Patient Perspectives: Medical Marijuana
As medical and even recreational marijuana is becoming more acceptable and legal, many people are curious as to whether it would help them. “Medical marijuana for migraines,” a recent migraine.com article, garnered so much interest that Katie and I teamed up to find a few people to share their experience with using marijuana for migraine. Due to any potential negative ramifications, those who chose to participate have asked that their identity be protected. We were able to find a range of people from those who just started using to others who had been using it for years. This is the second in our series of interviews, a patient who recently tried medical marijuana for the first time. The patients in both our first and second interviews use medical marijuana for acute pain relief, not as a preventive treatment.
How old where you when your migraine attacks started? I was 5 when I got my first migraine with aura. They were episodic until just before my 30th birthday and then they turned chronic.
How often do you currently get them and how long do they last? Currently I have some degree of migraine every day. On a good day, the pain averages 4-6 on the pain scale and then at night it tends to spike up to an 8 or 9. I go through weeks of having more manageable migraine attacks and then I can go through weeks of barely getting out of bed. I am not able to work anymore due to the severe and debilitating effects.
Have you tried any of these treatments and have they helped you? Please describe.
- Triptans: I was a young teen when triptans came to market. Imitrex, Maxalt, Frova, Amerge. I’ve tried them all. When the migraine attacks were episodic they were the best thing that helped me. Triptans helped me sleep through the pain, but it would still take two or three days to get over the migraine.
- Preventatives: I’ve been on antidepressants such as Zoloft, Wellbutrin and currently Effexor. I’ve been on beta-blockers like Inderal. Also tried Depakote, an anticonvulsant. Amitriptyline, an antidepressant, has been a mainstay for me since I was a kid. Topamax was helpful for years until I developed some serious side effects. I’ve used calcium channel blockers like Verapamil. Over the counter drugs like butterbur, feverfew and magnesium have also helped me.
- DHE: Once triptans stopped working for me, DHE has become my go-to for aborting an attack. Like any abortive, it’s not recommended to take it every day due to the risk of medication overuse headache (MOH). I limit my intake to 3 per week, however there is a DHE shortage so I rarely feel like I have enough in stock to use that many a week. For me the positive effects of DHE don’t usually show up until the next day and it makes me very nauseous. When the migraines seem to be intractable, I often take injections of Toradol, an anti-inflammatory, along with the DHE to get the best results.
- Opioids: I have been using Percocet on and off for about 3 years. I am extremely cautious about using it. I’m well aware of the risk of MOH and the potential for addiction. When used properly, it can really help chronic pain patients. It tends to be a last resort for me to avoid the emergency room.
- Botox: I’ve been on Botox for 3 years. I find that it helps tremendously. It has a life cycle, so during the 12 weeks between injections I experience the most relief for 4-6 weeks in the middle. It never gives me full relief, but I am much more functional during those weeks.
- Physical Therapy: My neck and shoulder muscles are in a constant state of tension. I’ve had massage therapists say my muscles are like steel cables. I’ve done physical therapy 3 different times over the years. I always found it helpful during the actual sessions, but could never get a long term fix using PT.
- Yoga: Yoga has been extremely helpful in working out the kinks in my neck and shoulders. Whenever I feel stiff, I stretch it out. I try to practice at least 3 times a week. It has made me feel stronger and more in touch with what my body needs.
- Acupuncture: I tried acupuncture years ago, before the migraines became chronic. Instead of providing relief, it actually triggered multiple migraines during treatments. I would be open to trying it again.
- Surgery: I’ve not had any kind of surgery for my condition. I considered a neuro-stimulator but found that I was not a good candidate. At this time, it is not something I am pursuing.
When did you start using marijuana to help with your migraines? I never really experimented with marijuana in high school or college. The first time I used it was about 8 years ago during a migraine attack when a friend suggested it. Until recently, I only used it a handful of times specifically during attacks. I began to use it more frequently last summer.
Why did you start using it for your migraines? As you can see, I’ve tried a lot of options to deal with my chronic migraines. I figured I should see if it would really help me if I used it more frequently.
How often do you use it? At this point, I’m using it maybe twice a week.
Do you find it helpful? Is it more or less helpful than any of the other treatments you have tried? It is helpful. My body is still adjusting to this treatment so I don’t feel like I’ve gotten the full effect yet. I like to be in control and when smoking marijuana I feel useless. There are other abortives that I’ve taken that allow me to still feel in control. I’m going to continue to try to find a type that I am fully comfortable with.
Do you also use it for another medical condition you have? If so, what and does it also help that condition? I use it primarily for the headaches, however it helps me to sleep so that’s been a beneficial side effect.
Is your headache specialist aware that you use medical marijuana? (Don’t have to answer if you don’t want to!) Yes, my headache specialist is aware. She says there haven’t been too many studies on how effective it is for migraines but it’s worth a shot to see if it works for me.
I’ve had a headache specialist say that medical marijuana could potentially cause rebound headaches. Have you experienced this? I’ve not noticed that it causes rebound headaches. I also make sure that if I’m going to use marijuana, I’m not taking any triptans or Percocet.
Do you have a preferred species that you use? Indica or sativa or do you like hybrids? Do you use each type depending on the situation? Since I’m relatively new to using marijuana, I’m still exploring the different types and strains. Indica is great when I just want to sleep. I’ve tried a few hybrids. I haven’t found a great sativa that I feel comfortable using during the day.
How do you prefer to smoke marijuana? Joint, bowl, bong, vaporizer, etc. My first experience was with a bong and it was awful. I currently have a vaporizer that I use and it is much cleaner than a joint or using a bowl. With the vaporizer, I don’t have to fight the urge to cough during the process.
Have you tried edibles? I’ve tried edibles, specifically chocolate caramels. The problem is that figuring out the proper dose can be tricky as the packaging isn’t very clear (even when purchased through a dispensary). My first time, I thought I was taking the correct dose, but turns out I used 4 times what I should have. I could not function for a whole day.
Describe what happens when you use marijuana during a migraine. How long does it take before you notice a change in the pain? How long does it last? With the first puff, my body feels transformed, altered. Almost immediately time slows down and I feel like every action takes so much effort. The pain in my head changes as well. Most times, the pain decreases but doesn’t necessarily go away completely. The migraine changes into an everyday mild headache- annoying, but nowhere near as bad as a typical migraine. Depending on how much I smoke, I can get to a point where the pain completely dissipates. Being that high almost always forces me into bed, which isn’t necessarily a bad thing.
Are there other side effects of using marijuana that you experience? (like time moves slowly, you’re euphoric, you get hungry) When I get high, one minute seems like 4 hours to me. I am constantly asking what time it is. I definitely get the munchies too and try to pull out healthy foods to eat before I start smoking. I can also be in the middle of a sentence and completely forget what I was talking about. To be honest, I don’t love the effects. However I am still pretty new to this and maybe I’ve just not found the right strain that helps me.
When it wears off, is the pain any different? Usually the pain has subsided by the time the high wears off. I tend to sleep soon after smoking so it’s not until the next morning when I notice the difference. I’ve had it keep migraines at bay for a few days, but then I’ve also had the pain come back within hours.
How functional are you when you use marijuana? (Clearly not while driving!) I am basically useless. Getting off the couch seems like the hardest thing in the world. This is typical when using the indica species. I would like to try more of the sativa species to see if I could use it and still feel coherent.
Is there any part of using marijuana that you don’t like? (like not being able to focus, forgetting things, feeling lethargic, etc) To be honest, I don’t love feeling worthless when I smoke. Almost every time, I remind myself that I don’t really like the product I am currently using and want to try other types—which can get expensive!
Do your family and/or friends know that you use medical marijuana? Over the years I’ve had so many people encourage me to try marijuana for migraines. When I finally got my license, everyone in my life was very supportive of it since they’ve seen how much I’ve gone through.
Have you come across anyone who is not supportive of your use? No.
Do you think other migraineurs should try it? I absolutely think that migraineurs should try it. Everyone responds differently and it could be an amazing way to deal with the pain. Again there aren’t a lot of studies that support medical marijuana for migraines, but if it helps…why not!
Any advice on how to start? What to look out for? What to be careful of as a first time user? I would suggest trying it with someone who is familiar with it. Do it in a safe space and don’t schedule anything while you’re high until you know how it will affect you. I was lucky to have a few people in my life that helped me through the process since I was clueless.
Anything else you want to mention? I am in the early stages of using marijuana for my chronic migraines. I’m still learning and experimenting. In the end, I may find that it just isn’t for me or it may be another tool to use in fighting the pain.
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