How to Ease Migraine Pain With Cannabis

Migraine is the most common neurological disorder, affecting about 10% of the world’s population. Symptoms range from visual disturbances to debilitating headache pain that lasts for days. Though the causes of migraines remain unclear, recent research points to deep connections between the endocannabinoid system (ECS) and migraine—and those connections can explain why cannabis can be an effective treatment for a variety of migraine symptoms.

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Migraine Types & Common Symptoms

There are many different types of migraines that produce numerous symptoms. Migraine types include:

• common migraine, characterized by severe and disabling headache pain.
• classic migraine, which includes an aura stage characterized by temporary vision loss, strange distortions in vision and in some cases even hallucinations.
• optical or ocular migraines, characterized by the visual distortions of the aura without the accompanying severe headache.

Besides aura and headache pain, migraine sufferers of all kinds can also experience:

• nausea
• chills
• temporary numbness or tingling in extremities
• sensitivity to light and sound

Migraine: The Mystery Disease

Although migraine treatments aim to relieve symptoms, the actual mechanisms that trigger migraine are still largely unknown—but that may be changing.

Studies on the causes of migraine have cited many factors such as:

• genetic predisposition
• hormonal imbalances
• stress
• flashing lights
• food sensitivities that trigger changes in neurological activity in the brain and central nervous system

But recent research on the functions of the ECS suggests that this vast and still relatively unexplored network of cannabinoid receptors may play a major role in the migraine process. These discoveries help explain why many migraine sufferers are able to find relief by using marijuana in some form.

The Endocannabinoid System: Key to the Migraine Puzzle?

The human body is home to a number of receptor systems—cells that are stimulated to respond when they come in contact with a triggering chemical; these chemicals can be naturally produced by the body or introduced from an outside source. Some receptor systems are relatively limited, but others, such as the ECS, are found throughout the body and affect the activity of many other processes.

The ECS’s receptor network responds primarily to natural cannabinoids produced by the body, and so far, two of these have been identified: anandamide—or AEA—and 2-AG. These chemicals contribute to the regulation of a variety of processes including pain signaling, immune response, mood regulation and digestion.

These natural cannabinoids are very similar to the compounds in cannabis called tetrahydrocannabinol (THC) and cannabidiol (CBD). When marijuana is consumed, these compounds can trigger the body’s ECS receptors in virtually the same way. That’s why, for example, marijuana can help relieve conditions such as chronic pain, anxiety or depression—it triggers a response from the ECS in areas of the brain related to pain modulation or mood.

Endocannabinoid Deficiency May Set the Stage for Migraine

For a variety of reasons, the ECS can become deficient or dysfunctional so that the body doesn’t produce enough of the natural cannabinoids anandamide and 2-AG. Recent research suggests that endocannabinoid deficiency may play a role in a number of chronic conditions including fibromyalgia, arthritis, irritable bowel syndrome, a variety of mood disorders—and headaches including migraine.

RELATED: DO YOU HAVE CLINICAL ENDOCANNABINOID DEFICIENCY?

Some research on the connection between cannabis and migraine reveals that sufferers appear to have a decrease in the expression of a gene called CNR1, which encodes the cannabinoid receptor CB1. This deficit appears to be associated with brain activity that can trigger migraine.

Migraine sufferers also tend to have higher activity related to fatty acid amide hydrolase (FAAH), a fatty acid that degrades anandamide. This contributes to an overall decrease in endocannabinoids throughout the body. In general, people with migraine tend to have lower levels of anandamide and elevated levels of a protein called CGRP, which can trigger the inflammation in the brain’s blood vessels that lead to migraine pain and other symptoms.

Lower levels of endocannabinoids also affect the composition of a migraine patient’s blood. Cannabinoids play a role in stabilizing blood platelets, and one migraine study found that endocannabinoid levels are low in the platelets of migraine patients’ blood. This could explain why antiplatelet medications—often prescribed to prevent dangerous blood clots—can sometimes alleviate the symptoms of migraine.

Consuming cannabis in all its forms can increase cannabinoid levels and help cannabinoid receptors perform their many functions—including preventing migraines from developing and easing symptoms once the process begins. Although research on cannabis for migraines has been limited, consumers say anecdotally that it can help stop the pain of a headache and ease other migraine symptoms as well.

How to Treat Migraine Symptoms With Cannabis

In general, the most effective cannabis products for treating migraine are typically high in CBD, a non-psychoactive compound with anti-inflammatory and pain-relieving properties. That said, everyone has a unique endocannabinoid system and biochemistry—so experimentation is necessary to figure out if a pure CBD product or one containing both CBD and THC works best for them. Effective delivery methods include inhalation, sublingual sprays and tinctures along with cannabis salves and creams that can be rubbed into the temples, forehead and neck during a migraine attack.

When a migraine begins, cannabis expert Dr. Patricia Frye recommends inhaling cannabis, either by vaping or smoking, which gets cannabis compounds into the bloodstream quickly and can help to “head off” the impending migraine. Then, taking small doses of a CBD tincture or sublingual spray can help keep pain levels low. Experienced cannabis consumers recommend starting with small amounts of an unfamiliar product and increasing doses gradually until the desired effect is reached.

Some cannabis strains tend to offer more relief for migraine symptoms than others. Consumers say that high CBD and low THC strains such as Cannatonic, ACDC and Hawaiian Dream are most effective for treating pain and other migraine symptoms—but you’ll need to find the marijuana products that work best for you.

Migraine is a common but complex disorder, and questions still remain about its causes and the best options for treatment. But recent research reveals that the endocannabinoid system can play a major role in the processes that trigger migraines—and for many migraine sufferers, cannabis is uniquely able provide the relief they’ve been looking for.

Photo credit: Jose Navarro

If you’re new to cannabis and want to learn more, take a look at our Cannabis 101 post. HelloMD can help you get your medical marijuana recommendation; it's easy, private and 100% online.