Over the last two decades or so, medical cannabis has become increasingly accessible in many countries around the world – including here in the UK. In fact, in 2020, the UN Commission on Narcotic Drugs officially reclassified cannabis to recognise its therapeutic potential. With this liberalisation, clinical research into the potential of cannabis is slowly beginning to catch up and patients are able to access medical cannabis for a growing number of indications.
In the UK, medical cannabis was legalised on the 1st of November 2018. The rescheduling of cannabis to allow for its medicinal use meant that specialist doctors would be able to prescribe cannabis-based medicines to their patients for a wide range of conditions. While medical cannabis prescriptions remain critically low in the NHS, private clinics are able to offer medical cannabis treatment for any condition for which there is evidence it may be helpful – including migraine.
What are migraines?
Most people are familiar with the concept of a migraine – it’s a bad headache, right? Well, yes – but it can also be much more significant than that. It is estimated that around 1 in 5 women and 1 in 15 men suffer from migraine which usually develops in early adulthood. A migraine is typically characterised by a “moderate or severe headache felt as a throbbing pain on one side of the head.” However, many people also experience further symptoms.
Migraine can also be associated with auras that either occur just before a migraine begins or in the absence of a headache – this is known as a “silent migraine”. Migraines can also be linked to nausea and vomiting and increased sensitivity to light and/or sound. The frequency of migraine attacks can vary significantly, with some people experiencing multiple migraines a week while others will experience them only occasionally – sometimes with years passing between attacks.
The exact cause of migraines is still not fully understood; however, they are often associated with certain triggers, including the start of a person’s period, stress, tiredness, and certain foods and drinks. While many people with migraine are able to manage their symptoms with everyday painkillers, such as paracetamol and ibuprofen, in more severe cases, the condition can be debilitating.
Despite being a common and often disruptive condition, treatment options for migraines are often ineffective. This has led many people to seek alternative therapies to more effectively manage their migraines and associated symptoms – with medical cannabis becoming an increasingly popular option.
Medical cannabis and migraine
As we mentioned earlier, medical cannabis may be considered for the treatment of chronic migraines when other therapies have proven ineffective. But could it actually work? Well, the Endocannabinoid System (ECS) – that’s the receptor system with which cannabinoids like CBD and THC interact in our bodies – has been implicated in a number of physiological functions, including pain signalling. What’s more, this system has also been proposed as a potential target in models of migraine.
It is well-known that cannabis has a long history of medicinal use, but it may surprise you to learn that, between 1843 and 1943, it was actually a common therapy for the treatment of migraines in Europe and North America. Reports from the time suggested that it was beneficial for both the prevention and acute treatment of the condition! But what about more modern evidence?
What’s the evidence?
In recent years, a number of studies have focused on the potential of medical cannabis in the treatment of migraines. One such study, published in 2022, reviewed the existing clinical evidence in this area. After identifying a total of 12 studies involving 1,980 participants across Italy and the USA, the authors concluded that “medical cannabis significantly reduced nausea and vomiting associated with migraine attacks after 6 months of use.” The treatment was also found to reduce the number of days of migraine and the frequency of migraine headaches per month. Finally, to top it off, medical cannabis was found to be 51% more effective in reducing migraines than the non-cannabis products used in the included studies.
Another literature review noted similar findings, concluding that “medical cannabis use decreases migraine duration and frequency and headaches of unknown origin. Patients suffering from migraines and related conditions may benefit from medical cannabis therapy due to its convenience and efficacy.”
A recent analysis of the UK Medical Cannabis Registry also posed some promising outcomes. The study aimed to assess clinical outcomes for patients with headache disorders who had received medical cannabis treatment. According to patient and clinician-reported outcomes, migraine-associated disability was significantly reduced following the initiation of medical cannabis. The authors of the study concluded that the results for headache- and migraine-specific patient-reported outcome measures reached “clinically important thresholds.”
While the current evidence may seem promising, it is important to note that research in this area is still limited. There remains a lack of high-quality clinical evidence, such as randomised, controlled trials; however, as restrictions and barriers to research eventually loosen, it is likely that research into medical cannabis for migraines will continue to develop.
If you would like to learn more about the process of obtaining a UK medical cannabis prescription for migraines, either for you or a loved one, take a look at leafie’s extensive guide.