Marijuana and CBD Oil

Reviewed by: HU Medical Review Board | Last reviewed: April 2024 | Last updated: April 2024

Migraine is one of the most common causes of disability in the world. Treating the symptoms is a top priority for people with migraine disease. People with migraine generally need 1 or more treatments that they can rely on to manage their symptoms consistently.1,2

Some of the more common treatments available over-the-counter include the analgesic acetaminophen (Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin®, Advil®). Triptans like sumatriptan (Imitrex®) are also commonly prescribed for migraine.1,2

Another potential migraine treatment is cannabis, also called marijuana. Some people use cannabis as symptoms happen (acute treatment). Other people use it as part of a routine to prevent and reduce the severity of migraine attacks (preventive treatment).1

What is marijuana? How is it different from CBD?

People have been using cannabis to treat their health issues since ancient times. The active ingredients in marijuana are called cannabinoids. They act on cannabinoid receptors in the brain and body. Delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD) are the 2 main cannabinoids present in marijuana.2,3

THC has psychoactive properties. CBD does not. Both are used to treat a variety of issues. THC has been used to enhance appetite and to treat chronic pain and nausea. CBD causes sedation and is more studied to treat migraine and headaches. Cannabis is generally classified by its proportion of THC to CBD.2,3

In the United States, many states allow medical marijuana. About half of states also have legalized nonmedical use. Nonmedical use is also called recreational or adult use. But any use of cannabis is still illegal under federal law.4

How does cannabis work for migraine attacks?

Cannabis works as an anti-inflammatory, anti-nausea, and analgesic therapy for migraine. THC can cause short-term changes to brain regions that control pain during an attack. It also may modulate migraine-related pathways long-term.2

There is evidence that cannabinoids made within the body may regulate chronic migraine. There is also evidence that THC acts on dopamine levels to keep them from rising too high. This has been shown to help treat acute migraine attacks and their symptoms, including nausea and pain.2

Is marijuana an effective treatment for migraine disease?

Research shows that after 6 months of use, medical marijuana significantly reduces:2

  • Migraine frequency
  • Migraine severity
  • Migraine days per month
  • Headache days per month

Around 87 percent of people with migraine who used cannabis reported a reduction in headaches and migraine attacks. Of those who benefited, women reported slightly better outcomes than men.2

Cannabis users reported significantly reduced symptoms than nonusers, even when accounting for migraine severity. This includes non-headache symptoms like nausea and vomiting. Migraine relief was reported regardless of:2,3

  • THC concentration
  • CBD concentration
  • Dosage
  • Preparation (edible, vaporizer, flower, etc.)

Medical cannabis has also been reported to be effective as an acute treatment. Inhaled or sublingual (under the tongue) cannabis takes a shorter amount of time to take effect and is quicker to leave the body. These ways of taking cannabis may be most effective as acute migraine treatment. Edible formulations may be most helpful for preventive treatment.2

Side effects and other precautions

Research shows that the use of medical cannabis for migraine relief is generally well-tolerated. About 1 in 4 users report mild adverse effects, but it is very rare to experience severe adverse effects. Side effects include:2

  • Drowsiness or sedated feeling
  • Vertigo, lightheadedness
  • Cognitive deficits
  • Stomach issues
  • Euphoria
  • Anxiety or psychosis
  • Headache exacerbation

Adverse effects usually occur when people take too much CBD or THC. High doses of CBD carry a small risk of stroke.3

The right dose for migraine relief varies according to each person’s tolerance. The best source for advice on treating migraine is your own migraine specialist. Before beginning treatment for migraine, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.3

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