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Cannabis Education

What Current Research Can Tell Us About Treating Migraines with Cannabis

If you’ve ever had a migraine, you know the telltale symptoms: throbbing headache, extreme sensitivity to light and sound, blurred vision, nausea, and even vomiting. For many sufferers, these symptoms are debilitating, rendering them incapable of going about their daily lives until the migraine subsides. With the average migraine lasting up to 72 hours, an effective and fast acting remedy is in order.  

As cannabis has received recent press as a rapid pain reliever and potential alternative to opioids, could the benefits also extend to migraines?

Research Overview

The overarching outcomes of studies on cannabis for migraines have been positive, and researchers have gleaned how medical marijuana could be applied to treat this ailment.  

The Studies

A 2017 literature review, published in Cannabis and Cannabinoid Research by Mary Ann Liebert Inc., examined the use of cannabis for headache disorders in general. Researchers concluded that, in tandem with more clinical trials, cannabis will likely emerge as a treatment option for some headache sufferers. Identifying the unique benefits of oral cannabinoids as a preventative treatment for headaches, researchers also pinpointed CBD as a treatment for headache-related conditions, including anxiety.  

A more recent literature review, published in 2018 in Frontiers in Pharmacology, concluded that cannabinoids are a promising class of compounds for preventing and treating migraines. Cannabinoid receptors in the brain can also be targeted to reduce inflammation associated with severe migraines, according to researchers.

In addition, medical marijuana use was found to reduce the frequency of migraines in a 2016 study published in Pharmacotherapy. Researchers studied 121 adult migraine sufferers at two medical marijuana specialty clinics in Colorado and found that supervised cannabis use decreased occurrences of migraine headaches in some patients.

Due to varying U.S. state and international laws on cannabis, some migraine patients have taken matters into their own hands.

Patient Perspectives

Migraine sufferer Anna Reynolds proclaims that smoking marijuana is the only thing that banishes the symptoms, according to her 2016 story published in Self magazine.

Reynolds’ excruciating migraines had prevented her from enjoying social events since college. One migraine struck while Reynolds was attending a Pearl Jam concert in a blindingly bright arena in New York City, but Reynolds found the remedy: “A friend offered me a hit of a joint; I only accepted because of my throbbing brain. Instantly, the migraine disappeared, and I was able to enjoy the concert and three tubs of cheese-drenched nachos.”

In a 2010 article for the UK publication The Independent, Kathryn Cain related how cannabis saved her life after coping with “sinister” daily migraines. Prescription medications, heavy on dosage and side effects, did nothing to alleviate the constant pain. When Cain finally turned to cannabis, the weight of chronic pain lifted immediately: “Within minutes of taking a small amount of cannabis there was not an inch of my body in pain, and my tremors had stopped. My body felt at peace, and I don’t think I can ever convey the enormity of that to anyone. Nothing hurt or felt wrong.”

What is it about cannabis that gives it the power to offer such profound and instant relief to some people?

What the Experts Say

Characterizing cannabis as an analgesic and anti-emetic (pain reliever and anti-vomit agent, respectively), Dr. David Bearman, vice president of the American Academy of Cannabinoid Medicine, explained in the 2016 Self magazine article above how medical marijuana slows down active neurological signals in the brain.

“This slowing of speed is what provides some of the migraine relief,” Bearman said.

Further, Bearman said that cannabis comes with fewer side effects than other types of medication:  “A key principle of prescribing is to weigh a medication’s therapeutic effects vs. its side effects. In comparison to other treatments, cannabis wins hands-down in terms of safety and fewer side effects.”

What form of cannabis delivers the best results to migraine sufferers? Dr. Ethan Russo, a neurologist and psychopharmacology researcher, shared in the 2016 Self magazine article: “Some people find that smoking, or preferably vaporization, is a rapid intervention that can abort a migraine attack, and as a preventive treatment, regular oral administration is the best approach.”

Russo is optimistic about future research illuminating how cannabis can be viewed not as an alternative or complementary treatment for migraines, but as a primary treatment. Russo said, “Once we get randomized controlled clinical trials of a proper cannabis-based medicine for migraines, and are able to demonstrate its efficacy and safety, I believe that it could move into the mainstream as a first-line treatment.”

Dr. Gary L. Wenk, professor of immunology and medical genetics at Ohio State University in Columbus, presented a clinical explanation for Russo’s vision in a 2013 article published in Psychology Today. Describing the body’s endocannabinoid system, Wenk wrote: “Our brain’s own endogenous marijuana-like chemicals (called endocannabinoids) produce analgesia by modulating the entry of pain signals into the brain at the level of our spinal cord.  Future generations of pain relievers will likely be developed based upon the action of marijuana in the body.”

The Bottom Line

Current research suggests that cannabis medicine could be an effective treatment for migraines, and future studies could propel medical marijuana beyond alternative treatment status.



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Cannabis Education

What Current Research Tells us About Cannabis and Fibromyalgia

Fibromyalgia is one of the most common pain disorders in the United States affecting up to 12 million people, the majority of whom are women. The origins of fibromyalgia may be genetic, or there may be triggers such as an injury or trauma. Though widespread pain in any part of the body is a primary symptom of fibromyalgia, the disease also causes psychological distress, sometimes referred to as “fibro fog.” There are currently three U.S. Food and Drug Administration (FDA)-approved medications to treat fibromyalgia, but there is no cure.

As cannabis has been used to treat pain, could the plant help relieve some of the debilitating muscle stiffness and headaches associated with fibromyalgia?

Research Overview

Science is at the genesis of research to establish whether cannabis can treat a variety of painful ailments, including fibromyalgia. Though studies are limited, there have been some encouraging findings regarding cannabis as more than a pain management option for fibromyalgia.

The Studies

Alleviating pain may be the most pressing concern for a fibromyalgia patient, but addressing the root cause of any disease is ultimately more vital. Some studies have suggested that fibromyalgia sufferers have an underlying dysfunction of their endocannabinoid systems. Correcting this dysfunction with cannabis may be useful for both pain management and pinpointing the possible origin of the disease.

In a 2016 review for Cannabis and Cannabinoid Research, Ethan B. Russo wrote, “If endocannabinoid function were decreased, it follows that a lowered pain threshold would be operative, along with derangements of digestion, mood, and sleep among the almost universal physiological systems subserved by the endocannabinoid system.”

Therefore, the pain that fibromyalgia patients experience may be traced, in part, to measurable decreases in the body’s endocannabinoid function. This doesn’t mean that restoring balance to the endocannabinoid system (ECS) is a cure for fibromyalgia, but it could lessen the pain associated with the disease.

Also, a 2018 study published in the Journal of Clinical Rheumatology surveyed 26 fibromyalgia patients in Israel. The patients were given medical cannabis for a period of about 11 months, after which researchers learned that half of the patients had stopped taking their other prescription medication. The scientists concluded that “Medical cannabis treatment had a significant favorable effect on patients with fibromyalgia, with few adverse effects.”

A larger 2018 study, published in Pain Research and Treatment reported questionnaire responses from 383 Israeli fibromyalgia patients. Of the respondents, 84 percent reported use of cannabis to treat their fibromyalgia, and 94 percent of these individuals claimed to experience pain relief. Depression and anxiety were also greatly reduced in individuals who used cannabis.

“Only 12 percent of all cannabis users in our study reported adverse effects, compared to 94 percent reporting adverse effects from other pain meds prior to cannabis use,” wrote George Habib and Iris Avisar, the co-authors of the study. “Most cannabis-related adverse effects were mild and transient such as eye or throat irritation. … Nearly 85 percent of the patients either completely stopped taking any other pain medications or reduced the dosage of other meds. This reflects the advantage of cannabis over other meds in alleviating pain in addition to its favorable effects on sleep and mood.”

The two studies share several key points in common: Many cannabis users reported improvement of their fibromyalgia symptoms, cannabis had minimal side effects, and at least half of the patients stopped taking their prescription medications.

However, pain is a subjective issue, and the improvements experienced by the fibromyalgia patients in these studies may be perceived benefits. At the same time, perceived benefits can offer powerful physical and psychological comfort to those who experience them.

Patient Perspectives

Colorado resident Teri Robnett has suffered from fibromyalgia for more than three decades and has been using cannabis to manage her symptoms since 2009.

“It completely changed my life,” Robnett told the Denver Post, claiming that cannabis has been the only medicine to treat her fibromyalgia without major side effects.

In 2018, 32-year-old Carly Barton became the first person in the United Kingdom to receive a cannabis prescription for pain management. Barton survived a stroke in her 20s and was subsequently diagnosed with fibromyalgia. Desperate to ease her chronic pain, Barton reluctantly turned to cannabis.

“That was the point where I realized that I had no idea about medicine at all and that what we had been told about it was incorrect — really this plant has got the ability to completely take my pain away,” Barton said.

Since she started taking cannabis, Barton has abandoned her morphine and fentanyl prescriptions, now relying entirely on medical marijuana to treat her pain.

Actor Morgan Freeman also cites marijuana as a healing factor for his fibromyalgia pain.

“I have fibromyalgia pain in this arm, and the only thing that offers any relief is marijuana,” Freeman shared in a 2015 interview with the Daily Beast. But do physicians agree with patient accounts regarding cannabis and fibromyalgia pain relief?

What the Experts Say

Many medical experts are still on the fence about prescribing cannabis to their fibromyalgia patients.

“It’s a tricky pain because people have a higher rate of comorbidity with other conditions, such as depression, and the data [are] not clear if marijuana is good for treatment in fibromyalgia itself,” said Dr. Ajay D. Wasan, vice chair of pain medicine at the University of Pittsburgh Medical Center. “We definitely need to have medical marijuana studies in specific pain conditions — people think we can use it for everything, these pain conditions are different in their biology, physiology, and responses to treatment.”

We definitely need to have medical marijuana studies in specific pain conditions. Click To Tweet

Since there is no cure for fibromyalgia and the disease can be difficult to treat, some physicians have expressed the necessity of going beyond current prescription medications, such as pregbalin, which can cause a host of side effects.  

“Fibromyalgia is devastating for those who must live in its grip. There is much we do not understand. We need innovative, ‘out of the box’ solutions that change the face of this disease,” said Dr. Dan Bennett, an interventional spine and pain surgical physician in Denver and chairman of the National Pain Foundation.

Based on emerging research and anecdotes, cannabis could be that innovative, “out of the box” solution to bring relief to fibromyalgia patients.

The Bottom Line

The outlook is hopeful for treating fibromyalgia with cannabis medicine, and further research could validate what many patients have already experienced.



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Cannabis Education

What Current Research Tells us About Cannabis and Glaucoma

Glaucoma is the leading cause of blindness for adults older than 60, afflicting nearly 61 million people globally. The condition is characterized by fluid buildup in the front part of the eye that leads to increased pressure within the eyeball. Over time, this pressure damages the optic nerve, causing a gradual and permanent loss of sight. There is no cure for glaucoma, but the disease may be treated with laser or traditional surgery, prescription eye drops, and oral medication.

There is evidence that the THC in cannabis can lower intraocular pressure (IOP) in a majority of individuals whether or not they have been diagnosed with glaucoma. As IOP is often a precursor to vision loss in glaucoma patients, could cannabis be an effective treatment option for the disease?

Research Overview

Since the 1970s, glaucoma has been one of the most frequently cited reasons to use medical marijuana. In fact, many sources attribute glaucoma to being the impetus for launching the medical marijuana movement.

The medical marijuana revolution began in 1974. Robert Randall, a 26-year-old man with advanced, poorly controlled glaucoma, observed that the halos around lights he experienced because of his high IOP disappeared after he smoked marijuana,” Dr. Thomas Graul, a board-certified ophthalmologist from Nebraska, wrote in an article published in 2018 in Glaucoma Today.  

Graul goes on in the article, however, to voice his skepticism about the efficacy of cannabis in treating glaucoma, but does the current research support his opinion?

The Studies

A 2015 study published in the Yale Journal of Biology and Medicine found, with cautious optimism, that cannabis could be beneficial to patients with end-stage glaucoma.

While standard options are superior to medical marijuana in the management of glaucoma, there may be a role of medical marijuana use in end-stage glaucoma patients who have failed maximal medical therapy and surgery or who are poor surgical candidates,” the authors of the study wrote.

A 2018 study conducted at Indiana University revealed contradictory results. Researchers found that the cannabidiol (CBD) in marijuana could actually worsen glaucoma by increasing eye pressure. In the study, CBD appeared to cancel out the beneficial effects of THC by increasing eye pressure in 18 percent of test mice. However, as this study was conducted on mice, it may be difficult to draw definitive conclusions without appropriate research on the effects of CBD in humans with glaucoma.

Photo by Amanda Dalbjörn

Could THC in isolation help patients with end-stage glaucoma? Most studies that connect THC to lowering IOP date back to the 1970s, and more contemporary research is vital to understand whether cannabis could help to manage glaucoma.

“There is literature — the literature isn’t new — that shows marijuana can reduce the IOP, it just doesn’t last long. You can’t get away from the issue that marijuana can lower eye pressure, but the extent is still open for debate and the data is so old, who knows what we would find now,” said Dr. Murray Fingeret, a clinical professor at State University of New York College of Optometry.

Further, it has been shown that THC may only lower IOP for about three or four hours, while it would be necessary to keep the pressure at bay 24 hours a day for an optimal outcome. Despite these conflicting ideas about cannabis and glaucoma, some patients might be able to find relief for their eye disease.

Despite these conflicting ideas about cannabis and glaucoma, some patients might be able to find relief for their eye disease. Click To Tweet

Hypotheses are emerging on how glaucoma could be reclassified as a neurodegenerative disease, or a condition that affects the neurons in the brain. This classification is significant because cannabis has offered hope in treating other neurodegenerative diseases, such as chronic traumatic encephalopathy (CTE), a common brain injury in football players. But until more is understood about the biological basis of glaucoma, it is too early to say whether there could be a correlation between cannabis treatment for neurodegenerative diseases and for this particular eye disorder.

Patient Perspectives

Robert Randall, who died of AIDS in 2001, was one of the most outspoken activists for the medical marijuana movement, especially with regard to treating the glaucoma from which he suffered. A native of Sarasota, Florida, Randall moved to Washington, D.C., where he lobbied for the legalization of cannabis medicine and was nicknamed the father of the medical marijuana movement.  

In a 1998 book he co-authored, “Marijuana Rx: The Patients’ Fight for Medicinal Pot,” Randall wrote: “In 1976 I became the first American to gain legal access to marijuana for medicinal purposes, specifically to treat glaucoma, a blinding eye disease. For the next twenty years, together with my partner and mate Alice O’Leary, I worked to expand this unique privilege to others.”

Throughout his life, Randall never stopped conveying his message of cannabis as a viable treatment option for glaucoma. Eighteen years after Randall’s death, there are scant patient accounts of how cannabis may or may not benefit glaucoma. One 2016 study did, however, examine the attitudes towards medical marijuana of 204 patients with glaucoma. The results indicated that the majority of patients did not intend to use cannabis to manage their glaucoma.  

In regard to treating the symptoms of glaucoma, such as severe headaches, at least one public figure is advocating the use of cannabis in the form of vape pens. Actress Whoopi Goldberg, who has glaucoma, founded a medical marijuana company in 2016 targeting women patients. While the company, Whoopi & Maya, specializes in cannabis medicine for menstrual discomfort, Goldberg said she uses vape pens to ease her glaucoma-triggered headaches.

Of her vape pen, which she calls “Sippy,” Goldberg said, “It helps my head stop hurting, and with glaucoma your eyes ache, and she takes the ache out. It’s wonderful.”

What the Experts Say

Some doctors are implementing cannabis into their medical practices to treat glaucoma. One such physician is Dr. Jason Zannis, founder of the primary care clinic Walk-In Wellness in Coral Springs, Florida. But Zannis does not represent the norm in his willingness to treat glaucoma patients with medical marijuana.

In his article, “Should You Be Smoking Marijuana to Treat Your Glaucoma?”, Dr. Henry D. Jampel, an ophthalmology professor at Johns Hopkins, argues against the use of cannabis as management for the eye disease.

“ … [A]lthough marijuana can lower the eye pressure, recommending this drug in any form for the treatment of glaucoma at the present time does not make sense given its side effects and short duration of action, coupled with a lack of evidence that its use alters the course of glaucoma,” Jampel wrote.

Photo by George Evans

Jampel’s opinion falls in line with that of the American Academy of Ophthalmology, the American Glaucoma Society, and the Canadian Ophthalmological Society, none of which presently view cannabis as a practical treatment option for glaucoma.

The Bottom Line

The current medical consensus suggests that cannabis is not a treatment for severe cases of glaucoma, though many states accept glaucoma as a condition qualifying for medical marijuana. In order for cannabis to be effective, high doses of THC would need to be administered into patients continuously, and marijuana’s effects last only for a few hours at most. As a result, most prominent ophthalmologists maintain a skeptical or negative stance on the topic.



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Concerns with marijuana legalization In-Depth Analysis Current Affairs 2019



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