Is marijuana really a cure for migraine?

By now you’ve probably read that sensational headline, Medical marijuana: New study proves pot can nix migraine headaches. Headlines don’t often tell the whole story. In this case, a lot of important facts were left out – facts you can only discover by reading the original report. Fortunately, this study is available at no cost. You just need to know the original report title, “Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population.” A simple web search will take you right to page where you can download your very own PDF copy.1

Live human trials are prohibited by federal law. Any organization which receives federal funding can loose that funding if they conduct such trials. A group of researchers at Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, CO decided to study the next best thing – patient records. Medical marijuana has been legal by prescription in Colorado since 2001 and was legalized for recreational use in 2014. Prior to 2014, patients were required to follow-up with their prescribing physician in order to maintain their medical marijuana cards. After full legalization, that requirement was eliminated. Enlisting the help of Gedde Whole Health, a private medical practice specializing in the treatment of state-qualified medical conditions with medical marijuana, they identified patients with a confirmed primary diagnosis of migraine and selected only those patients who participated in follow-up visits. 121 patient charts were reviewed — documenting diagnosis, frequency of migraine attacks before and after treatment, plus dose and delivery method of marijuana.

Results:

  • Slightly less than half (48%) of the patients reported using prescription preventive or abortive medication either before or after treatment.
  • 8% reported prior marijuana use.
  • The average monthly consumption was 2.38 oz. or a little more than 2 g per day.
  • Delivery methods included: vaporized, edible, topical, and smoked.
  • Most patients reported daily use as a preventive.
  • 11% also reported using vaporized marijuana as an acute abortive.
  • 85.1% of subjects experienced a significant reduction in migraine headache frequency.
  • Prior to treatment, these patients averaged 10.4 attacks per month.
  • At follow-up appointments, these same patients reported an average of 4.6 attacks per month.

Most clinical trials are considered successful if ≥50% of subjects experience a ≥50% reduction in frequency and/or severity of symptoms. With 85.1% experiencing a 52.6% improvement in migraine frequency, results are on par with some of the most successful pharmaceutical preventives.

Positive effects reported:

  • Decreased headache frequency
  • Aborts migraine attack
  • Relieves pain
  • Reduces nausea

Adverse effects* reported:

  • somnolence
  • difficulty controlling effects due to timing & dose
  • increased headache
  • bad dreams
  • nausea
  • memory loss

*Patients using edibles were more likely to report negative effects.

Limitations

This is the first study to demonstrate that marijuana use reduces the frequency and severity of migraine headache. The results are, admittedly, promising. But before you get too excited, remember that this study was a retrospective chart review. By design, it contained several major weaknesses.

Even the research team acknowledged several limitations:

  • The results do not prove that marijuana was the definite cause of reduction in migraine attack frequency.
  • Chart documentation was inconsistent from patient to patient
  • Most patients reported previous use of marijuana prior to their first visit.
  • There was no distinction between prior medicinal or recreational use.
  • The study could not allow for controlling the type of dose used.
  • Doses varied from less than 1 to over 2 ounces per month.
  • Daily doses were not standardized and were prepared and administered in patient homes.
  • There was no documentation in patient charts of specific instructions on preparation or dosing.
  • There was no documentation of dosing frequency or strain used.

They recommend the following for further studies:

  • Randomized, placebo-controlled clinical human trial
  • Marijuana washout period prior to start of trial
  • Standardized quantities and potencies of medical marijuana
  • Tracking of patient adherence to dosing instructions
  • Tracking of migraine headache frequency
  • Tracking of adverse effects

They readily admit that federal laws will have to change dramatically in order to make such as study possible.

My observations:

There were other weaknesses to this study not mentioned by the researchers. As with the ones they mentioned, only changes in legislation will make it possible to design a study without these weaknesses.

Diagnosis

Most glaringly, records did not indicate whether or not patients had been diagnosed by a true headache specialist according to the ICHD. All patients had already received the diagnosis of “migraine” without specifying if it was Migraine with Aura, Migraine without Aura, Hemiplegic Migraine, Chronic Migraine, or any other migraine diagnosis. It is possible that some patients were incorrectly diagnosed. Future studies should be designed so that subjects’ diagnoses are confirmed by a headache specialist using the diagnostic criteria in the ICHD. Future studies should isolate subject groups by diagnosis or enroll only patients with a single diagnosis for more accurate results.

Associated symptoms

Another weakness I observed was that there wasn’t a lot of information regarding the impact marijuana use had on other migraine symptoms.  By relying on chart review, the team could only report what was in the charts. Some patients reported that marijuana use reduced the symptom of nausea, but none reported an impact on light or sound sensitivity. Most of us agree that migraine is a lot more than just a headache. So it would be nice to know if treating migraine with marijuana will reduce all the symptoms of migraine, not just the headache. Future studies should include subject education on the tracking of all symptoms to ensure that this information is part of the results.

Timing of follow-up

Lastly, not all patients were required to follow up with the prescribing physician. The time between initial and follow-up appointments was 1 to 3 years. We all know that migraine frequency can vary from time to time. The follow-up time is simply too long to rule out other factors that may have influenced migraine attack frequency. In clinical trials, patients are usually asked to follow up every few weeks, a month at most.

A girl can dream

Like many of you, I’m in favor of ending marijuana prohibition so that it can be properly studied for its medical effectiveness. It has a long history of use for a variety of medical problems. I’d really like to see some definitive proof that doctors throughout history have been on the right side of this debate.

Alas, I live in a state that is unlikely to legalize marijuana any time soon. Darn.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
1. Rhyne, D. N., Anderson, S. L., Gedde, M. and Borgelt, L. M. (2016), Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. doi:10.1002/phar.1673

Comments

View Comments (15)
  • SilverPhoenix13
    3 years ago

    I’ve never tried it for my migraines. What I do know is that the smell of marijuana is a new trigger for me. The last three times I’ve had a customer come into work smelling like they’ve just recently smoked it has resulted in a migraine for me. It never used to. I have family and friends that smoke it and it never set me off until recently. I don’t know why it changed, but it has. Don’t ya just love how triggers can change like that?

  • Brandy
    3 years ago

    I am one of the people that just can’t tolerate marijuana. I tried it recreationally as a young adult, and felt so paranoid and like my skin was crawling. In later years I was assured by pot-smoking friends that this was an effect of the strain, and a different strain wouldn’t have that effect. So, at age 41, during a 5 month long migraine of which 5 days hospitalized hadn’t broke, I did the research on strain and tried again out of desperation. Once again I had the paranoia/skin crawling feeling, but more importantly my headache intensified SEVERELY. I didn’t go to the ER, as I probably should have, but instead laid in bed perfectly still holding my head while tears ran down my face. Obviously marijuana is a life-saver for some, but for me it is the devil. Never again will I try that route…For the record, what finally broke that particular migraine, after 6 months, was a psychiatrist prescribed Depakote. That’s helped more than any other preventative or abortive I’ve tried…

  • Candy
    3 years ago

    I myself have had good luck with it, though I know it can cause some pretty bad allergic reactions in people. I’ve used it as a preventative, and it had reduced the number of migraines, though not eliminated them (I have chronic migraine). It doesn’t really work once the migraine has started however, so no luck there. I’m just glad that it’s given me any relief at all.

  • kdmoore512
    3 years ago

    As an option to legalized marijuana, what about Marinol? It is synthetic marijuana and, therefore, legal in every state. I have been suffering from chronic migraines like many of you for 15 years. I have had to go on disability and as a “last resort”, my headache Doctor put me on Marinol. Doctors often prescribe it for cancer patients who are nauseated by treatment. Marinol has not cured me, but has helped.

  • my.head.hurts
    3 years ago

    I have to admit, the few times I have tried marijuana while afflicted with a migraine, it did cut the pain by more than half. I have lived with migraines since I was 19 (almost 30 years), through 4 kids, full time employment and a failed marriage. I’ve lost jobs due to absences from migraines. No abortive medication works for very long for me. I’ve been thru most available (I’m also limited by what is in the VA pharmaceutical formulary) and I might get 1 year’s benefit.

    Back to medical marijuana as an abortive. I was very hesitant to try it. A friend convinced me that I should try it since all other medications had failed and I was on week 3 of a migraine. Well, I caved and tried it. It didn’t totally get rid of that migraine but it sure cut the severity of it. I’ve only used it 2 more times but wish it was more readily available for use when I’m to a bad point in a migraine. I prefer no medication as I am on so many others for other medical conditions.

    I’d gladly be a guinea pig for any studies!

  • my.head.hurts
    3 years ago

    Also, I have done Botox. It helped for a few months but took a few injections to get results.

  • Sean
    3 years ago

    It never helped me back when I used it daily, not as a preventive and definitely not as a cure, if anything it made them worse so I never used it if having a migraine and this was back in my teens when I didn’t yet know the headaches were migraines due to not having the then usual symptoms of one. That’s just me though and people will try or possibly want to try anything that works, but until they can have real trials regarding this, all you can do is try what you can, what works for some does not work for all and I expect that’s what future real trials will reveal, same old story. Thanks for pointing out the things most people don’t know regarding these current “trials”

  • Luna
    3 years ago

    “Is marijuana really a cure for migraine?”
    Tammy, in your own words from a previous post “Remember, there is no cure for migraine.”
    I know people that medical marijuana has help with pain relief so I tried it for migraine. Only time I’ve been to the ER. I am one that has unpleasant side effects from it.

  • Tammy Rome author
    3 years ago

    LOL…glad to hear someone remembered that one! 🙂

  • Eleanor R.
    3 years ago

    Am I missing something? The results reported seem to apply only to the 1% of subjects who experienced a significant reduction in headache frequency. What about the remaining 99%?

  • Tammy Rome author
    3 years ago

    I took a closer look and realize there was an editing error. That bullet point should have been 85.1% not 1%. I have corrected the error. Sorry for the confusion!

  • calicatch22
    3 years ago

    Thank you for bringing up this important topic of discussion.
    I tried cannabis as an abortive & as a preventative.
    Tried different delivery methods, different strains & my result went from being optimistic about the benefits- to realizing it did me more harm in multiple ways, than I care(d) to admit.
    Whether smoked, ingested through edibles, taken as a tincture or any other possible source; what happened in the early stages was, I started off with a mild sinus reaction (within minutes of the effects; I had a completely congested nose,swelling sinus’ to itchy watery eyes & anxiety because of a hard time breathing) and eventually an even worse migraine munutes after that, then a rebound headache after the initial hell was over.:/
    That pount was when I figured I had better keep an eye on my strains, strengths and quality…that ended up making no difference.
    Seems I progressively ended up having seizures before realizing there seemed a connection, even unsure, I ditched the method after 4 years went by of me insisting results were going to be positive as long as I played Guinea pig & ignored how broke I was going, in trying to get some relief (Which never really came.)
    I did black out/numb out/pass out…whatever you wish to call it.
    I cannot officially say my convulsions were entirely due to the cannabis, but I also can’t say that it was not & that it did not validly lower my “threshold” as doctors put it, either.
    Still undergoing tests about that messy seperate issue.

    I’ve had migraines since before I could effectively communicate the pain that I was feeling to my mom (at about 5 yrs old)
    I would have nightmares, wake up in tears, with one particular memory of a pendulum coming right at my head & try to explain my pain.
    It wasn’t til 6 years later at age 11,that I was diagnosed with migraine.

    At 36, here I am, honestly no better off with any type of relief, no abortives, no effective preventatives, just a antiseizure medication & a valid disability for what it’s worth, which I am greatful for since I truly can not function normally.
    Just for notes; I never tried medicinal cannabis until age 27, so my hopes were crushed in all the good I had heard about it working miracles for others.
    Now perhaps the docs can, more accurately diagnose the epilepsy (or “seizure disorder.” which btw, I’ve heard it all from endless amounts of doctors theorizing the cause for my pain, who seem to lean toward, indirectly blaming me for it)
    >imagine me rolling my eyes right now<
    With the documented history of *multiple blunt force head traumas after migraine diagnosis or maybe even, a result of all the years with no pain relief & massive, explosive migraines.
    Who really knows.
    It's depressing & I'm so tired of being treated like a psycho for it being so debilitating.
    The stigma has to go.
    If people only really ever knew.
    It's one long dragged out yo-yo/roller coaster migraine after another.
    I truly prayed cannabis would've worked for me.

    For now, I move on to round three of Botox injections.
    No such relief quite yet and I am beside myself with one type of infection after another for whatever reason…or is it just one infection that won't go away(same unclear dilemma as the migraines)
    Is it me or does this seem really outdated for as advanced as we are today with technology?
    I don't understand why invisibility equals psychosis this day in age.
    The disability in chronic migraine would cause anyone a certain level of psychosis and shouldn't be treated the way it is.

  • Meaghan Coneys moderator
    3 years ago

    Hi Calicatch22,

    I happened upon Tammy’s article and your comment. I wanted to express gratitude to you for sharing your experience with us at Migraine.com. We hear you and see how difficult your path has been. Please know that we are here for you and we appreciate your comments. We hope you continue to use our community as a support. Wishing you all the best and sending lots of good energy your way.

    Best,

    Meaghan (Migraine.com Team)

  • calicatch22
    3 years ago

    Please excuse the very long winded reply, my bad writing skills and typos.
    Not feeling well at all.
    The topic struck a nerve and I kinda went off.
    .Lovelovelove,cc22

  • Tammy Rome author
    3 years ago

    No need to apologize. Your experiences are a valuable addition to the discussion. Hopefully others can learn from what you have shared.

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