Nearly everyone who’s used medical cannabis can relate to its ability to soothe headaches. From easing stress and tight forehead muscles to reducing body pain, cannabis naturally lends itself to being a headache cure. Yet, surprisingly, no clinical tests are being performed at this time to treat migraine patients with medical cannabis. In other words, while some doctors are already prescribing cannabis for recurring headaches, no large clinical studies on actual humans are being conducted. As readers may guess, this may have something to do with the difficulty of getting approval for human studies involving cannabis. In any case, the situation is now remarkably unusual; medical cannabis dispensaries sometimes have more access to medical information than physicians.
Specifically, as a general physician, you may have the opportunity to prescribe cannabis to a number of patients, with only a handful of those seeking treatment for headaches. On top of that, after the prescription for medical cannabis, you can’t track what cannabis was used, how potent it was, where it came from, etc. A large part of the treatment data is inherently unknown by the physician, and getting patients to carefully record and report that data is difficult, further reducing the number of people who could realistically be involved in a study. In fact, busy, time-strapped patients may not even return after successfully treating their problems. Contrast this situation with that of a dispensary. At a medical cannabis dispensary, providers can keep a file on each patient, using purchases to record average usage and potency. Patients also continue to come in even after successful treatment. Medical cannabis providers, such as Cornerstone, really delve into patients’ needs by surveying their medical conditions on the first visit. This means dispensaries can differentiate between groups of patients, such as “headache” patients vs. “arthritis” patients. Dispensaries literally have thousands of medical patients to pull data from. As a result, it’s no wonder that dispensaries often understand much more about what helps specific types of patients than many doctors.
For this reason, in order to conduct one of the first clinical studies of using cannabis to treat migraines, researchers at the University of Colorado decided to pair with Gedde Whole Health, a private medical practice specializing in prescribing medical cannabis for various conditions. Although partnering with a dispensary may have actually provided more data, partnering with a cannabis-centric medical practice still allowed access to a much greater number of patients than would have been possible in a traditional medical practice and made the study more likely to be observed by the medical community. In this particular study, 121 adults with a primary diagnosis of “migraine headache” were identified and prescribed cannabis at the clinic. These same patients were later evaluated at follow-up visits to record any changes in their symptoms.
The results fit with anecdotal knowledge of cannabis: 85.1% reported a decrease in the frequency of migraine headaches, and the total migraine frequency per month decreased from 10.4 to 4.6. When asked to address the effects of cannabis specifically, twelve percent specifically credited cannabis with the ability to end headaches on the spot, and ultimately 40% of patients reported positive benefits in regard to their headaches. Few reported negative effects, and most of those negative effects centered on sleep or difficulty of controlling intensity of dose (with edible users).
Some interesting aspects about the patient data lend extra credibility to the results. For one, the average length of migraine diagnosis was 14 years, meaning that a good chunk of the patients had been through over a decade of trying different medications. For many of those patients, the very reason they’re turning to alternative medicines is because so far traditional pharmaceuticals have offered incomplete or inconvenient solutions. In hand with this, the number of patients using other prescription medicines decreased by 7% over the course of the study. Meaning that at least some of these patients were able to totally eliminate other pharmaceuticals based on the effectiveness of cannabis. The method of consumption also contributes to the reliability of this data. Traditional pharmaceuticals are usually in pills, meaning that it is much more difficult for a patient to draw the line of when the drug has taken effect. As the pill is digested, the concentration of substance in the blood gradually increases. Contrast this to cannabis use, where the majority is inhaled and supplied to the bloodstream almost immediately (with the exception of a handful of patients who chose to eat edibles). This is an important distinction, because for someone aiming to interrupt/abort a migraine headache, it’s not difficult to figure out if vaporizing cannabis helped or not. The migraine is stopped or it isn’t, and since the traditional pharmaceuticals are not taken on the spot in the same way, it’s unlikely the patient would easily be confused between the effects of cannabis vs. the effects of other prescriptions.
Of course, a few weaknesses exist with this method of observation. First, again, the only members who can be included are the ones who returned for a follow up visit, meaning that inevitably the data could be skewed as explained above. Secondly, 50% of these patients were recorded to already be taking traditional migraine pharmaceuticals at the same time. With this scenario, it’s truly impossible to know what cannabis was responsible for alone. Finally, frequency and amount of cannabis use was not taken into account. Perhaps a threshold dose exists for effects, and users who reported no effect did not meet that threshold. These are all serious issues with the data. However, the truth is, until a study is approved that exclusively treats patients with cannabis vs. pharmaceuticals vs. placebo, this is some of the best data we have. As of now, it strongly suggests that there is a clear link between regular cannabis use and treating migraines. For this reason, individuals who have not had success with traditional pharmaceuticals have very good reason to consider giving cannabis a try.
Danielle Rhyne, Sarah Anderson, Margaret Gedde, et al. Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Pharmacotherapy (2016). DOI: 10.1002/phar.1673