Medical Cannabis for Migraines in Canada

Living with migraines can be extremely challenging, affecting your ability to work, maintain relationships, and enjoy everyday activities. Migraine headaches vary in severity and length, but can be debilitating episodes that last upwards of three days, causing intense pain, sensitivity to light and sound, nausea, and other disruptive symptoms.

For many Canadians suffering from migraines, traditional treatments provide only partial relief or come with unwanted side effects. Taking cannabis when you have migraine symptoms has been known to quickly decrease the pain, offering a potential alternative or complementary approach to conventional migraine treatments.

Migraines are more than just headaches—they’re a neurological condition characterized by severe, debilitating headaches often accompanied by other symptoms. They affect approximately 2.7 million Canadians, or about 8.3% of the population, with women being three times more likely to experience migraines than men.

Types of Migraines

There are several types of migraines, each with distinct characteristics:

Migraine Without Aura (Common Migraine)

• The most frequent type of migraine
• Characterized by pulsating, one-sided headache
• Moderate to severe intensity
• Aggravated by routine physical activity
• Associated with nausea, vomiting, and/or sensitivity to light and sound

Migraine With Aura (Classic Migraine)

• Includes visual disturbances before or during the headache
• May experience flashing lights, zigzag lines, or temporary vision loss
• Can also include sensory auras (tingling or numbness) or speech/language auras
• Usually followed by the headache phase, though not always

Chronic Migraine

• Headache occurring on 15 or more days per month for more than three months
• At least eight of these headaches must have migraine features
• Often results from medication overuse

Other Types

• Vestibular migraine (associated with vertigo)
• Hemiplegic migraine (includes temporary paralysis)
• Retinal migraine (affects vision in one eye)
• Abdominal migraine (primarily gastrointestinal symptoms)

Migraine Phases

A typical migraine may progress through four phases, though not everyone experiences all phases:

1. Prodrome: Occurs hours or days before the headache, may include mood changes, food cravings, neck stiffness, increased thirst, and frequent yawning
2. Aura: Visual, sensory, or motor disturbances that precede or accompany the headache
3. Headache: The pain phase, often accompanied by nausea, vomiting, and sensitivity to light, sound, and smell
4. Postdrome: The “migraine hangover,” characterized by fatigue, difficulty concentrating, and mild headache that can last for a day or more

Common Migraine Triggers

Dealing with migraine pain starts before the migraine itself even occurs. Preventive treatment is a large part of pain management, and sufferers of migraines attempt to pinpoint and understand their specific triggers to cut down on painful episodes.

Common triggers include:

• Hormonal changes (especially in women)
• Stress and stress release
• Changes in sleep patterns
• Certain foods and food additives
• Alcoholic and caffeinated beverages
• Sensory stimuli (bright lights, strong smells, loud sounds)
• Weather and barometric pressure changes
• Medications
• Physical exertion

Research into cannabis for migraine management is growing, with encouraging results. In May 2015, The American Headache Society conducted a comprehensive review of the clinical use of medical cannabis to treat migraines, finding supportive evidence for its role in several headache disorders.

The effectiveness of cannabis for migraines may be linked to several mechanisms:

1. Endocannabinoid deficiency: Some research suggests migraines may be associated with a deficiency in the body’s endocannabinoid system, which cannabis compounds can help supplement
2. Anti-inflammatory effects: Cannabinoids may reduce neurogenic inflammation involved in migraine pathophysiology
3. Serotonin modulation: THC and CBD may affect serotonin levels, which play a role in migraine development
4. Vasodilation control: Cannabis compounds might help regulate blood vessel constriction and dilation implicated in migraines
5. Pain modulation: Cannabinoids interact with pain receptors in the brain and nervous system

Studies have shown vaporizing cannabis allows THC to enter the bloodstream quite rapidly, meaning it may also help alleviate migraine symptoms as quickly as they are noticed. This rapid onset makes it particularly suitable for migraine attacks, where quick relief is essential

A 2016 study found that medical cannabis use was associated with a significant decrease in migraine frequency, dropping from 10.4 migraines per month to 4.6 migraines per month. Additionally, about 40% of subjects reported positive effects, with the most common effects being prevention of migraine onset and decreased migraine frequency.

For Canadians struggling with migraines, medical cannabis may offer several potential benefits:

Primary Symptom Management

Many patients report improvements in core migraine symptoms, including:

• Reduced headache intensity
• Shorter duration of migraine attacks
• Decreased nausea and vomiting
• Relief from light and sound sensitivity
• Prevention of migraine progression when used at aura or prodrome stage
• Improved sleep during and after migraine episodes

Complementary Therapy

Others find cannabis helpful as a complementary treatment to address the limitations or side effects of conventional migraine treatments:

• Alternative for those who cannot tolerate triptans
• Reduced reliance on NSAIDs and their gastrointestinal side effects
• Decreased need for opioid medications
• Option when other acute treatments fail
• Support for preventive strategies

Potential Advantages Over Traditional Medications

While not everyone experiences these benefits, many patients report meaningful improvements in their migraine frequency and severity when incorporating medical cannabis into their treatment plan under proper medical supervision.