Marijuana has been used as a migraine treatment for hundreds of years.
Scientists have discovered many therapeutic uses for marijuana. Many of them have been verified though studies, but one condition that we don’t fully understand is migraines.
There are anecdotal reports of people using marijuana to treat or prevent migraines, but is there any research to verify those claims?
In this article, we take a look into what causes migraines, how marijuana can help migraine sufferers, and what research tells us about medical marijuana as a treatment option.
What are migraines?
A migraine headache is much worse than a regular headache. The pain caused by migraines is far more intense and lasts much longer. Migraines are a complex condition and each individual sufferer has their own experience with it. This broad variation makes it difficult to determine exactly what causes them.
In the US, 35 million people suffer from migraines, about 12% of the population. They mostly affect people aged 15-55, and tend to be more common in women.
A migraine headache can last anywhere from 4 to 72 hours. The main symptom is a painful headache, and other symptoms include increased sensitivity to light, sound, and smell, and nausea and vomiting.
For some people, a migraine can be so debilitating they can’t go to work or perform basic tasks. A migraine sufferer may have to lock themselves in a dark, quiet room until the symptoms subside.
Possible triggers include: bright light, stress, hunger, allergies, lack of sleep, loud noises, jet lag, certain odors or perfumes, alcohol, tobacco smoke, dehydration, and certain foods and medications.
History of medical marijuana for migraines
The history of marijuana as a medicine goes back further than most people might realize. In the first two centuries AD, Chinese writers documented that Emperor Shen Nuang used marijuana medicinally in the third century BC. This was the first ever recorded use of medical cannabis.
In a 2013 study called Cannabinoids and Hallucinogens for Headache, the authors write about marijuana being used in Ayurvedic mixtures to treat headaches in 400-300 BC.
In the 12th century, a German mystic, abbess, and philosopher named Hildegard Von Bingen wrote about marijuana in Physica, “Whoever has an empty brain and head pains may eat it and the head pains will be reduced. Though he who is healthy and full of brains shall not be harmed by it.”
Marijuana as medicine in the west
With regards to western medicine, the 19th century Irish physician W.B. O’Shaughnessy takes credit for introducing medical marijuana. In a paper he wrote in 1839, the doctor identified marijuana (what he called Indian hemp) to be an effective analgesic and muscle relaxant.
In 1840, Dr. Clandenning, a physician from St. Marylebone Infirmary in London, became the first person in a clinical setting to use marijuana to treat headaches. In the 1850s, Dr. Greene recommended daily cannabis intake for migraine prevention. In the 1890s, Sir John Russell Reynolds, then president of the British Medical Association, called it “one of the most valuable medicines we possess,” in a study published in the Lancet.
In 1890, Dr. Mackenzie published a paper in the British Medical Journal about the treatment of headaches with gradually increasing doses of marijuana twice a day. It was the first published scientific account of cannabis being used to treat headaches.
Then, in the early 1900s, Sir William Osler endorsed marijuana for migraine treatment in his medical textbook The Principles and Practise of Medicine. Osler urged the medical community to use cannabis for both acute treatment and prevention of migraines — over 100 years ago.
The Prohibition Era
But in the 1930s, anti-drug campaigns started moving western nations towards marijuana prohibition. The Marihuana Tax Act of 1937 imposed a heavy tax on anyone who used marijuana, forcing them to either pay, or go to jail and pay a fine. The act made it very difficult for anyone to study or use marijuana for medical purposes. As a result, the use of marijuana as a migraine treatment fell out of practice.
When full prohibition began, research into medical marijuana ground to a halt and, in 1941, marijuana was removed from the US Pharmacopoeia and National Formulary. The American Medical Association strongly opposed this motion, and it ushered in an age of darkness for medical marijuana research.
For decades, research into the efficacy of marijuana to treat migraines and the prevalence of people using it to treat migraines, were essentially non-existent.
Studies on medical marijuana for migraines
The state of marijuana research has improved significantly in recent years due to the increasing acceptance of medical marijuana around the world. Scientists have found evidence that marijuana can help treat many different conditions, from pain and glaucoma to depression and epilepsy.
But there still aren’t any clinical studies on the use of medical marijuana for treating migraines.
Much of the evidence is anecdotal and comes from case reports and patient surveys. For example, a 2009 report published in the scientific journal Headache describes one case where researchers witnessed a man with a cluster headache fully relieve his symptoms within five minutes of smoking marijuana.
As another example, a survey of 2480 marijuana users performed by the Oakland Cannabis Buyers Club found that 5 percent used cannabis for migraine relief.
The first formal study on marijuana and migraines
In 2016, the first formal study on marijuana as a migraine treatment was published in the journal Pharmacotherapy. The results finally shed some light on the question of whether marijuana can be helpful for migraines.
The study surveyed 121 adults with migraines over a period from January 2010 to September 2014. All subjects were prescribed medical marijuana, and they all attended at least one follow up appointment. In the end, the study found that after regular consumption of cannabis, the average frequency of migraines decreased from 10.4 per month to 4.6 per month — a significant difference.
Many patients used more than one consumption method, and dosage and frequency data were all patient-reported. After the follow up appointment, the mean monthly dosage per patient was 2.64 oz (vaporized), 2.59 oz (edible), 2.73 oz (topical), and 1.59 oz (smoked).
The study also found that some consumption methods were better than others for migraine treatment. Smoking or vaping was preferred by most patients because it’s easier to monitor how much you’re taking, and because of the quick onset of action. Edibles, on the other hand, were less desirable because dosage is harder to gauge, and it takes longer to reach maximum effect.
The study is promising, and it breaks new ground in a severely understudied area of medical research. Even still, the authors admit that it had a few weaknesses. More data needs to be collected on strain and dosage, patients need to fill out their reporting forms more completely, and many patients didn’t go for a follow up appointment, causing them to be excluded from the study.
As a next step, the researchers suggest a randomized, placebo-controlled clinical trial similar to a prescription drug study. To date, there have been no clinical trials conducted on marijuana as a treatment for migraines. However, anecdotal evidence collected from patients and physicians suggests marijuana could indeed be effective.
How does marijuana help with migraines?
The way marijuana helps with migraines all comes down to the endocannabinoid system, which is one of the biological systems in the human body. All vertebrates have one, so scientists believe it has ancient origins.
In humans, the endocannabinoid system is composed of cannabinoids produced naturally by the human body (endocannabinoids) and the receptors that they bind to (CB1 and CB2). These receptors are found everywhere, not just in the brain but in many tissues and organ systems as well.
The role of the endocannabinoid system is to regulate vital functions such as sleep, pain sensitivity, appetite, memory, body heat, and movement.
According to studies, when CB1 receptors are activated, they cause a release of dopamine, which can be helpful for headaches. They also inhibit the release of various other neurotransmitters including serotonin.
CB2 receptors are not psychoactive, but they do have analgesic and anti-inflammatory effects, which can also help with migraine symptoms.
The cannabinoids in marijuana imitate our body’s own cannabinoids and have the same effect on CB1 and CB2 receptors. Chronic migraine patients have been found to be deficient in anandamide, the human body’s most important endocannabinoid.
By consuming marijuana, patients can boost the activity of the endocannabinoid system, which theoretically could stop their migraines. For this reason, it’s been suggested that migraines, and other neurological conditions, may be nothing more than a cannabinoid deficiency.
THC and CBD
There are 60 different cannabinoids in marijuana, but the ones that attract the most attention are THC and CBD. THC is the primary psychoactive component of cannabis. It has a similar molecular structure to anandamide, so it easily binds to cannabinoid receptors.
Researchers have found that THC boosts dopamine levels and prevents the release of serotonin, helping to correct imbalances with either of those two neurotransmitters.
CBD, on the other hand, is not psychoactive but it still possesses anti-inflammatory and analgesic properties that make it of significant interest as a medicine. These special properties are also believed to give it strong potential as a migraine treatment.
The role of serotonin in migraines
A class of drugs called triptans has been used to treat migraines for decades. These drugs activate the receptors that respond to serotonin, so scientists believe that serotonin plays an important role in migraines.
Since cannabinoids in marijuana are known to activate those same receptors, researchers believe marijuana might be useful as a therapeutic alternative. Research has also shown that cannabinoids can block the release of serotonin during a migraine attack, providing one more reason to believe in its effectiveness.
Although we don’t have any clinical research to prove that marijuana treats migraines, we do have anecdotal evidence going back hundreds of years showing that it has been used for that purpose.
Now that marijuana is more widely accepted and medical use is more common place, researchers are starting to uncover more evidence of its benefits as a migraine treatment.