Patient Perspectives: Medical Marijuana
Kerrie recently wrote an article called “Medical Marijuana for Migraines”, which got a lot of attention. As medical and even recreational marijuana is becoming more acceptable and legal, many people are curious as to whether it would help them. Kerrie and I decided to team up to find a few people to share their experience with using marijuana for their Migraines. 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 first in our series of interviews, a patient with years of experience.
How old where you when your Migraines started? I have had Migraines for as long as I can remember. They became chronic with puberty.
How often do you currently get them and how long do they last? I currently get them maybe six times a week. If I take triptans early enough, they usually last a couple hours at most.
Have you tried any of these treatments and have they helped you? Please describe. You name it, I have tried it. Triptans did not work for me for years. I tried them again after I found a preventive that helped a little and now they work most of the time. I have tried probably 40 preventives. I have tried DHE, Migranal and opioids multiple times, but they do nothing but give me side effects. Botox, physical therapy, yoga, acupuncture and surgery were all ineffective.
When did you start using Marijuana to help with your Migraines? 8 years ago.
Why did you start using it for your Migraines? No matter how many treatments I tried, I could not control the Migraines with preventives or abortives or alternative treatments. The pain and nausea finally got to be too much to bear.
How often do you use it? I used it daily for a few years, but my use has been decreasing slowly. Now I use it every couple months.
Do you find it helpful? Is it more or less helpful than any of the other treatments you have tried? It is most helpful for me for nausea and fatigue and helps the pain some. When my nausea was constant and severe and I was losing too much weight, it allowed me to eat enough that I was able to stop the weight loss. My nausea is both less frequent and less severe now and Zofran is just as effective. The marijuana works faster. I use it when I need relief quickly.
I was surprised when I found that marijuana helps my fatigue, but gives me 1-3 hours of productivity after I use it. My fatigue is normally so bad, I can barely move. When the marijuana wears off, I go back to the fatigue level I was at before using it. If I get the full three hours of productivity, I can use a little more to reduce the fatigue again. If the original reduction in fatigue only lasts an hour or two, using more will just make me more tired. Even if it is only an hour, I am happy that instead of lying in bed, I can do some things around the house or go out with friends. I would have had to miss a friend’s wedding if I had not smoked a small amount before leaving the house.
Sometimes it reduces the pain, sometimes it sends me to a happy place where I can ignore the pain a little bit. Sometimes it increases the pain, but that is rare.
Triptans are now more effective than marijuana. If for some reason the triptan does not work, the marijuana is a good backup.
Do you also use it for another medical condition you have? If so, what and does it also help that condition? No.
Is your Headache Specialist aware that you use Medical Marijuana? My current headache specialist does not know, but I have told the last few I have seen. They have all told me that smoking is bad for my lungs, but that it seems to help some patients. I do not use it enough now to feel like it is relevant for my treatment.
I’ve had a Headache Specialist say that Medical Marijuana could potentially cause rebound headaches. Have you experienced this? I am not sure. I used it daily for the first three years. The Migraines were really bad anyway, so I do not know if rebound headaches were a factor. After starting a preventive and abortive, both which helped a little bit, I stopped using marijuana for a couple months. My mood improved and the Migraines were less disabling than when I was using marijuana heavily. I cannot tell you if that was the new preventive or abortive or stopping the marijuana, but I am guessing it was all three. When I started using it again, I tried not to use it more than a few times a week.
Do you have a preferred strain that you use? Indica or Sativa or do you like hybrids? Do you use each type depending on the situation? Someone at a dispensary told me that sativas would give me energy and indicas would help me sleep. Fatigue is a bigger problem for me than insomnia, so I use sativas the most. Sometimes I use hybrids, but mostly sativas. I like Maui, Jack Herer, and Strawberry Cough. Green Crack worsens my Migraines. A dispensary employee told me that was probably because of its high THC levels, so I try to go for lower THC.
How do you prefer to smoke Marijuana? Joint, bowl, bong, vaporizer, etc. I have tried all of the above. I try to use as little as possible, which is not a use bongs support. I used a one hitter and a small water pipe (which makes the smoke less harsh to inhale) for a while and have also tried several vaporizers. I now have the Pax, which is a small, portable vaporizer. It is great. I do not think I will use marijuana any other way again.
Have you tried edibles? Yes. I do not like them. They take too long to work and are too unpredictable in their effects.
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? Relief comes on within about 10 minutes and lasts for about three hours. If I do not have any relief after 15 minutes of taking my first hit, I will take another hit. I stop if that does not work. I have learned that smoking more will not help me. When it does help the pain, I take an additional hit every hour or so. If it helps the fatigue, but not the pain, I do not take any additional hits until at least three hours after the first one. Otherwise, it cancels out the effects and I become fatigued again.
Are there other side effects of using Marijuana that you experience?(like time moves slowly, you’re euphoric, you get hungry) Yes, depending on the strain. Some make me really hungry, some do not. Euphoria is a little strong for how I feel, but I get giddy and happy. Maui makes me think my ideas are really clever, which is fun when I can not do anything other than think. A friend gave me some that made me paranoid, but I do not know what the strain is. I have not had that problem with any I got at a dispensary.
When it wears off, is the pain any different? My pain relief is limited to the time I feel high. I try to take it so it gets me through the worst of the Migraine, then I have lower pain when I stop feeling the effects of the marijuana.
How functional are you when you use Marijuana? (Clearly not while driving!) Quite functional most of the time. That is the primary reason I use it.
Is there any part of using Marijuana that you don’t like? Sometimes I think it gives me a hangover headache or makes me slow the next day. I generally like the effects of it and used to think I would use it recreationally. Maybe I would use it recreationally if I did not have to use it for Migraines. It is just a medicine to me now. I weigh the benefits versus the side effects just as I would with any other medication.
Do your family and/or friends know that you use Medical Marijuana? Yes. I do not think there’s anyone I have kept it from except kids.
Have you come across anyone who is not supportive of your use? No one has told me they are not supportive. I do not know if they say anything behind my back.
Do you think other Migraineurs should try it? If they want to, but be careful. Rebound headaches are a possible issue.
Any advice on how to start? What to look out for? What to be careful of as a first time user? Get it from a dispensary so you know what strain you are using and what effects to expect. If you can, go to a dispensary with strict growing conditions and testing methods and knowledgeable staff. The staff should be able to consider your symptoms and recommend the best possible strains. I thought all dispensaries were this way until I went to one where the employee gave me a blank stare when I asked for advice. He then opened a jar and said, “Does this smell good to you?” When I said yes, he said, “Well, the nose knows. If you like the smell, it will help you.” That was not helpful. Despite large numbers of people who actually use marijuana as medicine, many dispensaries still act as though their clients are faking a medical condition so they can get marijuana for recreational use. Many have staff who sample the goods while at work.
Start slowly and use as little as possible. Take one hit and wait at least 15 minutes before taking another. Marijuana makes some people feel worse. You would rather know that when you have as little as possible in your system. Otherwise you will be even more miserable while you are waiting for the effects to wear off.
If possible, have someone who is supportive with you when you use it. If you get paranoid, it can be calming to know someone is around who could take you to the ER or answer the door or take care of whatever it is you are paranoid about. If the marijuana makes your Migraine worse, it is nice to have someone who can sit with you through the worst of it.
Take note of each strains you try and whether you think it was effective and for which symptoms. You may find some strains are better for certain symptoms than others.
Anything else you want to mention? Marijuana is best for me when an abortive does not work. It does not work as an abortive on its own. I only use it when a Migraine has gotten too bad to function, when I need fast nausea relief, or need help getting to sleep with a Migraine. Even when the pain is high, I rarely use it unless I really need to get out of bed. Marijuana is too unreliable in my experience. Sometimes I can use it and it gives me energy or makes the pain better, sometimes it makes it worse (but that is rare).
Can you tell when a migraine attack is coming?