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Medical Marijuana for Migraine: A Reader’s Story

Medical marijuana stories tend to fall into one of two categories: “OMG, it’s so amazing!” or “Marijuana is the worst thing ever.” Reality, as well all know, tends to be a bit more nuanced. A reader left her story on my most on medical marijuana for migraine and headache disorders. I’m sharing it with you because she is detailed in her explanation and also acknowledges some of those nuances.

I have had migraines for 34 years. (since I was 5)

I have tried everything. (No need for a list, we all seem to have similarly long lists of failed meds.)

One thing I had never tried (for migraine) was medical marijuana! I just assumed it was a recreational drug with out real abilities to help with pain, nausea and many other ailments. So, when it became legal to obtain medical marijuana I gave it a try. This plant has helped me tremendously. (Ok, here is where you wonder….) this is what I have found… I can take one or two inhalations off of a Vaporizer or just old fashioned joint and I am able to function again (remember that feeling you had the first time you took a triptan and it worked, yeah, that kind of amazing) now, I’m not saying this will work for everyone or is it for everyone but, if your in a state where medical marijuana is legal, you owe it to yourself to try it and see. It’s not like all the serious medications we’ve all tried over our life time aren’t putting us at risk for a lot of other side effects. Funny none of them offer feeling happy and relaxed as a side effect;) There have been times where I feel a migraine coming on and I inhale one or two hits and I am almost instantly feeling better, heck often I want to do something, like make a yummy dinner or go for a bike ride! (Really, no other medication has ever made me feel that way and helped curb a migraine)

I’m glad I got over the stigma of marijuana. My conservative family sees the change in my health, and are supportive. (I didn’t dare tell anyone until I tried it and knew that it was a reliable tool in my migraine tool box of medications and supplements)

Questions:

Yes, I have a job. (Landscape Desinger) yes, I do keep careful eye on what I eat and drink tons of water. I consider myself a migraine scholar, always reading and trying to learn more. I am a regular gal, looking for answers…willing to try just about anything to just feel better and regain my life)

No, I don’t drink or do other drugs, never been my thing. I don’t get all silly and goofy when I medicate with marijuana. Yes it makes me feel better. I I medicate with marijuana I do feel uplifted, like life is a bit better and my cup feels full. My nausea goes away, severity of throbbing is diminished and I am able to function again.

Now, if I’ve had a migraine for days, and have taken all my rescue RX’s and at that point nothing seems to help, but the marijuana still takes the edge off of my nausea and pain. When I am days into a migraine I prefer to use an edible marijuana candy, (like a flavored cough drop with 25, 50, or 100mg of THC a compound in marijuana)

I don’t think marijuana is a cure all. It does help for me. I am thankful a simple flowering plant has helped me regain some quality of life with my family. I can only hope that enough folks will be willing and able to try this medicine as an option in their migraine tool box. Thank you for reading. I appreciate your time.

This is, of course, only one person’s story. Marijuana, like any medication, should be used wisely and with caution. Please read Medical Marijuana for Migraine & Headache Disorders for guidance and remember to use it in moderation to avoid the risk of rebound (medication overuse) headaches.

If you’d like to share your experience, please leave a comment or send it to me by email: kerrie[at]thedailyheadache[dot]com.

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Medical Marijuana for Migraine & Headache Disorders

Considering treating your migraine or headache disorder with medical marijuana? It’s a complicated topic with a variety of perspectives, so I’ve tried to distill some of the most important information below. I hope it’s a helpful guide.

Marijuana’s Efficacy for Migraine or Headache Disorders

Because laws make research of medical marijuana very difficult, there have been no blinded studies on its use for migraine or headache disorders. Anything you learn about it for migraine or headache is based on anecdote (or extrapolated from a small amount of research on rats). I’ve asked multiple headache specialists for opinions and have been told repeatedly that patients are pretty much evenly split between those who get relief and those who feel worse after using it. My discussions with patients are along those same lines. Its strongest track record is with treating nausea, which can be as debilitating as the pain for some of us.

Efficacy of Different Strains

There are hundreds (may be even thousands) of different marijuana strains, all cultivated to have different effects and address different symptoms. If the marijuana that your brother’s friend’s cousin got for you didn’t help (or made you feel worse), a different strain may still be effective. You can look up many of the strains on Leafly by condition or symptom that they treat, including migraine, nausea, anxiety and insomnia. Leafly also displays the most commonly reported adverse effects of each strain. Not all of these strains will be available at your local dispensary, but dispensary employees can give you recommendations for which might be most useful for you.

Rebound Headache Risk

A couple headache specialists have told me that they don’t know for sure, but believe that marijuana has a similar risk for rebound (medication overuse) headaches as opioids do. It’s best to follow the same rules for opioids (no more than 10 a month) and use as little as possible each time.

How Much to Use

There are no set guidelines for how much to use, though starting with a very small amount is probably wise. Watch your symptoms carefully to see if you feel better, worse or about the same, then decide if you want to try more. If you smoke (or eat) too much, there’s a chance you’re not actually treating the migraine or headache, but getting so stoned that you don’t notice it very much. That may be what you’re going for, but remember that the more you use could increase your risk of rebound headaches.

Smoking/Vaporizing vs. Eating

The two main ways to use medical marijuana are to smoke it or to eat it. The differences are akin to those of oral triptans vs. injected triptans.

Smoking gets the marijuana into your system the fastest and you can quickly see if you need more. Smoking anything can be harmful, although a recent large-scale study found marijuana to cause less lung damage than tobacco. (Using a vaporizer has similar advantages to smoking, but is thought to be less potentially damaging to the lungs. Vaporizers are expensive, so you may not want to invest in one until you discover if marijuana is even helpful for you.)

If you eat marijuana, it will take longer to take effect and your digestive tract may not process a second dose in time for it to be effective. Gastric stasis (delayed emptying of the stomach, which is a migraine symptom) could also mean that you don’t absorb as much as you need when you need it. And, of course, if you vomit during your migraines, you may not absorb much at all.

A friend who was using Marinol (prescription THC capsules) for chemo-induced nausea told me its effects were highly variable. Sometimes it did nothing, other times it helped tremendously. It depended on how how long it had been since she’d last eaten and how effectively her digestive tract processed the drug that day.

Depression and Marijuana

Although depression is one of the many conditions that marijuana is purported to treat, some research indicates that people who use marijuana are more likely to be depressed than those who don’t. However, this could be coincidence rather than causation. As the Mayo Clinic says, “Marijuana use and depression accompany each other more often than you might expect by chance, but there’s no clear evidence that marijuana directly causes depression.”

Legality

Different states have different laws and restrictions governing the use of medical marijuana. Even if it is legal in your state, the regulations may make it undesirable. (In Arizona, for example, employers can check a database of all registered medical marijuana users… if you’re not OK with your employer knowing that, you probably don’t want to get registered.) In your research, check both official statutes and news articles. The official statutes provide the legal framework, while the news stories tell you how the law is being implemented. Whatever the laws, it’s better to investigate exactly what issues you might encounter rather than stumbling into a mess.

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Marijuana a “Wonder Drug”

“If marijuana were a new discovery rather than a well-known substance
carrying cultural and political baggage, it would be hailed as a wonder
drug,” according to Harvard Medical School emeritus professor of psychiatry Lester Grinspoon. Marijuana as Wonder Drug, Grinspoon’s Boston Globe opinion piece, is an interesting take on the controversial topic.

You can learn more on Marijuana Uses, Grinspoon’s website. RxMarijuana has links to articles he has written for the general public. And you’ll find many more by Googling Lester Grinspoon.

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Opioids a Major Topic at the American Academy of Pain Management’s Annual Meeting

Opioids were, not surprisingly, a major topic at the American Academy of Pain Management’s annual meeting, which was held last week. The three main areas discussed were opioid therapy and prescribing opioids, as well as the legal implications of both. The role of cannabinoids (more commonly known as medical marijuana) as a new class of analgesics was also considered.

I haven’t seen many news stories come out of the meeting. I’m hoping for more press releases now that the meeting is over. In the meantime, here are some morsels:

Opioid Prescribing At Forefront Of Pain Medicine Meeting
Opioid treatment is an essential component of pain care for many patients and can be delivered safely and effectively, according to Frederick Burgess, M.D., Ph.D., AAPM president, who estimates that 20 to 60 million Americans live with chronic pain.

“Knowing what the current drug diversion scams are can help physicians decide who is trying to take advantage of them,” says Burke, commander of the Warren County Drug Task Force in the Cincinnati area of southwest Ohio. “The vast majority of patients are not drug seekers and that is where the balance comes in. We do not want to deprive legitimate patients effective pain relief through legally prescribed medications because of the acts of a relative few.”

Scientific Research Highlights Of The American Academy Of Pain Medicine Annual Meeting
Despite media reports suggesting that the Internet is the primary source for illegally obtained prescription opioids, only a small percentage of opioid analgesic addicts who are seeking methadone maintenance treatment reported this as a direct source of their drug supply.

The most commonly reported sources for obtaining opioid analgesics included: dealers (79.96%), friends or relatives (51.3%), physician prescription (30.17%), emergency room visits (13.53%), theft (6.48%), forged prescription (2.48%), Internet (2.9%), and other (not specified) (2.7%).

. . .

[R]eports from the local sources indicated that hydrocodone and oxycodone (immediate-release and extended-release) were reported to be the most frequently abused and diverted opioid analgesics. . . .

Abstracts from the poster presentations are also available.