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Medical marijuana or cbd oil for headaches

The Truth About Treating Migraine With CBD and Marijuana

You’ve probably seen headlines announcing the legalization of marijuana in an increasing number of states. You’ve likely also noticed CBD showing up in more and more products every time you go shopping. And as someone with a chronic condition, you’ve likely been told that one or the other (or even both) can cure basically every symptom you’re experiencing. But just because something is legal to sell doesn’t necessarily mean it’s the right treatment for your needs. And when you’re living with migraine, you can’t afford to waste your time on treatments that won’t work.

That’s why we spoke to board-certified neurologist and marijuana expert Dr. Eric Baron to get the facts on this trending treatment.

But before we get to the interview, let’s make sure we’re all on the same page about what we mean when we say “marijuana” and “CBD.” Marijuana is a type of plant whose flowers are famous for their psychoactive effects. You might know it by one of its other names, like cannabis, weed, or pot. No matter what you call it, it always has two main active ingredients. One is CBD, which stands for “cannabidiol.” The other is THC (that’s where the psychoactive effects come from).

Now that you know the basics, let’s get right to what you’re probably wondering.

Is there any scientific evidence that CBD or marijuana can relieve migraine?

Let’s start with CBD. Unfortunately, there haven’t been any trials evaluating pure CBD use in any pain, migraine, or other headache disorders, so it’s currently impossible to say for sure whether it works.

Marijuana, on the other hand, has been tested for migraine and headache in some small studies that suggest it could be beneficial, but there haven’t been enough well-controlled scientific trials to really prove it.

However, in January 2017, the National Academies of Sciences, Engineering, and Medicine concluded that there is substantial evidence that marijuana is an effective treatment for chronic pain in adults. Since different types of pain travel overlapping pathways in the brain, marijuana may work for migraine as well. We’ll need high-quality clinical studies to confirm this theory, but plenty of anecdotal evidence and smaller studies support it.

Have you treated patients who use marijuana or CBD?

I see patients who use these treatments often. In fact, I led a study of over 2,000 patients who were using marijuana as medication. 25% of them reported using marijuana for headache symptoms, and 88% of those were migraine sufferers.

How could marijuana or CBD work to relieve migraine?

Individually, CBD has great potential to relieve migraine pain because it’s several hundred times more anti-inflammatory than aspirin, with more than 65 molecular receptor targets and over 80 mechanisms of action.

Since CBD is one of the main components of marijuana (along with THC and aromatic compounds called terpenes), these pain-relieving effects are even stronger if you’re using marijuana rather than CBD alone. In fact, the combination factor is so important to how marijuana works that it has an official name: the “marijuana entourage effect.”

That means marijuana could be an effective treatment for fibromyalgia and other chronic pain syndromes. For migraine sufferers, marijuana could be an effective acute or preventive treatment. It could also relieve more symptoms than just head pain.

Like migraine-associated nausea?

Yes, that could be true. THC is much better at relieving nausea than CBD, which makes marijuana a better choice for treating this symptom. In fact, the FDA has approved two synthetic THC medications for the treatment of nausea.

Are there any specific marijuana strains that are best for migraine?

Other than anecdotal reports, this is currently unknown. Marijuana strains are mostly defined by their ratios of THC and CBD, and we need more studies to determine which ratio is best for migraine.

However, I suspect the answer will vary from patient to patient. It’s best to think of marijuana as a broad class of medication, like triptans. Within this medication class, there are many types of cultivars or chemovars (the scientific terms for strains). Just like a medication, there will be some variation in benefits and side effects between patients, and what’s best for you may not be best for someone else.

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I’ve heard marijuana and CBD can help with stress and anxiety. Is that true?

Some patients have reported this, and a few smaller studies have suggested that marijuana and CBD could be beneficial for anxiety and PTSD. However, large scientific studies are needed to prove it for both.

What are the side effects of marijuana? What about CBD?

Marijuana side effects vary widely based on the strain, but can include altered perception of time, anxiety, dizziness, dry mouth, heightened sensory awareness, hunger, paranoia, racing heart beat, sedation, and short-term memory impairment. This probably won’t come as a surprise to anyone who’s used it recreationally.

Pure CBD, without any traces of THC or other cannabinoids, doesn’t have many side effects. That’s because most of the side effects of marijuana come from THC.

Can CBD or marijuana be dangerous if used too frequently?

Higher doses of CBD can affect the liver enzyme system, which is what breaks down medications. So CBD could potentially cause other medication levels to increase or decrease in the blood, depending on the medication type. That’s why it’s important to talk to your doctor before trying CBD.

As for marijuana, it can affect blood pressure and heart rate, which can lead to strokes or heart attacks in rare cases. Excessive marijuana use can also severely impact a person’s professional and personal life.

Is it possible to get addicted to CBD or marijuana?

There’s no addiction potential with pure CBD, but it is possible to get addicted to marijuana, particularly high THC strains. Estimated addiction rates of marijuana are around 9%, much lower than many other substances, such as tobacco (32%) and alcohol (15%).

Should certain people avoid CBD or marijuana entirely?

Good question. People with liver disease should not use CBD because it can affect liver function. Don’t use marijuana or CBD if you’re pregnant or breastfeeding.

Teenagers shouldn’t use marijuana since this is a time when the brain is pruning, rewiring, and organizing itself. People with cardiovascular or cerebrovascular diseases and people who are predisposed to schizophrenia or other mental health conditions also shouldn’t use it.

Would you ever recommend using marijuana or CBD for migraine?

In the right patients, these therapies could have a potential role, especially for those who haven’t responded to more conventional treatments. Given the minimal side effects of CBD, I think it could certainly be a relatively safe thing to try. However, marijuana use would require a more in-depth conversation with a doctor about the potential risks, as well as research into any legal restrictions.

If you decide to try CBD, choose a full spectrum or “whole plant” product—they’re most likely to provide the “entourage effect.” And make sure it’s been tested for content and quality by an independent laboratory. In 2017, researchers studied 84 CBD products and found that 70% were inaccurately labeled and 21.4% had levels of THC that were above legal limits.

The bottom line here is that even though there are a ton of CBD and medical marijuana products out there, there’s very little credible information about their safety and efficacy. While it’s possible that these treatments could relieve pain, nausea, and other migraine symptoms, you’ll need to know the laws where you live and have a thorough conversation with your doctor before getting started.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Medical Cannabis for Headache Pain: a Primer for Clinicians

Purpose of review: Public acceptance of Cannabis sativa L. (cannabis) as a therapeutic option grows despite lags in both research and clinician familiarity. Cannabis-whether as a medical, recreational, or illicit substance-is and has been commonly used by patients. With ongoing decriminalization efforts, decreased perception of harms, and increased use of cannabis in the treatment of symptoms and disease, it is critical for clinicians to understand the rationale for specific therapies and their medical and practical implications for patients. In view of the opioid crisis, overall patient dissatisfaction, and lack of adherence to current chronic pain and headache therapies, this review provides up-to-date knowledge on cannabis as a potential treatment option for headache pain.

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Recent findings: Research into the use of cannabinoids for disease treatment have led to FDA-approved drugs for seizures, nausea, and vomiting caused by cancer chemotherapy; and for decreased appetite and weight loss in people with HIV/AIDS. For a wide variety of conditions and symptoms (including chronic pain), cannabis has gained increasing acceptance in society. The effects of cannabidiol (CBD) and tetrahydrocannabinol (THC) in pain pathways have been significantly elucidated. An increasing number of retrospective studies have shown a decrease in pain scores after administration of cannabinoids, as well as long-term benefits such as reduced opiate use. Yet, there is no FDA-approved cannabis product for headache or other chronic pain disorders. More is being done to determine who is likely to benefit from cannabis as well as to understand the long-term effects and limitations of the treatment. Cannabis can refer to a number of products derived from the plant Cannabis sativa L. Relatively well-tolerated, these products come in different configurations, types, and delivery forms. Specific formulations of the plant have been shown to be an effective treatment modality for chronic pain, including headache. It is important for clinicians to know which product is being discussed as well as the harms, benefits, contraindications, interactions, and unknowns in order to provide the best counsel for patients.

Keywords: CBD,; Cannabidiol,; Cannabis sativa,; Chronic migraine,; Chronic pain,; Dispensary; Endocannabinoid system,; Legislation,; Medical marijuana,; Migraine treatment,; Opioid crisis,; Opioids,; THC,; Tetrahydrocannabinol,.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Can CBD Oil Treat a Migraine?

Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer’s research.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey.

With the laws governing the legal use of medical marijuana beginning to loosen up, there’s quite a bit of focus on the use of CBD oil—a component of the marijuana plant—for treating everything from arthritis to chronic pain, including migraines. But what is CBD oil, and does it really work to relieve migraine headaches?

Verywell / Ellen Lindner

Cannabidiol (CBD) is just one of over 100 different substances found in the the Cannabis sativa plant. The portion of the cannabis plant that produces a high (the psychotropic effect) is called tetrahydrocannabinol, or THC. Depending on how it’s processed, CBD oil contains very little (or is completely void of) THC.  

Due to the pervasiveness and debilitating effects of migraine headaches, there’s been a lot of clinical research aimed at trying to find an effective treatment to minimize the frequency of migraines and alleviate the pain.

Medical experts currently consider the pain from a migraine headache the result of intense stimulation to sensory nerves—a response to inflammatory agents which are released when a migraine occurs. This would explain why powerful analgesic and anti-inflammatory agents, such as CBD oil, may be effective in the treatment of migraines.  

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Properties of CBD Oil That Relieve Migraine

  • Potent analgesic (pain relieving) properties
  • Antiemetic (preventing nausea and vomiting) properties
  • Powerful anti-inflammatory effects  

CBD oil has gotten a lot of attention for its powerful pain-relieving properties, particularly since cannabis use is becoming legal in many states (33 as of October 2019, according to the National Conference of State Legislatures, but details vary). In June 2018, the FDA approved CBD for the first time for a new seizure medication called Epidiolex (cannabidiol) [CBD] oral solution.

Research

According to a study published in Frontiers in Pharmacy, while there are many experts who advocate for the use of CBD oil for migraines, there is still not enough evidence to prove that treatment will CBD oil will be completely effective for alleviating migraine headaches.

The researchers add that given time, as the legalities around medical marijuana and CBD oil change, more research may be able to show that CBD oil works well enough and consistently enough to treat migraines.

“Cannabinoids—due to their anticonvulsive, analgesic, antiemetic, and anti-inflammatory effects —present a promising class of compounds for both acute [short-term, severe] and prophylactic [preventative] treatment of migraine pain,” explained lead study author Pinja Leimuranta, of the University of Eastern Finland. Although the researchers say that we are not completely there yet, they add that CBD oil can “absolutely help relieve some symptoms related to migraines.”  

While few clinical research studies have examined the use of CBD to treat migraines, a 2016 study, published in Pharmacotherapy, found that the frequency of migraines was reduced from nearly 10 per month to only approximately four per month in a group of medical marijuana users.   Research presented in 2017 at the Congress of the European Academy of Neurology showed that cannabinoids might help prevent migraines as well as easing the pain of migraine headache.

Additionally, a 2017 review of cannabis treatment for headaches outlined existing research, patient surveys, and case reports showing the efficacy of cannabis for migraine and other headache disorders.   A 2018 review described experimental evidence for the use of cannabinoids in the treatment of migraine as well as other headaches and chronic pain.

Uses and Safety

Previous research studies have shown that CBD oil, unlike THC, does not cause a euphoric high or psychotropic effects, and is typically less controversial and safer for medicinal use. CBD oil has been shown, in a limited number of studies, to be effective in the treatment of many disorders, including diabetes, arthritis, multiple sclerosis, and migraines.  

The type of cannabis that CBD is composed of is well tolerated and safe in humans. In one study, when cannabis with THC was given to study subjects, they experienced an increased heart rate, anxiety, and psychotic symptoms. However, participants who took CBD oil—lacking THC—did not experience side effects (including psychotic symptoms).  

Should You Use It?

Anyone considering the use of CBD oil for migraines should consult with their healthcare provider before taking it. It’s important to note that not all sources of the product are reputable.

Prescription drugs with CBD do not have any THC at all. But many over-the-counter CBD oil products, such as those sold online, contain trace amounts of THC.  

Another important action step to take before deciding to use CBD oil is to check to ensure that it is legal in your home state. Many states still consider even the prescribed use of CBD oil illegal, due to its link to marijuana. And the FDA has not approved any CBD products (prescription or over-the-counter), aside from Epidiolex.

This certainly does not indicate that people with migraines should stop searching for an effective treatment to alleviate pain and discomfort, nor should they give up hope. There are many proven effective solutions available for those who suffer from migraine headaches.