New research paves the way for medical cannabis in migraine treatment

“We know a lot about the risks of recreational use. We know next to nothing about the risks of medical marijuana. So we absolutely do need research.” Dr David Casarett

Medical cannabis in migraine treatment

Scientists at the University of Arizona have found evidence supporting the use of medical cannabis for the treatment of migraine. The researchers say medical cannabis lowers migraine frequency and reduces symptoms associated with migraine attacks.

There is a network of receptors known as the cannabinoid receptors in every person’s central nervous system. When an individual uses cannabis, cannabinoid, a substance found in cannabis attaches to the cannabinoid receptors and alters their effect. Researchers at the University of Arizona say this helps to alleviate the severe, recurring headaches of migraine and secondary symptoms accompanying migraines, such as nausea and vomiting.

According to the National Institutes of Health (NIH), cannabis has been used in treating different medical conditions for at least 3000 years. Over the years, research has shown results suggesting that cannabis may be of benefit in the treatment of conditions, such as chronic pain, alcoholism and drug addiction, cancer, multiple sclerosis, epilepsy, depression, post-traumatic stress disorder, social anxiety, and now, migraine.

This is a step away from traditional migraine treatments, such as with different types of pain medications, antiemetics, and serotonin-receptor agonists-triptans. The primary issue with these treatments is the variance in results and potential side effects that depend on the individual patient. For instance In patients with chronic migraine, peripheral nerve decompression, a surgical procedure has been reported to only have 47% success rate. This led to the consideration of dietary and herbal remedies, including the use of medical cannabis for the treatment of migraine.

However, the FDA has not yet deemed cannabis safe or effective in the treatment of any disease.

As there is increased legalization of cannabis, the conflict between the general belief that cannabis is effective in treating a number of ailments and the lack of scientific knowledge on its effects becomes exacerbated. In fact, a recent study titled “Trends and age, period and cohort effects for marijuana use prevalence in the 1984–2015 US National Alcohol Surveys,” published in the journal “Addiction” found that the use of cannabis is rapidly increasing across the United States, causing major public health concerns.

Weighing the benefits of medical cannabis

The benefit of the research conducted by the researchers at the University of Arizona was to evaluate how effective and safe medical cannabis is for treating migraine in adults.

In this review study, Dr Cecilia Rosales and her team found that medical cannabis was about 50% more effective in reducing migraine compared with non-cannabis treatments. After reviewing 12 publications involving close to 2,000 participants ages 18 and older in Italy and the United States, they reported a significant reduction in the frequency of migraine per month and migraine-associated nausea and vomiting in participants who used medical cannabis.

Medical cannabis does not come without its own risks, however. Rosales pointed out some potential downsides, stating side effects such as increased heart rate, dizziness, impaired concentration and memory, slow reaction time, drug-drug interactions, increased appetite, and potential for addiction among others. The researchers however reported that the adverse effects were mostly mild and took place in about 44% of participants using oral cannabinoid preparations.

In an interview with Medical News Today (MNT), Dr Medhat Mikhael, a pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California, expressed the need to only treat patients with medications with the least amount of side effects and do not cause any other headache on top of the migraine.

Daily use of medical cannabis has been linked to medication overuse, rebound headache, and worsening symptoms of bipolar disorder.

Another downside to the use of medical cannabis lies in its legalities. The use of cannabis is not allowed in many countries. Hence, even if people are seeing good results using medical cannabis as a treatment, their countries, jobs, and schools may have rules in place barring its use.

Is cannabis-based migraine treatment worth it?

Globally, migraine affects more than 1 billion people every year, and migraine headaches are also the second leading cause of disability, thus necessitating an effective and long-lasting treatment. However, questions have been raised concerning the use of medical cannabis in the treatment of diseases, including migraine: is it good or bad for the health? Is it worth it or not?

There is yet to be a straightforward answer to these questions. Currently, from the available reviews of the scientific studies evaluating the benefits and harms of the drug, there is an apparent need for more research to fully determine the public health implications of rising medical cannabis use.

Many scientists and health bodies support the need for further scientific research on the use of cannabis and cannabinoids to treat medical conditions. Mikhael and Rosales also agreed on the need for further study and hoped Rosales’ study’s findings will provide clinicians with additional tools to treat migraine in adults.

However, cannabis is classed as a Schedule I substance under the Controlled Substance Act. The Drug Enforcement Administration, through its imposition of strict conditions on the researchers working in this area, deters the study of cannabis and cannabinoids. This is an obstacle to the progress of the research on medical cannabis in this area.

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