Medical marijuana, hemp and CBD have begun to receive increasingly serious consideration as viable medical alternatives, though research on cannabis’s impact on migraine headaches has been limited - that is until a group of headache experts all gathered in one spot.
The 2023 American Headache Society Annual Meeting took place on June 15-18, in Austin, Texas. The many experts in attendance included Nathaniel Schuster, MD, who presented data from a double-blind, placebo-controlled, randomized controlled trial of vaporized cannabis as a potential treatment for migraine headaches. And the results were positive.
Most studies on cannabis and migraines up to this point have been relatively small, retrospective and with no placebo control group involved.
Schuster’s Research Was Different.
In the placebo-controlled trial, a combination of THC and CBD proved to decrease headaches and most bothersome symptoms at two hours. There was no dose-dependent effect observed, indicating that low amounts of cannabis may be effective to treat migraines.
Schuster, a pain management specialist and headache neurologist at the University of San Diego’s Center for Pain Management, conducted the study from November 2020 to February 2023.
Patients were randomly assigned to either tetrahydrocannabinol (THC) 6%, a mix of THC and cannabinoid (CBD) 11%, CBD 11% and placebo cannabis.
"The doses that we used are probably lower than what a lot of people out there are using on their own, and higher doses do not necessarily mean more effective," Schuster said. "The highness patients were having in the study was not very high, probably somewhere between a 2-4 out of 10 on subjective highness.”
At the conclusion of the trial, four puffs of vaporized THC/CBD mix flower was efficacious for acute migraine treatment, showing impacts on two-hour pain relief and freedom, as well as resolution of most bothersome symptoms at least two hours after the migraine attack.
Beware Stong Weed
Schuster noted that for some of his regular patients in California where marijuana is legal, weed can often be too strong and can therefore have a hyperalgesic effect or cause people to hyper-focus on their pain. He suggests that people who use cannabis to treat migraine headaches should experiment with lower doses. "You don't need to use recreational doses."
Migraine Disease
Migraines affect 47 million Americans, 75% of whom are women. Although a splitting headache is one symptom, migraine attacks can include visual disturbances, nausea, extreme light and sound sensitivity, brain fog and debilitating pain.
See Schuster’s 5-minute overview of the trial in an interview with NeurologyLive.
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