.N., Anderson, S.L., Gedde, M., and Borgelt, L.M. (2016, January 9). Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Pharmacotherapy, doi: 10.1002/phar.1673. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1002/phar.1673/full.
- Russo, E.B. (1998, May). Cannabis for migraine treatment: the once and future prescription? An historical and scientific review. Pain, 76(1-2), 3-8. Retrieved from http://journals.lww.com/pain/pages/articleviewer.aspx?year=1998&issue=05000&article=00002&type=abstract.
- Russo, E.B. (2001). Hemp for Headache: An In-Depth Historical and Scientific Review of Cannabis in Migraine Treatment. Journal of Cannabis Therapeutics, 1(2), Retrieved from http://www.tandfonline.com/doi/abs/10.1300/J175v01n02_04.
- Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., and Donaghe, H. (2013, February). Low-dose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain, 14(2), 136-48. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566631/.