Is the use of marijuana preparations effective in the treatment of various types of headache? Is it safe and effective? What proof do we have that it works? Was pot ever used historically in the treatment of migraine or other types of headache? These are just some of the questions patients often ask me when considering medical marijuana for the treatment of their headache. I’ll try to answer these and other questions in this enlightening series on marijuana and headache.
TYPES OF HEADACHE
Although there are dozens of types of headache we can put most of them into four main categories: tension, migraine, cluster, and sinus. Each has a different mechanism of action and each is treated accordingly. Without much argument cluster and migraine are clearly the most debilitating compared to the self-effacing sinus or tension type headaches. Even so there are no medications that patient’s may take for these excruciating disorders that are completely effective and side effect free. Millions of work hours are lost worldwide because of these ailments, and the inability to control them.
Furthermore, we are no closer to a cure for cluster or migraine headaches than we were two millennia ago when Ancient Roman physicians were prescribing marijuana to ease the cyclic suffering these people endured. Anyone who has a history of migraine headache certainly knows this simple fact. It’s even worse for cluster headache which can be very disabling.
CANNABIS, HEADACHE, AND HISTORY
I’ll bet you didn’t know that cannabinoid preparations have a long history of use in abortive and prophylactic treatment of migraine and other types of headache. Moreover, most MDs have no idea that marijuana was once considered a “major” pharmaceutical which held great prominence among physicians of past eras.
Sadly because of ignorance among our elected officials, and the strong-arm tactics of the US DEA, we are told that pot is useless as a medicine. But folks that’s only a very recent phenomenon conjured from opportunists with conflicts of interest. Let’s see what the science tells us.
MIGRAINE AND CLUSTER SHARE A COMMON ORIGIN WITH THE ENDOCANNABINOIDS
For those not familiar with the pain of migraine or cluster headache consider yourself lucky. We still don’t know the exact mechanisms of how they are triggered, but both of these conditions involve a collection of nerves located several inches behind your nose called the trigeminal ganglion. It projects branches to both sides of the face.
This vital ganglia dovetails into the brain’s blood vessels creating the trigeminovascular system which plays a vital role in dilation and constriction of brain blood vessels. The dilation of brain vessels is presumably how migraine and cluster headaches are produced. Yet the details still evade the most ardent researchers.
This nerve bundle also delivers, among other functions, exquisite sensory information from the face to the brain. For example the trigeminal nerve transmits the searing sting from a scratched corneal lens, or the throbbing agony from a toothache. Because of this, the trigeminal system can become extraordinarily painful when diseased.
In fact, trigeminal neuralgia, or tic douloureux, is considered one of the most painful conditions known to affect humans. Here the pain is described as lancinating-like a hot lance burrowing through your cheek.
TRIGEMINAL GANGLIA AND CB1 RECEPTORS
We do know however, that both the trigeminal ganglia and the brainstem are densely populated with CB1 receptors. Marijuana’s action on these receptors, and quite possibly other receptor systems, could help explain why pot smoking quickly relieves the agony of migraine or cluster headache. In fact, it’s the safest and effective treatment we currently have.
In the following segments we’ll discuss the past and current consensus on the use of marijuana for the treatment of migraine and cluster headache.