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Cannabis in the Treatment of Headache and Migraine

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Dr. Feldman reports no financial relationships relevant to this field of study.

SOURCE: Cuttler C, Spradlin A, Cleveland MJ, Craft RM. Short- and long-term effects of cannabis on headache and migraine. J Pain 2019. pii:S1526-5900(19)30848-X. doi:https://doi.org/10.1016/j.jpain.2019.11.001. [Epub ahead of print].

EXECUTIVE SUMMARY

• Data for this study came from Strainprint, a free app designed for users of medical cannabis to track strains and doses of cannabis by rating symptoms at baseline and after use.

• Analysis of data covered 12,293 sessions of headache treatment and 7,441 sessions of migraine treatment with inhaled cannabis. Diagnosis was based solely on self-identification.

• Results for headache: Headache rating decreased in 89.9% of the sessions; men reported relief more frequently than did women; an average 47.3% decrease in severity was reported; a larger reduction in severity was noted with the concentrate form of cannabis (vs. flower); there appeared to be tolerance with use of the flower form.

• Results for migraine: Migraine rating decreased in 88.1% of the sessions; no gender differences were noted; an average 49.6% decrease in severity was reported; concentrate and flower form of cannabis appeared equally effective; there appeared to be a pattern of dose escalation over time.

Cannabis is now legal for medicinal use in over half of the 50 U.S. states. 1 Multiple factors, including federal restrictions on funding cannabis research, have hindered the research necessary to provide evidence-based guidelines for use. 2

Cuttler et al noted that 35% of medical cannabis users cite headache or migraine as a primary reason for medicinal cannabis use, but studies looking at the specifics of the responses are limited to one randomized, double-blind study in 30 outpatients.

With barriers limiting a traditional research protocol, Cuttler et al used an innovative approach to gather data for this study. Strainprint is a free, Canadian-based...