The use of cannabis in the treatment of migraines and chronic pain.

Due to the number of studies confirming the effectiveness of kannabinoids in the treatment of pain, in 2014 the Canadian Pain Society issued a statement recommending cannabinoids as a tertiary therapy for chronic pain neuropaque[5].

Hemp - natural analgesics

We live in times when people's awareness of the comprehensive, beneficial effects of hemp is growing, which is associated with the more frequent use of various types of hemp preparations, whether in the form of CBD dried products, CBD oils, or e.g. capsules and cosmetics. Currently, there are many scientific studies confirming the therapeutic properties of compounds obtained from hemp.

The research concerns, among others: cannabinoids such as CBD, CBG, THC, as well as their acidic forms CBDA, CBGA, THCA. In addition to cannabinoids, cannabis terpenes, i.e. organic chemical compounds that are responsible for, among others, for the smell of individual varieties and phenotypes of hemp.

Flavonoids are another group of compounds that occur, just like in any other plant, also in hemp. Flavonoids are responsible for the color of the plant, but also for its taste and smell. They have long been used in medicine and the cosmetics industry, including: due to its antioxidant and anti-inflammatory properties. All this and much more is found in these unique plants, which are both Indian hemp called marijuana and hemp.

medical marijuana for migraines

Many people are aware that in the case of serious diseases, such as glaucoma, cancer, Parkinson's disease, drug-resistant epilepsy, hemp is very helpful and often used during therapy, and its beneficial properties have been confirmed by numerous studies. Fewer people are aware, however, that in Poland it is possible to obtain a prescription for medical marijuana, i.e. the so-called Indian, containing a large amount of psychoactive THC (tetrahydrocannabinol) for therapeutic purposes. Marijuana is a plant that, in our opinion, should replace most chemical agents and drugs, also used in less serious but troublesome diseases. Despite the generally available hemp preparations based on CBD cannabidiol, which also has a lot of health properties, we believe that we will be able to see the times when every Pole will have full freedom in using any hemp, including those with a higher THC content. We want as many people as possible to know the huge potential of this plant, which will only be possible through education and presenting facts. In this post, we will focus on a problem that affects a large number of people, i.e. various types of pain, e.g. head and the migraines. What do previous studies say about the beneficial properties of cannabis in the case of pain and migraines? What compounds contained in hemp have analgesic properties? What hemp preparations will be the best for migraines and headaches?

The effectiveness of compounds obtained from hemp in eliminating pain and migraine attacks.

Headaches and migraines are a nuisance for many people nowadays. Many people do not find a solution that would permanently help get rid of the troublesome problem, which is why they regularly stuff themselves with chemical painkillers that are not indifferent to our body. How can hemp help in this case and what does science say about this topic, i.e. medical research conducted so far?

Migraines - a problem for about 15% of people in the world

cannabis for migraines and headache

The current treatment of migraine is mainly based on prophylactic therapy, e.g. with the use of antiepileptic, antidepressant and antihypertensive drugs.[1] In the case of acute migraines, stronger, specific drugs are used, i.e. non-steroidal anti-inflammatory drugs (NSAIDs) and triptans. Triptans are one of the basic and most commonly used groups of drugs that inhibit migraine attacks and the associated headache [2]. As it turns out, there is no rage. In the conducted studies, as many as 25% of patients do not respond to triptans at all. One-third of triptan patients are pain-free for as little as 2 hours, and only 17%-25% are pain-free for 24 hours[3,4]. Finding an effective preparation in the treatment of migraine seems therefore necessary.

There are studies that have shown that cannabinoids work within the migraine and pain pathways in the human body, including the pathway involving triptans.

The US National Academies of Sciences, Engineering, and Medicine has released a statement that the use of cannabis for pain management is supported by well-controlled clinical trials and that there is substantial evidence that cannabis is an effective treatment. treatment of chronic pain in adults[6].

The endocannabinoid system

We briefly discussed the work of the endocannabinoid system (EKAN) in this post: read moreit includes the central and peripheral nervous system. As we know, the EKAN system plays a significant role in the regulation of physiological processes occurring in almost every organ system. It is also involved in processes related to inflammation and pain.

endocannabinoid system

CB1 endocannabinoid receptors

CB1 receptors of the EKAN system are located mainly in the presynapses of peripheral and central nervous system fibers, but also in a significant amount on the so-called anatomical paths of pain, e.g. :

  • in the periaqueductal gray matter (PAG) - the gray matter of the midbrain surrounding the cerebral aqueduct. It has the function of modulating pain,[7]
  • in the ventrolateral anterior spinal cord,
  • ineurinternal parts of the spine,
  • in nociceptors, i.e. pain receptors,
  • in other areas of the brain, such as the amygdala, cerebral cortex, hippocampus, and in the substantia nigra, where most ofeurons, it inhibits neurGABAergic ions (Te neurthey release inhibitory neurtransmitter – gamma-aminobutyric acid – GABA, which is responsible for calm and relaxation) [6].

CB2 endocannabinoid receptors

CB2 receptors are concentrated mainly in peripheral tissues and immune cells, where they influence the release of cytokines, chemokines and cell migration, including neutrophils and macrophages, and to a lesser extent in the nervous system. They can be found in lower concentrations in certain brain regions, including the PAG and some n subpopulationseuronal astrocytes, microglia and oligodendrocytes. [38,39] CB2 receptors may also contribute to pain relief by modulating dopamine release [40].

The role of cannabinoids in the treatment of migraines, headaches - Research

There are many studies and scientific articles confirming the effectiveness of cannabis, specifically cannabis cannabinoids in the treatment of headaches, migraines [9-12], chronic migraines [13,14,15,1,], headaches caused by overuse of drugs, as well as cluster headaches head. [1]

In one of the prospective studies, the results of which were presented at the 3rd Congress EurOpean Academy Neurology (EAN) in Amsterdam in June 2017 [16] investigated the effects of cannabinoids in the prophylactic and acute treatment of both chronic migraines and cluster headaches.

Cluster headache - a type of primary headache that is much less common than migraine or tension-type headache, but its exact frequency is unknown. In many cases, it remains unrecognized.[17]

In the cited study, patients were administered two compounds - one contained 19% THC and the other contained a combination of 0,4% THC + 9% CBD. The study involved 48 volunteers suffering from chronic migraine. In the first phase of the study, the appropriate dose was selected. Below 100mg was ineffective, while oral doses above 200mg were administered during acute migraine attacks. reduced the intensity of pain by as much as 55%.

In the second phase of the study, the dose of cannabinoids selected in phase 1 was used. The study involved 79 patients with chronic migraine, who were randomly divided into groups. The first group was treated prophylactically for 3 months with amitriptyline (a psychotropic drug) 25 mg daily, and the second 200 mg of a solution of 0,4% THC + 9% CBD dissolved in 200 ml of emulsion fat.

Patients with chronic cluster headache (n = 48) were randomly assigned to 1 month of prophylactic treatment with verapamil 480 mg daily or THC + CBD 200 mg daily in 200 ml of a 50% fat emulsion. In the case of acute pain attacks, additional doses of THC + CBD were administered, up to a maximum of 200g.

In migraine patients, prophylaxis with THC + CBD 200 mg led to a 40,4% improvement compared to 40,1% with amitriptyline. In cluster headache patients, THC + CBD 200mg prophylaxis showed minimal benefit. The additional administration of THC + CBD 200 mg during acute attacks reduced pain intensity in migraine patients by 43,5%. The same result was seen in patients with cluster headache, but only if they had a history of migraine in childhood. In cluster headache patients with no previous history of childhood migraine, additional treatment with THC-CBD 200 mg did not result in a clear improvement in acute therapy.

Tested doses of cannabinoids have been shown to be effective for migraine sufferers, but ineffective for cluster headache sufferers. The effectiveness is slightly higher compared to the effectiveness of a psychotropic drug. One way or another, in favor of hemp cannabinoids is their 100% natural origin.

medical marijuana and hemp - scientific research

Another study is a retrospective study, which is really an analysis of data collected in the past. This study looked at the effects of cannabis use in the treatment of migraine. The results are quite promising.[18] Patient data was collected from 121 adults treated at two medical marijuana clinics in Colorado. Everyone in this group was treated for migraine temporarily or preventively with marijuana. There were 7 patients on daily prophylaxis only, 4 patients on rescue therapy only, and 110 patients on both rescue and preventive therapy. The value that was compared was the average number of migraines per month. The average number of migraines per month fell from 10,4 to 4,6. Overall, 103 (85,1%) patients reported a decrease in migraine frequency per month, 15 (12,4%) reported the same number of migraines per month, and three subjects (2,5%) had an increase in the number of migraines per month.

The results of this study highlight the importance of an individual approach to the patient. There were 3 people who could be said to have been harmed by marijuana, but as many as 110 people got rid of more than half of their migraine attacks so far! It's not to say that other doses or different strains of marijuana wouldn't help these three people as well. These results show how important an individual approach to the patient is, and individual selection of the appropriate hemp preparation for specific problems and diseases.

How can cannabinoids help with migraines and other pains?

THC - analgesic effect

  • THC reduces the response of the NMDA Receptor (N-methyl-D-aspartate receptor) by 30-40% with an accompanying antioxidant effect neurprotective. [19,20,21] NMDA mechanisms play a significant role in secondary and tertiary hyperalgesia (i.e. increased response to stimulation[22]) in chronic pain syndromes such as fibromyalgia and chronic migraine.[23]
  • It inhibits the activity of CGRP [24]. CGRP peptide is considered the main mediator of the pain reaction. It has been shown that it can activate neursensory cells, which directly regulates pain reactions, among others. during migraine attacks. Therefore, research is underway to develop effective drugs that block its action or reduce its concentration. [25]
  • Blocks the so-called capsaicin-induced hyperalgesia. [26]
  • It reduces the reuptake of serotonin - 5HT, which translates into an increase in its concentration, while low levels of serotonin may result in increased sensitivity to pain. [27] Increases brain production of 5HT and inhibits the release of 5HT from platelets. All of these mechanisms can certainly influence the trigeminal vascular pathways of migraine [28-31].
  • Intrathecal and intraventricular administration of THC produces analgesia (pain relief) similar to opioids. However, the use of opioids may cause a number of adverse effects on the central nervous system. [32]
  • THC also stimulates the production of beta-endorphins, where endorphins bind to opiate receptors (they are their antagonists), thus reducing the sensation of pain.
  • THC increases the mRNA levels of proenkephalin [34], a precursor to the formation of enkephalins, in regions of the brainstem, with enkephalins acting as endogenous ligands for opioid receptors [33], so they are involved in pain processing.thc AND cbd CANNABINOIDS

There are many studies in various chronic pain syndromes showing the benefits of varying amounts of THC delivered to the body by smoking or vaping dried marijuana [1]. Therefore, it cannot be unequivocally stated whether these research results are due to the effect of THC alone or the synergistic effect of other undefined cannabinoids, terpenes or hemp flavonoids.

CBD - analgesic effect

  • It inhibits the uptake of Ananamide (AEA) and its metabolism in the body - thanks to which the level of Ananamid is higher, and it has been shown that the presence of Ananamid - a natural cannabinoid found in the human body, is associated with a reduction in the level of pain. [35]
  • It acts as a TRPV1** agonist* similar to capsaicin, although without the associated harmful side effects.
  • It acts as a positive allosteric modulator of α1 and α1β glycine [36]. It has been suggested that this plays a role in chronic post-inflammatory pain and nerve injuries because glycine itself inhibits postsynaptic neurons.eurrelay in the dorsal horns of the spinal cord.
  • CBD acts as a ligand of the μ-opioid receptor and a positive allosteric modulator of the μ- and δ-opioid receptors, suggesting that it may potentiate the effects of opiates, which, among others, raise the pain threshold. [37]

However, there is no study that has evaluated pure CBD in the treatment of chronic pain or headache disorders. As with THC, other cannabinoids and phytochemicals in cannabis may also contribute to the overall positive effect.

TERPENES - analgesic effect

Terpenes and terpenoids are the main components of plants. Cannabis contains up to 200 different terpenes. Terpenes have a therapeutic effect on their own, but they also work synergistically with hemp cannabinoids. They can affect the binding of THC to CB1 receptors, and they can also interact with other receptors in the body, the action of which shows analgesic reactions. [1] The most common terpenes in cannabis that have an analgesic effect include:

  • β-caryophyllene – occurs in cinnamon, cloves, black pepper, oregano, basil, rosemary and hops. It has an analgesic effect in inflammatory paineuropathic, [41]
  • myrcene – often found in aromatic herbs such as basil, bay leaves, lemongrass, wild thyme, parsley, tropical fruits such as mangoes and hops. Has strong anti-inflammatory, analgesic and anxiolytic properties [42]
  • linalool – found in many spices and flowers, including lavender, citrus, coriander, rosewood, and birch. It has anti-inflammatory and analgesic properties, analgesic by activating the opioidergic and cholinergic systems, [43]
  • limonene - found in the peel of all citrus fruits. It is the second most common terpenoid found in nature.[1] It is used in many household cleaners, perfumes and foods. Studies have shown its analgesic properties. [44]
  • terpineol is found in pines, lilacs, eucalyptus and linden flowers. Commonly used in soap, perfumes and cosmetics. It has also been shown to have analgesic properties, but also anti-inflammatory and antioxidant properties.[1]

    pain reliever

Some of the reported benefits attributed to individual terpenes come from studies evaluating whole essential oils or plants where a particular terpene may be present. It should be taken into account that the demonstrated effects of terpenes could also depend on the presence of other phytochemicals in the tested oils or extracts.

Why does one CBD oil help and another not?

Individual strains of hemp, including indica and fiber hemp, differ in composition, but above all in the proportions of cannabinoids, terpenes, flavonoids and other phytochemicals contained in them. All the effective effects of these plants on the human body are mainly due to the synergistic effect of the compounds contained in them. Hence, there may be differencesice experienced by patients using prophylactic and ad hoc use of CBD oils, dried CBD or medical marijuana in various forms, from various manufacturers.

One of the proofs that it is the synergistic effect of the compounds present in hemp that matters most is the fact that hemp sativa i indicawhich have similar proportions of the main cannabinoids THC and CBD, produce different effects. This is due to the difference in the content of other cannabinoids, terpenes and other plant compounds. There is a study that showed that hybrid strains were the most effective for migraines and headaches indica/sativacharacterized by a high level of THC / THCA, a low level of CBDA / CBD, and in which the terpenes β-caryophyllene and β-myrcene were dominant [1].

Cannabis for migraine opinions

Cannabis (also known as marijuana) is often discussed in the context of treating various conditions, including migraines. Opinions about the effectiveness of marijuana in the treatment of migraines vary and depend on many factors, including the body's individual response.

Potential Benefits: Some research suggests that marijuana may help relieve migraine symptoms such as headache, nausea and photophobia. Marijuana's active ingredients, such as THC and CBD, can affect the body's endocannabinoid system, which could theoretically help reduce pain and inflammation.

Various Opinions and Experiences: User and patient opinions vary. Some report significant relief from migraine symptoms, while others see no significant improvement or experience unwanted side effects. It should be noted that there is still a lack of clear, large-scale clinical trials confirming the effectiveness of marijuana in the treatment of migraines. Most current data are based on anecdotal accounts or limited-scale studies.

Due to its legal status, hemp has limited access to appropriate research. Fortunately, this trend is changing, so it is worth keeping up to date with scientific research that will mushroom.

Consultation with a doctor: When considering marijuana as a treatment for migraines, consulting with your doctor is crucial. A specialist can advise on the potential benefits and risks, and can legally prescribe medical marijuana if it is recommended and permitted in your country.

Let's sum up!

Hemp is an extraordinary plant that contains a number of substances that have a beneficial effect on the human body. There is increasing evidence of the therapeutic benefits of hemp cannabinoids in many diseases and bothersome ailments such as chronic pain, migraines and headaches, but there are no precisely developed compositions of preparations most suitable for the treatment of specific diseases. As you can see, it is necessary to deepen knowledge about hemp and the compounds it contains. It is important to select the appropriate proportions of individual cannabinoids and other hemp phytochemicals, and to select the appropriate dose in the treatment of various diseases.

What speaks in favor of hemp compared to available painkillers is that they are natural. To replace chemical drugs, you just need to approach the topic sensibly and slowly observe the body's reaction to different doses of cannabinoids. It is also worth being under the care of cannabis specialists and therapists who are knowledgeable about the symptoms of using too much or too little.

At the moment, everyone can use oils, dried herbs or other preparations obtained from hemp. In these preparations, the THC content is below 0,2%. However, studies have repeatedly shown that a higher THC content in combination with CBD gives even better therapeutic effects, including: in the case of migraines and headaches. For our part, we confidently recommend visiting doctors who know cannabis and are not afraid to use their rights to prescribe medical marijuana also to patients struggling with migraine pain.

* The agonist binds to the receptor and causes a reaction in the cell. It's the opposite antagonists, which, by binding to the receptor, blocks it without causing a reaction.
**TRPV1 is also called the capsaicin receptor, which is a spicy substance found in chili peppers. The receptor is located in sensory nerve fibers and non-sensory cellseuronal, for example in vascular endothelial and smooth muscle cells. It is believed to act as an integrator of various physical and chemical stimuli that provide heat and pain
  1. Baron EP. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science. 2018 Jul;58(7):1139-1186. doi: 10.1111/head.13345. PMID: 30152161.
  3. Ferrari MD, Goadsby PJ, Roon KI, Lipton RB. Triptans (serotonin, 5-HT1B/1D agonists) in migraine: detailed results and methods of a meta-analysis of 53 trials. cephalalgia. 2002;22:633-658.
  4. Ferrari MD, Roon KI, Lipton RB, Goadsby PJ. Oral triptans (serotonin 5-HT(1B/1D) agonists) in acute migraine treatment: a meta-analysis of 53 trials. 2001;358:1668-1675.
  5. Moulin D, Boulanger A, Clark AJ, Canadian Pain Society, et al. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Res Manag. 2014;19:328-335.
  6. Committee of the Health Effects of Marijuana: An Evidence Review and Research Agenda. The Health Effects of Cannabis and Cannabinoids. The Current State of Evidence and Recommendations for Research. Washington, DC: The National Academies Press; 2017.
  9. Noyes R, Jr, Baram DA. Cannabis analgesia. Compr Psychiatry. 1974;15:531-535.
  10. Schnelle M, Grotenhermen F, Reif M, Gorter RW. Results of a standardized survey on the medical use of cannabis products in the German-speaking area. Forsch Komplementarmed. 1999;6:28-36.
  11. Mackenzie S. Remarks on the value of Indian hemp in the treatment of a certain type of headache. Br Med J 1887;1:97-98.
  12. Nunberg H, Kilmer B, Pacula RL, Burgdorf J. An analysis of applicants presenting to a medical marijuana specialty practiceice inCalifornia. J Drug Policy Anal. 2011;4. www.ncbi.nlm.nih.
  13. Russo E. Hemp for headache: an in-depth historical and scientific review of cannabis in migraine treatment. J Cannabis Ther. 2001;1:21-92.
  14. Russo E. Cannabis for migraine treatment: the once and future prescription? An historical and scientific review. Pain. 1998;76:3-8.
  15. Greco R, Gasperi V, Maccarrone M, Tassorelli C. The endocannabinoid system and migraine. Exp Neurol. 2010;224:85-
  16. Nicolodi M, Sandoval V, Terrine A, Therapeutic use of cannabinoids – Dose Finding, Effects, and Pilot Data of Effects in Chronic Migraine and Cluster Headache. Abstract presentation at 3rd Congress of the European Academy of Neurology (EAN), Amsterdam, 6/24/17
  18. Rhyne DN, Anderson SL, Gedde M, Borgelt LM. Effects of medical marijuana on migraine headache frequency in an adult population. 2016;36:505-510.
  19. Hampson AJ, Grimaldi M, Axelrod J, Wink D. Cannabidiol and (-)Delta9-tetrahydrocannabinol are neurprotective antioxidants. Proc Natl Acad Sci U S A 1998;95:8268-8273.
  20. Hampson AJ, Bornheim LM, Scanziani M, et al. Dual effects of anandamide on NMDA receptor-mediated responses and neurotransmission. JNeurooh.
  21. Hampson AJ, Grimaldi M, Lolic M, Wink D, Rosenthal R, Axelrod J.Neurprotective antioxidants from marijuana. Ann NY Acad Sci. 2000;899:274-282.
  23. Nicolodi M, Volpe AR, Sicuteri F. Fibromyalgia and headache. Failure of serotonergic analgesia and N-methyl-D-aspartatemediated neuronal plasticity: their common clues. Cephalalgia. 1998;18: 41-44.
  24. Wilkinson JD, Kendall DA, Ralevic V, Delta 9-tetrahydrocannabinol inhibits electrically-evoked CGRP release and capsaicin- sensitive sensors neurogenic vasodilatation in the rat mesenteric arterial bed. Br J Pharmacol 2007;152(5):709-716.
  25. The importance of CGRP in the pathogenesis and treatment of migraineOlga Kuzawińska1, Krzysztof Lis1, Grzegorz , Medical University of Warsaw, Department of Experimental and Clinical Pharmacology
  26. Li J, Daughters RS, Bullis C, et al. The cannabinoid receptor agonist WIN 55,212-2 mesylate blocks the development of hyperalgesia produced by capsaicin in rats. pain. 1999;81:25-33.
  28. Russo E. Cannabis for migraine treatment: the once and future prescription? An historical and scientific review. Pain. 1998;76:3-8.
  29. Akerman S, Holland PR, Lasalandra MP, Goadsby PJ. Endocannabinoids in the brainstem modulate dural trigeminovascular nighticeptive traffic via CB1 and “triptan” receptors: implications in migraine. JNeurfishbones 2013;33:14869-14877.
  30. Akerman S, Holland PR, Goadsby PJ. Cannabinoid (CB1) receptor activation inhibits trigeminovascular neurons. J Pharmacol Exp Ther. 2007;320:64-71.
  31. Russo EB. Cannabinoids in the management of difficult to treat pain. Ther Clin Risk Manager. 2008;4: 245-259.
  32. Manzanares J, Julian M, Carrascosa A. Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. Curr Neuropharmacol. 2006;4:239-257.
  34. Cichewicz DL. Synergistic interactions between cannabinoid and opioid analgesics. life sci. 2004;74:1317-1324.
  36. Ahrens J, Demir R, Leuwer M, et al. The nonpsychotropic cannabinoid cannabidiol modulates and directly activates alpha-1 and alpha-1-Beta glycine receptor function. Pharmacology. 2009;83:217-222.
  37. Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol. 2008;153:199-215.
  38. Mackie K. Signaling via CNS cannabinoid receptors. Mol Cell Endocrinol. 2008;286:S60-S65.
  39.  Klein TW, Cabral GA. Cannabinoid-induced immune suppression and modulation of antigen-presenting cells. JNeuroimmune Pharmacol. 2006;1:50-64.
  40. Zhang HY, Gao M, Liu QR, et al. Cannabinoid CB2 receptors modulate midbrain dopamine neuronal activity and dopamine-related behavior in mice. Proc Natl Acad Sci US A. 2014;111:E5007-E5015.
  41.  Klauke AL, Racz I, Pradier B, et al. The cannabinoid CB(2) receptor-selective phytocannabinoid beta-caryophyllene exerts analgesic effects in mouse models of inflammatory and neuropathic pain. EurNeuropsychopharmacol. 2014;24:608-620
  42. Lorenzetti BB, Souza GE, Sarti SJ, Santos Filho D, Ferreira SH. Myrcene mimics the peripheral analgesic activity of lemongrass tea. J Ethnopharmacol. 1991;34:43-48.
  43. Peana AT, D'Aquila PS, Chessa ML, Moretti MD, Serra G, Pippia P. (-)-Linalool produces antinociception in two experimental models of pain. Eur J Pharmacol. 2003;460:37-41.
  44. Piccinelli AC, Santos JA, Konkiewitz EC, et al. Antihyperalgesic and antidepressive actions of (R)-(+)-limonene, alpha-phellandrene, and essential oil from Schinus terebinthifolius fruits in a
    neuropathic pain model. Nutr Neurfishbones 2015;18:217-224.

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