Short- and Long-Term Effects of Cannabis on Headache and Migraine

Cuttler, Carrie; Spradlin, Alexander; Cleveland, Michael J.; Craft, Rebecca M.

doi:10.1016/j.jpain.2019.11.001

Cited by 48 publications

(58 citation statements)

References 28 publications

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“…We divided our sample into non-responders (i.e., <50%; n = 56, 39%) and responders (i.e., ≥50%; responders n = 89, 61%) based on their reduction of monthly frequency of migraine attacks from pre-MC to the current post-MC period. No significant difference was found in monthly migraine attack frequency prior to MC treatment initiation (15 (7.8-30) and 14 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), respectively) (0.06 95% CI (−0.27 to 0.41); p = 0.71), strengthening the division methodology, as both subgroups started from a similar standpoint. Moreover, there were no significant differences between the subgroups in any of the current migraine features, including the age of migraine diagnosis, average duration of migraine attacks, activity-induced aggravation of migraine, unilateral migraine, bilateral migraine, presence of aura prior to migraine, nausea during migraine, or phono-or photophobia during migraine (Table 2).…”

Section: Migraine and Sleep Featuresmentioning

confidence: 78%

“…A recent cross-sectional study found that nearly 36% of MC users reported using it to treat headache and migraine [9]. An additional survey reported about 50% reduction of migraine and headache severity following inhaled cannabis consumption [10]. Nevertheless, good clinical data supporting the beneficial effect of MC on migraine are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Migraine Frequency Decrease Following Prolonged Medical Cannabis Treatment: A Cross-Sectional Study

et al. 2020

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Background: Medical cannabis (MC) treatment for migraine is practically emerging, although sufficient clinical data are not available for this indication. This cross-sectional questionnaire-based study aimed to investigate the associations between phytocannabinoid treatment and migraine frequency. Methods: Participants were migraine patients licensed for MC treatment. Data included self-reported questionnaires and MC treatment features. Patients were retrospectively classified as responders vs. non-responders (≥50% vs. <50% decrease in monthly migraine attacks frequency following MC treatment initiation, respectively). Comparative statistics evaluated differences between these two subgroups. Results: A total of 145 patients (97 females, 67%) with a median MC treatment duration of three years were analyzed. Compared to non-responders, responders (n = 89, 61%) reported lower current migraine disability and lower negative impact, and lower rates of opioid and triptan consumption. Subgroup analysis demonstrated that responders consumed higher doses of the phytocannabinoid ms_373_15c and lower doses of the phytocannabinoid ms_331_18d (3.40 95% CI (1.10 to 12.00); p < 0.01 and 0.22 95% CI (0.05–0.72); p < 0.05, respectively). Conclusions: These findings indicate that MC results in long-term reduction of migraine frequency in >60% of treated patients and is associated with less disability and lower antimigraine medication intake. They also point to the MC composition, which may be potentially efficacious in migraine patients.

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Section: Migraine and Sleep Featuresmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Migraine Frequency Decrease Following Prolonged Medical Cannabis Treatment: A Cross-Sectional Study

et al. 2020

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“…35 Our data on dosage of cannabis and changes in dosage over time are also consistent with other studies. 12,36 We found overall increases in dosage and effectiveness score over time for participants treating pain symptoms. Changes in cannabis dosage over time varied by effectiveness score, suggesting that participants titrated dosages based on perceived effectiveness.…”

Section: Medical Cannabis Users: Products and Insightsmentioning

confidence: 84%

“…7,8 Several studies have observed that medical cannabis may have therapeutic benefit in patients with headache (including migraine), gastrointestinal pain, arthritis, and joint stiffness. 3,6,[9][10][11][12][13][14][15] However, randomized controlled trials (RCTs) are often too small and too short to draw definitive conclusions. 16 In addition, studies use different cannabinoid preparations and modes of administration, making meta-analyses complicated.…”

Section: Introductionmentioning

confidence: 99%

Cannabinoid Profiles in Medical Cannabis Users: Effects of Age, Gender, Symptoms, and Duration of Use

Kalaba¹,

Ware²

2022

Cannabis and Cannabinoid Research

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Introduction: Clinical trials remain the gold standard for evaluating efficacy, but there is increasing interest in using real-world evidence (RWE) to inform health care decision making. The aims of this observational study were to describe patterns of medical cannabis use, associated changes in symptom severity over time, and to evaluate change in cannabis dose over time for pain-related symptoms. Methods: Data were collected by Strainprint TM , an application that is HIPAA, PIPEDA, and PHIPA compliant. A total of 629 participants recorded data between May 2017 and August 2019. A total of 65 symptoms were grouped as Pain, Mental Health, Physical Symptoms, Seizures, Headaches/Migraines, and Other. Descriptive statistics and mixed-effects modeling were applied. Results: THC-dominant products were more frequently consumed for symptoms of pain and sleep, while CBDdominant products were more frequently consumed for anxiety and depression. Male and female participants demonstrated significant differences in the type of cannabis they consumed. Females more frequently consumed CBD-dominant products, and males more frequently consumed balanced (THC:CBD) products. Oil use was more prominent among females, while vaping was more common among males. Product use also varied by age tertiles ( < 31; 31-39; > 40 years). CBD-dominant products were more common among younger participants, < 31 years, THC-dominant products were more common among the 31-39 years category and balanced (THC:CBD) products were common among older participants > 41 years. Dosages of CBD-dominant and balanced (THC:CBD) products increased over time irrespective of symptom response. THC-dominant products demonstrated a significant relationship between dose and symptom reduction over time. Conclusions: Recognizing that RWE has important methodological limitations, we observed cannabis product preferences based on demographic characteristics, such as gender and age and the primary symptom treated such as pain and anxiety. Our study offers real-world insights into how participants use and respond to cannabis products and suggests important avenues and methodologies for future research.

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“…Despite perceived efficacy often reported by medicinal and recreational cannabis users across a range of psychological and physiological symptoms [12,13,70] , a growing empirical corpus supports the supposition that users experience worse pain outcomes when compared to non-users [9,17,40,41,49,68,76,77] . In one seminal study involving patients without chronic pain histories [41] , researchers tracked adults undergoing elective orthopedic operations during the postoperative period.…”

Section: Recreational Cannabis Is Associated With Worse Pain Outcomesmentioning

confidence: 99%

Pain Sensitivity Among Young Adult Recreational Cannabis Users

Ja¹,

Reid²,

Ly³

et al. 2020

Preprint

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Substantial effort has been directed toward understanding complex associations between cannabis and pain, yet we have many, and sometimes conflicting, theories regarding cannabinoid analgesia. Although acute effects of cannabis on pain have received considerable attention, long-term effects remain understudied. Two studies were conducted. First, during the laboratory study, we measured pain ratings and pain tolerance in response to pressure-based mechanical pain among recreational cannabis users (n = 33) and cannabis non-users (n = 31). Linear mixed-effects models demonstrated that: (i) pain ratings (0-100 VAS) were not different between groups (B = 1.57 (95% CI: -10.84, 13.99), p = 0.801), (ii) pain tolerance (0-240 mmHg) was associated with anxiety (B = -5.33 (95% CI: -8.29, -2.33) p < 0.001), and (iii) users had lower tolerance after controlling for anxiety (B = -24.62 (95% CI: -49.32, 0.43), p = 0.046). Second, during the internet study, we retested these associations using more ecologically relevant endpoints in a separate sample. Participants completed the Graded Chronic Pain Scale, and pain-related daily interference was compared between users (n = 185) and non-users (n = 586). Linear models showed that interference (0-10 points) was associated with anxiety (B = 0.07 (95% CI: 0.06, 0.09), p < 0.001) and users reported greater interference after controlling for anxiety (B = 0.27 (95% CI: 0.09, 0.46), p = 0.003). Together, these outcomes suggest that regular cannabis use is associated with differences in pain processing, although additional studies are needed to provide enhanced mechanistic understanding.

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Short- and Long-Term Effects of Cannabis on Headache and Migraine

Cited by 48 publications

References 28 publications

Migraine Frequency Decrease Following Prolonged Medical Cannabis Treatment: A Cross-Sectional Study

Migraine Frequency Decrease Following Prolonged Medical Cannabis Treatment: A Cross-Sectional Study

Cannabinoid Profiles in Medical Cannabis Users: Effects of Age, Gender, Symptoms, and Duration of Use

Pain Sensitivity Among Young Adult Recreational Cannabis Users

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