What is migraine?

Migraine is a neurological disorder that manifests in painful and debilitating headaches, affecting a billion people worldwide — more than 10 percent of the global population. A public-health issue with serious social and economic consequences, migraine is the third most prevalent and sixth most debilitating medical condition in the world.

Migraine headaches can last from a few hours to a few days, accompanied by throbbing in the forehead and temples; pain in the eyes, neck and shoulders; light sensitivity; blurred vision; nausea; and vomiting. Migraine headaches occur in two forms. Cluster headaches are brief. Acute headaches can for hours or days. Migraine headaches are sometimes preceded by auras and often followed by fatigue.  

Every 10 seconds in the United States, one person goes to the hospital emergency room unable to function from migraine headaches. According to the Migraine Research Foundation, 1.2 million emergency-room visits are for acute migraine attacks. Ninety percent of migraine sufferers cannot work or complete daily activities while suffering headaches.

While most migraine sufferers experience attacks once or twice a month, more than 4 million people suffer at least 15 migraine episodes per month. More than half of all migraine sufferers are never diagnosed. The vast majority of migraine sufferers do not seek medical care.

Stress is the most common migraine trigger. Other triggers include weather changes; insufficient or excessive sleep; odors such as cigarette smoke and chemicals used in nail salons; lack of eating; and eating foods high in glutamates, histamines, nitrates, sulfates and/or tyramine such as soy, cured and processed meats, aged cheese, red wine, avocados, bananas, citrus, nuts and chocolate. In women, fluctuations in estrogen levels can trigger severe and more frequent attacks.

Health-care costs are 70 percent higher for a family with a migraine sufferer versus a family not affected by migraine. Migraine costs American employers more than $13 billion each year as a result of 113 million workdays lost.

Who’s most affected by migraines?

Migraine disproportionately affects women. Worldwide, 85 percent of migraine sufferers are women. In the United States, women account for 28 million of 37 million people who suffer from the condition. Nearly 20 percent of women and 6 percent of men will experience migraine in their lives.

About 50 percent of women who suffer migraine headaches have more than one attack each month, and a quarter experience four or more severe attacks per month.

Migraine most often affects people between age 25 and 55. Half of all migraine sufferers have their first attack before age 12. About 10 percent of school-age children suffer from migraine and are absent from school twice as often as children without migraine.

About 90 percent of migraine sufferers have a family history of migraine. A child who has one parent with migraine has a 50 percent chance of inheriting the condition; if both parents have migraine, the chances rise to 75 percent.

How can cannabis help improve/relieve/reduce the occurrence and symptoms of migraines?

Cannabis has been shown to reduce migraine frequency and relieve symptoms as headaches occur. CBD, a non-psychoactive cannabinoid, has been found to be effective against migraine headaches because analgesic properties. THC, the primary psychoactive cannabinoid, is a potent anti-inflammatory that may also assist migraine relief by raising serotonin levels.

Cannabis has been used for centuries to manage migraine effects. Ancient Greek, Chinese, Indian, Roman and Egyptian literature contain references to its efficacy relieving headaches. Cannabis was Western medicine’s preferred recommendation for migraine treatment until the 1940s when cannabis was removed from the U.S. Pharmacopeia due to political and social changes.

Today, evidence from a 2017 study and evidence from a 2016 study suggest cannabis can treat migraine headaches better than prescription medications, including some opioid-based drugs whose overprescription can lead to addiction and death. In the recent study, researchers concluded they “cannabinoids are an alternative to established treatments for migraine prevention.”

How does cannabis integrate with/complement traditional migraine therapies?

Most migraine patients are prescribed pharmaceutical drugs to prevent headaches, but about 30 percent of migraine sufferers do not respond to these medications.

In addition to its analgesic and anti-inflammatory benefits, cannabis mitigates side effects caused by migraine headaches and migraine-prevention drugs, including nausea and vomiting, and can benefit people who suffer from insomnia, a condition that can trigger migraine headaches.

What are effective consumption methods for migraines?

Inhalation via vaporization or smoking delivers cannabinoids to the nervous system within seconds and can be used when a person feels an impending migraine or as necessary during periods of pain.

Sublingual sprays and orally-ingested oil extracts and liquid preparations provide convenience and longer-lasting effects.

Many people find relief by applying cannabis salve to their temples, forehead and neck at the onset of pain and muscle spasms.

What are effective ratios and dosages for migraines?

While much clinical researcher fails to note cannabinoid ratios used in migraine therapy, anecdotal evidence and self-reported patient data suggests cannabis preparations with a higher CBD:THC ratio are most effective. These ratios can range from 2:1 to 20:1.

As analgesic and anti-inflammatory agents, CBD and THC work in concert in what’s known as The Entourage Effect. Although some people respond adversely to THC’s psychoactive effects, some amount of THC is necessary for CBD to be fully effective. At high doses, however, THC can have the opposite effect and cause migraine symptoms to worsen.

Doses depend on individual factors, including severity of symptoms and a person’s tolerance for cannabis. Some researchers and patients report positive results from micro-dosing in increments as small as 5 mg as needed throughout migraine cycles.  

In one recent study, preventative effects were cumulative and it took up to three months of daily dosing to achieve positive results.