Curious About Marijuana for Migraine? What You Need to Know (2024)

Your Guide to the Research, Risks, and How to Get Started

Using medical marijuana to treat migraine symptoms is receiving more attention than ever, but the pain-relieving effects of medical cannabis use date back thousands of years.

The recent loosening of state medical marijuana laws is now making research a bit easier. Still, scientists’ knowledge of best practices for treating migraine attacks with medical marijuana is far from complete.

A review of studies shows some promise, with medical cannabis users seeing 11 percent of acute migraine attacks aborted. Medical cannabis users also experienced significantly reduced migraine-associated nausea and vomiting associated with migraine attacks after six months of use, and a slight decrease in migraine frequency.

But more research is needed. Another study, released in 2021, found that medical cannabis use is significantly associated with medication overuse headache (MOH), or “rebound headache,” in people with chronic migraine. Of the 368 people studied, researchers found those using medical cannabis for migraine pain were six times more likely to have MOH than those who did not use cannabis. Researchers concluded that advising patients with chronic migraine and MOH to reduce their medical cannabis consumption may help treat MOH more effectively.

If you’re looking to try marijuana for migraine attacks, here are a few things you need to know.

1. Marijuana Laws and Restrictions

Before you consider using medical cannabis to reduce migraine symptoms like chronic pain, you need to know the laws in your state. Marijuana is still federally illegal. However, all but 12 states allow it for medical use, and some have legalized recreational cannabis use.

Only certain states list migraine specifically as a qualifying condition, although other states refer to “chronic pain” as a qualifying condition, which could include migraine attacks.

Another thing to keep in mind is that you are not allowed to cross state lines with marijuana products, as per federal law. The rule applies even if you’re traveling from one legal cannabis state to another.

2.The Best Marijuana Consumption Methods for Migraine

You need to consider consumption methods when using marijuana as a migraine treatment to relieve pain. There are a lot of excellent options, but they boil down to inhalation and ingestion. Each offers advantages and disadvantages.

More than 100 cannabinoids have been identified in the cannabis plant. Keep in mind that in this article, we are strictly addressing the cannabinoid referred to as tetrahydrocannabinol (THC). “Cannabis” refers specifically to marijuana, not low-THC hemp.

To learn more about cannabidiol (CBD) for treating migraines, see what real people who have tried CBD have to say.

Smoking Marijuana for Migraine: Pros

Smoking — think joints, pipes, water pipes (“bongs”), and vaporizers — is the best-known way to use marijuana for migraine treatment.

The effects of inhaled cannabis begin after just a few minutes, making this ideal for immediately treating migraine and acute pain. Aside from chronic pain relief, it also addresses other migraine symptoms that might accompany headache pain, such as anxiety or migraine-associated nausea.

Inhaled cannabis’ effects peak within 30 minutes and last two to four hours, depending on potency and individual tolerance.

Smoking Marijuana for Migraine: Cons

Unfortunately, there are drawbacks to inhaled cannabis. Smoking a dry herb involves combustion. Although the smoke from cannabis is not as toxic as tobacco, it can lead to issues like chronic bronchitis or lung inflammation.

The only exception is vaporized cannabis. Rather than light the herb on fire, a vaporizer heats the marijuana in a small chamber, boiling the compounds into a vapor. Not only does this preserve more of the cannabinoids and terpenes, but it also lessens the issue of toxins or irritants associated with smoke — to a certain extent.

Keep in mind, even when vaping, there are risks to medicinal cannabis. For instance, vaping cannabis at a temperature higher than 401 degrees F (205 degrees C) releases benzyne, a known carcinogen, or cancer-causing substance.

Smoke and vapor from medicinal cannabis use also can cause coughing. The violent jerking motions from a cough may make a headache or migraine attack worse — at least until the THC takes effect.

Ingesting Marijuana for Migraine: Pros

There are plenty of ingestible cannabis options — oils, tinctures, baked goods, gummies, chocolates, and drinks, to name just a few.

Unlike smoking, THC reaches the bloodstream through the digestive tract, making it less harmful to overall health. The effects also last longer — up to 12 hours in some cases — with the high peaking between two and four hours.

Ingesting Marijuana for Migraine: Cons

Edibles need to be processed by the body first, so onset takes an average of 30 to 90 minutes, sometimes more. Consequently, edibles are impractical for immediate relief by people with migraine, but are excellent for regular preventive dosing.

Another problem is that it’s a lot easier to overdose or “green out” when using edibles. Many beginners expect to feel the effects quickly, causing them to ingest more. Taking in more THC than needed can lead to symptoms like anxiety, nausea, vomiting, dizziness, and even hallucinations.

When using edible marijuana for migraine, remember the rule of “start low and go slow.” Begin with a low dose (2 mg to 5 mg) and gradually increase every 90 minutes as needed.

3. Which Cannabinoid Is Best for Migraine?

There are thousands of marijuana strains, each with their associated good and adverse effects. Although some were involved in studies, most information about their benefits comes from anecdotes.

However, one 2018 study examining the treatment of migraine with marijuana found more than 40 commonly preferred chemotypes (cannabis varieties). OG Shark — a high-THC hybrid strain with unknown origins — was the best liked, mainly due to its excellent ability to handle symptoms like migraine-associated nausea and to help chronic pain.

Also on the list were other famous strains, like Afghani, Alien OG, Bubba Kush, Cannatonic (high CBD), Jack Herer, OG Kush, Purple Kush, Rockstar, Skywalker OG, Warlock CBD, and White Widow.

You may also wonder if it’s better to ingest sativa or indica for treating migraines. The answer there depends on whether you want more energy and focus (associated with sativa) or need help with insomnia or anxiety (indica is more likely to make you relaxed and sleepy). And go easy, lest you wind up “couch locked” because you had too much. Too much marijuana can make it hard to move, let alone function.

CBS vs. THC

Most of the 40 strains in the aforementioned study were primarily THC, which typically sit in the 15 percent to 25 percent potency range. But some, like Cannatonic, contain virtually no THC and high CBD. Others fell into a more balanced THC-to-CBD ratio.

Researchers in the study found that people with migraine who took 200 mg of oral cannabis containing 0.4 percent THC and 9percent CBD experienced a 55percent drop in pain severity when consumed during migraine attacks. Patients who used that same dose daily experienced 40.4percent fewer headaches as compared to the 40.1percent reduction seen with amitriptyline.

This is good news since CBD is non-intoxicating. A THC level of 0.4percent at 200 mg may still cause impairment in rare cases, such as among THC-sensitive individuals. But any psychotropic effects fade as patients become used to the cannabinoid.

Also, keep in mind that the side effects of opioids or prescription migraine drugs can also cause drowsiness, dizziness, and other symptoms similar to the effects of medical marijuana use — often to a higher degree.

4.Side Effects

All medical treatments have side effects, and marijuana is no exception.

THC does have a long history of pain-relieving effects, but it’s also well known for many things that severely limit a patient’s ability to function.

Some of these include:

• Impaired motor/cognitive skills
• Drowsiness
• Paranoia
• Anxiety
• Rapid heart rate (problematic for those with cardiovascular issues)
• Dizziness

Consequently, those with migraine can’t use THC and still perform daily tasks, like driving or working. It puts them in the same position as an untreated migraine attack. The only difference is symptom relief (when used correctly).

CBD, on the other hand, has fewer side effects, including:

• Drowsiness
• Light-headedness
• Low blood pressure
• Nausea
• Diarrhea
• Irritability

Liver damage is also a concern, particularly at higher doses.

The real problem isn’t necessarily CBD’s potential side effects but rather the source. It’s always safer to get CBD from a licensed marijuana producer. Unfortunately, not all states offer this option. Thanks to the federal legalization of industrial hemp, CBD oil supplements are now legal in all 50 states (infused edibles and other CBD products are technically still illegal).

The supplement industry is unregulated and therefore it can be challenging to find a reputable supplier. Always strive to get CBD from a licensed producer and legal retailer.

5. Cannabis Can Affect Some Health Conditions

Before trying marijuana as a treatment of migraine, it’s important to discuss any existing health conditions with your doctor. Not all medical situations conflict with THC or CBD, but it’s essential to know which ones do.

Anxiety

If you suffer from anxiety, you need to find a delicate balance when using cannabis as a treatment of migraine.

According to a report by the University of Washington’s Addictions, Drug & Alcohol Institute (formerly the Alcohol & Drug Abuse Institute), studies on patients with anxiety found low doses of THC (7.5 mg) eased anxiety while higher doses (12.5 mg) made it worse.

CBD had no adverse effects at any dose. If you have anxiety, your best bet is to use a strain with more CBD and a THC level under 10 percent.

Pulmonary Issues

While there’s no evidence that medical marijuana use causes cancer, chronic obstructive pulmonary disease (COPD), emphysema, or any other tobacco-related illness, smoking cannabis can still be a problem for people with these conditions.

If you have any lung issue, avoid smoking, and stick to either vaporization (for quick relief from migraine attacks), topicals, or edibles.

6. CBD Can Impact Prescription Medication

In recent years, there has been a lot of chatter about hemp-based CBD supplements, which are federally legal (although some states have restrictions in place).

However, high-CBD “marijuana” (cannabis with more than 0.3percent THC) is available when permitted by law.

But CBD is CBD, whether you get it from a dispensary or a hemp extract vendor. The real concern is how it may interact with some medications.

During the groundbreaking epilepsy study on CBD, researchers found a disturbing interaction between the CYP450 family of liver enzymes and various subjects’ medications.

CBD relies on CYP3A4 — a member of the P450 group — for liver metabolism. But during the process, it can interfere with the breakdown of medications that also interact with CYP3A4.

The problem is that some antiepileptic drugs, like valproate (valproic acid), are also used in prevention of migraine attacks. Gepants are also metabolized by CYP3A4, so patients taking Nurtec ODT (rimegepant) or Ubrelvy (ubrogepant) would need to discuss it with their doctor prior to using CBD. Anti-CGRP (calcitonin gene-related peptide) monoclonal antibodies, however, are not metabolized by the liver.

Any medication simultaneously sharing CYP450 enzymes with CBD can lead to at least one of the following complications:

1. The medication inhibits CBD processing, reducing its effectiveness.
2. CBD alters the metabolism process, slowing down the processing of the migraine treatment in question. Medication levels in the blood remain too high, leading to potentially dangerous side effects.
3. CBD increases medication metabolism rates, processing them too quickly and reducing their effectiveness.

7. More Research Is Needed

Although lumped into indica and sativa categories, we now know that those classifications have nothing to do with a strain’s effects. THC and CBD certainly play a prominent role, but their terpenes work behind the scenes to narrow down a chemovar’s (strain’s) effects.

Unfortunately, further research is needed into terpenes and their relation to migraine and chronic pain. But one study in 2018 found two prominent terpenes — myrcene and caryophyllene — were helpful in headache pain reduction.

According to Everyday Health, in a survey of U.S. and Canadian adults published in Psychopharmacology in May 2022, as many as 35 percent reported using cannabis to treat their headaches and migraine.

In another survey, published in the Canadian Journal of Neurological Sciences in September 2021, 34 percent of 200 Canadian patients attending a headache clinic reported using cannabis both for prevention and acute treatment, and often at the same time. Sixty percent reported that cannabis reduced the severity of their headaches, while about 30 percent said it prevented their headaches altogether.

The Takeaway

Although research into medical cannabis use is increasing, there is still a lot we don’t know. Even so, many people use marijuana for treatment of migraine symptoms like chronic pain, and there is some science backing it up.

Overall, research shows that people using medical cannabis to treat migraines reported more positive effects than adverse effects with medical cannabis use. Some reported a long-term increase in well-being with prolonged medical cannabis treatment. And it’s credited with easing migraine-associated nausea.

As with all new migraine treatments, discuss with your healthcare provider and weigh the costs and benefits of preventive migraine treatment and acute treatment, and whether to include medical cannabis as an alternative therapy.

Have you tried medical cannabis for migraine? Share your tips about it.