A study published last month in the Journal of Pain found a statistically significant reduction in migraine and headache symptoms and recurrences among patients who used cannabis for treatment.

Researchers concluded that headache and migraine severity were reduced by nearly 50% after using cannabis.

The study, conducted by researchers at Washington State University, sampled the effects of smoking cannabis or cannabis concentrates on migraines and headaches among 1,959 anonymous adult participants over 16 months.

The results were extremely encouraging for patients looking for relief. They’re also surprising—and offer a taste of how incomplete current medical research into cannabis is.

Severe pain eased

The study data indicated that after using medical cannabis, “severe headache episodes are associated with greater reductions in headache severity,” which means that those suffering the most pain achieved the most relief. This is important, as the most severe episodes can be nearly impossible to treat with standard prescription pain medication. The new study indicates that cannabis may actually take the edge off, even in the toughest cases.

The study revealed some surprising results, too.

The authors found that cannabis’ effectiveness wasn’t dependent on the cannabis strain, ratio of THC:CBD, or dosage. “Results indicate that cannabis reduces migraine severity regardless of the type, dose, THC or CBD content,” they wrote. That could indicate that factors other than cannabinoid ratio and concentration are at play.

‘Entirely novel’ findings on concentrates

Perhaps even more strangely: While patients smoking cannabis flower found they needed higher doses over time to achieve the same results, patients smoking cannabis concentrate found their necessary effective dosage actually decreased over time.

To explain this, the authors point to “evidence that other phytocannabinoids and terpenes present in cannabis flower are reduced in some concentrates,” and suggest that the absence of these compounds in concentrates prevents them from blocking the effects of migraine-targeting cannabinoids from supplemental ingested cannabis.

In other words: The difference in effect between smoking flower and concentrate might not be due to users developing dosage tolerance, “but rather a differential ‘dialing in’ process between those who use flower and those who use concentrates.”

Data from app users

The study framework is a factor worth considering, too. It remains extremely difficult to obtain permission (and the actual cannabis) to carry out clinical research on cannabis use in the United States. For this study, researchers at Washington State University obtained anonymous data from 1,959 Canadian medical cannabis patients who used the app Strainprint.

Strainprint allows individuals to track their personal cannabis dosage, consumption, and effects against symptoms. Limiting the study to Canadian patients allowed researchers a greater degree of certainty with regard to cannabis strains and potencies, as producers licensed by Health Canada are held to a much higher degree of quality control than most US states.

Because the data came from Strainprint, patients had already self-selected for medical cannabis use. There were no control subjects using a placebo, and patients who found cannabis did not reduce their migraine symptoms might have taken themselves out of the data pool by discontinuing cannabis use, not entering data into Strainprint, or choosing not to download the app at all.

Because virtually no research exists on the medical effects of cannabis concentrates, the authors note that their finding is “entirely novel,” and express the urgency for further research in this area.

Key takeaways

To summarize the study’s findings:

• Canadian medical cannabis patients found that cannabis did lessen the severity and length of migraines and headaches.
• Smoked cannabis concentrate had a stronger effect on migraine alleviation than smoked flower.
• THC:CBD ratio and strain didn’t seem to matter with regard to effectiveness.
• For patients smoking flower, higher doses were required over time to maintain the same level of pain relief.
• Patients who smoked concentrates required lower doses over time to maintain the same level of pain relief
• No risk for overdose was detected.
• Study data suggested that terpene profiles and lesser-known cannabinoids play a role in preventing and managing symptoms, and that “dialing in” those compounds could achieve more targeted medical results.

Previous studies on migraines & cannabis

Humans have been using cannabis for pain relief for thousands of years, but only recently have research scientists specifically investigated its efficacy for migraines. Preliminary research from 2004 confirmed that the body’s endocannabinoid system “has numerous relationships” to migraines. A 2014 animal study offered further support for the therapeutic potential of supplementing the endocannabinoid system with cannabis to treat migraines. Patients suffering from migraines have been found to have deficiencies in anandamide, a primary endocannabinoid (ie, cannabinoids made by the human body) which serves, among other functions, to block the triggers that cause migraines. Researchers working with rats found that supplementing the animals’ anandamide deficiencies with cannabinoids reduced migraine symptoms.

Researchers have also noted that cannabis is also a known neuro relaxant, vasodilator (a substance that widens blood vessels), and anti-inflammatory agent. Those abilities, together, address the most critical aspects of both the onset and symptoms of migraines.

Although the new Journal of Pain study was limited to smoked cannabis and cannabis concentrate, and was lacking in some of the formal controls of a clinical environment, it represents the largest and most recent study of its kind to date. Its findings are encouraging for cannabis’ use in treating migraines, as well as the potential for endocannabinoid system therapies in general.

More notably, despite the new study’s relatively small size and limitations, it presents some new and fascinating discoveries which beg to be explored.

Quick links to research:

(2019) Journal of Pain: Short- and long-term effects of cannabis on headache and migraine

(2018) Frontiers in Neuroscience: Link between endocannabinoid disregulation and migraines and headaches—specifically low levels of anandamide

(2017) Cannabis and Cannabinoid Research: Cannabis for migraines in history, and summary of existing clinical research

(2014) Journal of Headache and Pain: Rat study examining effects of stimulating CB2 receptors with AEA for migraines

(2004) Neuro Endocrinology Letters: Early research into endocannabinoid system deficiencies, as they relate to migraines, fibromyalgia, and IBS