PainRelief.com Interview with:
Carrie Cuttler, Ph.D.
Assistant ProfessorWashington State University
Department of Psychology
Pullman, WA, 99164-4820
PainRelief.com: What is the background for this study?
Response: Many people report using cannabis for headache and migraine and claim that it is effective in reducing their symptoms. However, to date there has only been one clinical trial examining the effectiveness of a cannabinoid drug called Nabilone (synthetic THC that is orally administered) on headache. The results of that trial indicated that Nabilone was more effective than ibuprofen in reducing pain and increasing quality of life. There have also been a couple of preclinical (animal) studies suggesting that cannabinoids like THC may be beneficial in the treatment of migraine. But there are surprisingly few studies examining the effectiveness of cannabis, particularly whole plant cannabis rather than synthetic cannabinoids on headache and migraine.
PainRelief.com: What are the main findings?
Response: We analyzed data from the medical cannabis app Strainprint®. Specifically we analyzed data from nearly 2,000 medical cannabis patients who tracked their symptom severity before and after nearly 20,000 cannabis use sessions over a period of 16 months. The results revealed that medical cannabis patients reported nearly 50% reductions in headache and migraine severity from before to after inhaling cannabis. Cannabis concentrates produced larger reductions in headache severity ratings than did cannabis flower but both concentrates and flower were effective in reducing headache severity. We also found that people reported using larger doses of cannabis to treat headache and migraine over time and that people reported smaller reductions in headache as they continued to use the drug over time. These results suggest tolerance to the effects of cannabis on headache may develop over time with repeated use. On the bright side, baseline symptoms of headache and migraine remained rather stable with the repeated use of cannabis across time. This is good because most conventional medications produce medication overuse headache which involves more frequent and severe headaches across time as a function of the medication use. Cannabis does not seem to be associated with this problem.
PainRelief.com: What should readers take away from your report?
Response: Our results suggest that medical cannabis users experience fairly substantial benefits from inhaled cannabis but that tolerance to these effects may develop over time.
PainRelief.com: What recommendations do you have for future research as a result of this work?
Response: In addition to the absence of a placebo control group our sample was a self-selected sample of people who use cannabis to treat headache and migraine. This sample likely underrepresented people who do not find cannabis effective for reducing headache or migraine. In other words, it is likely that not everyone will experience the same beneficial effects of cannabis on headache and migraine.
I have no disclosures or conflicts of interest. The data were freely and openly provided by Strainprint® who developed the app patients used to track their symptoms.
Thank you again for your interest in our work.
PainRelief.com: Is there anything else you would like to add?
Response: We were not able to obtain a placebo control group for the study and as such some of the reported beneficial effects may be due to peoples’ expectations about the effects of cannabis on pain rather than real therapeutic effects per se. Future double-blind placebo controlled trials with inhaled cannabis are needed to more conclusively determine whether cannabis causes significant reductions in headache and migraine. This research should be conducted on experienced medical cannabis patients as well as less experienced/novice users to ensure that novice users experience the same beneficial effects as more experienced users.
The Journal of Pain, Vol 00, No 00 (), 2019: pp 1−9 Available online at www.jpain.org and www.sciencedirect.com
Short- and Long-Term Effects of Cannabis on Headache and Migraine Carrie Cuttler,*, y Alexander Spradlin,* Michael J. Cleveland,z and Rebecca M. Craft*, y * Department of Psychology, Washington State University, Pullman, Washington, y Translational Addiction Research Center, Washington State University, Pullman, Washington, z Department of Human Development, Washington State University, Pullman, Washington
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