Migraine headaches are one of the most common conditions facing the United States public, with up to 37 million people (13% of the adult population) is affected by the condition. Migraines are classified differently from other forms of headaches, and though little is known about their root cause, much is known about their symptomatology. Typically, migraines last between 4 and 72 hours with associated pain that worsens when exposed to light, sound, or motion. Nausea is also associated with migraine headaches, and many pharmaceuticals often prescribed for headaches (especially triptans) can worsen the effect. In contrast, cannabidiol, or CBD, one of the most prominent compounds in the cannabis plant, has shown potential to treat migraines naturally (Cherney, 2017) with theoretically fewer and less powerful side effects.
As aforementioned, there is no commonly accepted cause of migraines among neurologists at this time, however, it has been shown in studies to be linked to inflammatory responses in the brain and abnormalities associated with the vascular system (Greco, 2010). It is considered that, as little research has been done of the endocannabinoid system (ECS), perhaps the answer to the root cause lies in the migraineurs’ abnormal regulation of the inflammatory response that the ECS responds to (Greco, 2015), in conjunction with the immune response that can be positively affected by stimulating CB2 receptors in the spleen, tonsils, and other various soft tissues. Results of several studies seen in the References section below have shown results that indicate the nerve pain aspect of migraines could be influenced by the prevention of reuptake of the endocannabinoid anandamide, which is responsible for pain regulation (Cherney, 2017), leading to relief from migraine symptoms when CBD is used as an abortive or preventive measure. Additionally, CBD has demonstrated efficacy for conditions often related to migraines as well, including anxiety (Lochte, 2017).
There is little evidence where pure CBD has been studied specifically for migraines, as obtaining a permit for such experiments in the United States is a difficult process, but there have been studies on CBD rich medicinal cannabis which showed great promise, with 40% of patients reporting fewer migraines overall over a given period of time; those who did not find relief noted that they had difficulty finding the right dose to be effective for them (Cherney 2017).
There are several methods of ingestion for CBD, each of which can be beneficial in different ways for migraine sufferers. Vaping CBD oil can be an abortive measure if a headache is taking place, as it is the fastest method of getting CBD into the bloodstream. CBD oil can be taken sublingually on an as-needed basis or every day as a preventative measure in order to keep inflammation levels low, capsules can be taken regimentally, and CBD edibles can be used, though they are the slowest of the ingestion methods. It is generally the school of thought that one should start with the lower of the potential doses and work up until the desired effects are reached, though the more regularly one takes CBD the more effective is has potential to be.
As far as progress in the legal system goes, medical cannabis is legal in 25 states, while seventeen additional states allow products that are high in CBD and low in THC for medical use, which may in the near future result in more conclusive studies for CBD and its various uses, potentially including migraine prevention and treatment (Mead, 2017).
Cherney, K. (2017, December 11). CBD Oil for Migraines: Use, Benefits, Risks, and More (D. R. Wilson PhD., Ed.). Retrieved March 19, 2018, from https://www.healthline.com/health/ migraine/cbd-oil-for-migraines
Greco, R., Gasperi, V., Maccarrone, M., & Tassorelli, C. (2010). The endocannabinoid system and migraine. Experimental Neurology, 224(1), 85–91. https://doi.org/10.1016/j.expneurol.2010.03.029
Greco, R., & Tassorelli, C. (2015). Endocannabinoids and migraine. In Cannabinoids in Neurologic and Mental Disease (pp. 173–189). Elsevier. https://doi.org/10.1016/b978-0-12-417041-4.00007-2
Lochte, B. C., Beletsky, A., Samuel, N. K., & Grant, I. (2017). The Use of Cannabis for Headache Disorders. Cannabis and Cannabinoid Research, 2(1), 61–71. https://doi.org/10.1089/can.2016.0033
Mead, A. (2017). The legal status of cannabis (marijuana) and cannabidiol (CBD) under U.S. law. Epilepsy & Behavior, 70, 288–291. https://doi.org/10.1016/j.yebeh.2016.11.021
Conflict of interest Alice Mead is an employee of GW Pharmaceuticals, Inc., Carlsbad, CA.