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migraine

  • by Paul Armentano, NORML Deputy Director June 5, 2018

    More than two-thirds of chronic pain patients registered to legally access medical cannabis products substitute marijuana for prescription opioids, according to data published in The Journal of Headache and Pain.

    Investigators from the United States and Canada assessed the use of medical cannabis and prescription drugs in a cohort of over 2,000 Canadian patients licensed to access marijuana products. Among those patients with a primary diagnosis of chronic pain, 73 percent reported substituting cannabis in place of opioids. Among those patients diagnosed specifically with headache/migraine, cannabis was frequently reported as a substitute for other medications – including opiates (43 percent), anti-depressants (39 percent), NSAIDS (21 percent), triptans (8 percent), and anti-convulsants (8 percent).

    “Most patients in the pain groups reported replacing prescription medications with medicinal cannabis, the most common of which were opiates/opioids across all patient groups,” authors concluded. “This is notable given the well-described ‘opioid-sparing effect’ of cannabinoids and growing abundance of literature suggesting that cannabis may help in weaning from these medications and perhaps providing a means of combating the opioid epidemic.”

    The study’s findings are consistent with those of numerous others finding that patients in medical cannabis access programs significantly reduce or eventually eliminate their use of opioid analgesics over the long-term.

    Full text of the study, “Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort,” appears online here.

  • by Paul Armentano, NORML Deputy Director July 5, 2017

    mj_researchThe prolonged daily administration of cannabinoids is associated with a reduction in migraine headache frequency, according to clinical trial data presented at the 3rd Congress of the European Academy of Neurology.

    Italian researchers compared the efficacy of oral cannabinoid treatments versus amitriptyline – an anti-depressant commonly prescribed for migraines – in 79 chronic migraine patients over a period of three months. Subjects treated daily with a 200mg dose of a combination of THC and CBD achieved a 40 percent reduction in migraine frequency – a result that was similar to the efficacy of amitriptyline therapy.

    Subjects also reported that cannabinoid therapy significantly reduced acute migraine pain, but only when taken at doses above 100mg. Oral cannabinoid treatment was less effective among patients suffering from cluster headaches.

    “We were able to demonstrate that cannabinoids are an alternative to established treatments in migraine prevention,” researchers concluded.

    Some five million Americans are estimated to experience at least one migraine attack per month, and the condition is the 19th leading cause of disability worldwide.

    According to retrospective data published last year in the journal Pharmacotherapy, medical cannabis consumption is often associated with a significant decrease in migraine frequency, and may even abort migraine onset in some patients.

    A just published review of several studies and case-reports specific to the use of cannabis and cannabinoids in the journal Cannabis and Cannabinoid Research concludes: “[I]t appears likely that cannabis will emerge as a potential treatment for some headache sufferers.”

    An abstract of the study, “Cannabinoids suitable for migraine prevention,” appears online here.

  • by Paul Armentano, NORML Deputy Director January 12, 2016

    cannabis_pillsCannabis administration is associated with decreased migraine headache frequency, according to data published online ahead of print in the journal Pharmacotherapy.

    Investigators at the University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences retrospectively assessed cannabis’ effects on monthly migraine headache frequency in a group of 121 adults. Study participants had a primary diagnosis of migraine headache, had been recommended cannabis by a physicians for migraine treatment, and had participated in at least one follow up medical visit.

    Authors reported that 85 percent of subjects reported a decrease in migraine frequency and 12 percent indicated that the use of cannabis prior to migraine onset would abort headaches.

    “Migraine headache frequency decreased from 10.4 to 4.6 headache per month with the use of medical marijuana,” researchers concluded. “Further research should be performed to determine if there is a preferred delivery method, dose, and strain of medical marijuana for migraine headache therapy as well as potential long-term effects of medical marijuana.”

    Although case reports have previously documented the effect of cannabinoids for migraine relief, no prospective trials have yet to evaluate cannabis use in migraine patients. Nonetheless, scientists for some time have theorized that cannabinoids may play a role in migraine regulation. Writing in 2007 in the European Journal of Critical Pharmacology, Italian researchers reported that patients with chronic migraines possessed significantly lower levels of the endogenous cannabinoids anandamide and 2-arachidonylglycerol (2-AG) in their platelets compared to age-matched controls. “These data support the potential involvement of a dysfunctioning of the endocannabinoid and serotonergic systems in the pathology of chronic migraine and medication-overuse headaches,” authors concluded.

    The abstract of the study, “Effects of medical marijuana on migraine headache frequency in an adult population,” appears online here.

  • by Paul Armentano, NORML Deputy Director March 23, 2010

    For several years I have postulated that marijuana is not, in the strict sense of the word, an intoxicant.

    As I wrote in the book Marijuana Is Safer: So Why Are We Driving People to Drink? (Chelsea Green, 2009), the word ‘intoxicant’ is derived from the Latin noun toxicum (poison). It’s an appropriate term for alcohol, as ethanol (the psychoactive ingredient in booze) in moderate to high doses is toxic (read: poisonous) to healthy cells and organs.

    Of course, booze is hardly the only commonly ingested intoxicant. Take the over-the-counter painkiller acetaminophen (Tylenol). According to the Merck online medical library, acetaminophen poisoning and overdose is “common,” and can result in gastroenteritis (inflammation of the gastrointestinal tract) “within hours” and hepatotoxicity (liver damage) “within one to three days after ingestion.” In fact, less than one year ago the U.S. Food and Drug Administration called for tougher standards and warnings governing the drug’s use because “recent studies indicate that unintentional and intentional overdoses leading to severe hepatotoxicity continue to occur.”

    By contrast, the therapeutically active components in marijuana — the cannabinoids — appear to be remarkably non-toxic to healthy cells and organs. Further, they mimic compounds our bodies naturally produce — so-called endocannabinoids — that are pivotal for maintaining proper health and homeostasis.

    In fact, in recent years scientists have discovered that the production of endocannabinoids (and their interaction with the cannabinoid receptors located throughout the body) play a key role in the regulation of proper appetite, anxiety control, blood pressure, bone mass, reproduction, and motor coordination, among other biological functions.

    Just how important is this system in maintaining our health? Here’s a clue: In studies of mice genetically bred to lack a proper endocannabinoid system the most common result is premature death.

    Armed with these findings, a handful of scientists have speculated that the root cause of certain disease conditions — including migraine, fibromyalgia, irritable bowel syndrome, and other functional conditions alleviated by clinical cannabis — may be an underlying endocannabinoid deficiency.

    Now, much to my pleasant surprise, Fox News Health columnist Chris Kilham has weighed in on this important theory.

    Are You Cannabis Deficient?
    via Fox News

    If the idea of having a marijuana deficiency sounds laughable to you, a growing body of science points at exactly such a possibility.

    … [Endocannabinoids] also play a role in proper appetite, feelings of pleasure and well-being, and memory. Interestingly, cannabis also affects these same functions. Cannabis has been used successfully to treat migraine, fibromyalgia, irritable bowel syndrome and glaucoma. So here is the seventy-four thousand dollar question. Does cannabis simply relieve these diseases to varying degrees, or is cannabis actually a medical replacement in cases of deficient [endocannabinoids]?

    The idea of clinical cannabinoid deficiency opens the door to cannabis consumption as an effective medical approach to relief of various types of pain, restoration of appetite in cases in which appetite is compromised, improved visual health in cases of glaucoma, and improved sense of well being among patients suffering from a broad variety of mood disorders. As state and local laws mutate and change in favor of greater tolerance, perhaps cannabis will find it’s proper place in the home medicine chest.

    Perhaps. Or maybe at the very least society will stop misclassifying cannabis as a ‘toxic’ substance when its more appropriate role would appear to be that of a supplement.