First, the good news, something the migraine/cluster headache medical marijuana patient for whom I am a caregiver could’ve told you without any scientific studies:
Cluster Attacks Responsive to Recreational Cannabis and Dronabinol
Pharmacological preparations of cannabinoid compounds have a variety of therapeutic uses in medicine, including different pain syndromes, but have not been previously reported as beneficial for cluster headache. We present a patient with cluster headache who was refractory to multiple acute and preventive medications but successfully aborted his attacks with recreational marijuana use; subsequent use of dronabinol provided equally effective pain relief.
In other words, some people can kill their severe headaches by smoking pot or taking Marinol pills.
But once you dig past the abstract and into the full text of the paper, you step through Alice’s looking glass into the world where 100% potent synthetic THC is a Schedule III prescribable drug and 5%-20% potent natural THC + other medical cannabinoids is a Schedule I illegal drug.
A 19-year-old right-handed university student presented to the Montefiore Headache Center for evaluation and management of his cluster headaches. Over the past 2 years, he had a cyclical pattern of stereotyped attacks occurring predictably every 1 to 2 months, lasting approximately 2 weeks. During these 2-week cluster periods, he experienced 1 attack every other day. Each cluster period was typically followed by a remission phase lasting 1 to 2 months. However, over the past 3 months, the frequency gradually increased to 1 to 2 attacks daily.
The majority of attacks would abruptly awaken him from sleep at 12:30 am or 4:30 am with excruciating right temporal and peri-orbital pain. Each episode lasted 3 to 4 h untreated, with the pain reaching maximal intensity within 10 min and declining within 10 min at its conclusion.
He did not drink alcohol, but noted that marijuana use at the onset of his headaches consistently brought complete relief within 5 min of inhalation for each attack.
OK, so smoking pot relieved the headaches, that should be it, right? No! The researchers take him off the marijuana and subject him to traditional (legal) treatments for chronic headaches, including prednisone, methylprednisolone acetate, bupivacaine, verapamil, lithium, sodium valproate, melatonin, topirimate, nifedipine, indomethacin, zonisamide, venlafaxine, ergotamine tartrate, clonazepam, sumatriptan tablets, zolmitriptan nasal spray, ergotamine/caffeine, oxycodone, aspirin/butalbital/caffeine, acetominophen/dichlorphenazone/isometheptene, and indomethacin are all tried, “without benefit” and with “intolerable adverse effects” (click any drug for its fun list of adverse effects, like nausea, vomiting, constipation, loss of appetite, extreme thirst, urinating more or less than usual, weakness, fever, feeling restless or confused, eye pain and vision problems, restless muscle movements in your eyes, tongue, jaw, or neck, pain, cold feeling, or discoloration in your fingers or toes, feeling light-headed, fainting, slow heart rate, hallucinations, seizure (blackout or convulsions), depressed mood, thoughts of suicide or hurting yourself, chest tightness, fast or pounding heartbeats, and the worst adverse reaction, death.)
So, as the last resort…
Given the lack of responsiveness to multiple agents, dronabinol [Marinol pill] 5 mg was substituted for marijuana for acute treatment of his cluster headaches; dronabinol consistently provided dramatic relief within 5 to 15 min of ingestion.
OK, so smoking pot or using Marinol helps and pharmaceuticals don’t. I can understand giving the guy Marinol instead of marijuana if both are equally effective, if only to keep him out of jail. What I can’t understand is this conclusion by the researchers:
It may be of future interest to ascertain if pain relief can be achieved when recreational marijuana or dronabinol are used in a cluster attack. We would not recommend routine use of recreational or pharmacological preparations of cannabis for treatment of cluster headaches because of the risk of long-term dependence and other potential adverse effects.
You were more than willing to run this guy through 21 different phamaceutical therapies, including steroids, oxycodone and lithium, and you’re worried about the dependence and adverse effects of cannabis? What kind of insanity is it where the herb that is safer and more effective than 21 dangerous ineffective drugs is rejected by doctors who as a last resort turn to the synthetic preparation of one part of the exact same herb they’re rejecting because it is too dangerous?
My cousin gave me some weed as his mother, an RN an hospice care manager, suggested it. I thought I would try it just for the heck of it as the MS-Contin (morphine sulfate) was not even touching the pain. Would awake at 11:30 PM with excruciating left-temporal / periorbital pain. Wouldn’t wish that on my worst enemies!
I was so distraught that I decided to smoke just a little (from one of those pinch-hitters) and went back in to bed and put the ice pack back on and within 10 minutes I had relief. Brought my pain level down from 8 to 2 and then all pain was gone after around 20 minutes. I wish I would have tried it a couple of months earlier, but I just thought it was counter intuitive to smoke something when my head was about to explode. If you suffer from cluster headaches do yourself the best favor in your life: get some THC in your system and you will only have yourself to thank.
I was really skeptical, at first, and thought ‘sure, just a reason for people to smoke pot.’ I must admit that I was critical of peoples’ claims about the myriad uses of marijuana. What an idiot I’ve been.
Kimber Compiler
Wow, I can’t believe that I missed this post. I also suffer from cluster headaches, and I use cannabis for relief and prevention.
Here is some data:
Ethan Russo, M.D.
# Cannabis in Headache Treatment Study Survey
# Cannabis in Migraine Treatment Project Close to FDA Approval
# Cannabis in Migrane Treatment Study
http://www.cannabismd.org/reports/russo1.php
I’ve suffered from CH for several years now. After trying many medications on top of medications and getting addicted to Hydrocodone, my youngest son sent me a link to a paper from Europe (I don’t remember which, or where to find it) talking about the use of MJ for CH. I decided to try it (I hadn’t smoked it in quite a few years), and while not always effective, it usually helps quite a bit. Since I started smoking it regularly again, my headache clusters seem to be coming less often, and are generally not as severe as they used to be. Unfortunately, it seems that at times having a “toke” or two can actually trigger an episode. As soon as MJ is legal for medical use, my doc will be one of the first to write the prescription – he approves (unofficially of course!) of anything that actually helps me. Since I’ve been seeing him for more than eight years now, primarily for other reasons, we have speculated together whether taking the medications that I’ve tried (for those other purposes) may have actually caused the onset of these cluster headaches. But as several doctors have told me “no one really knows what causes them”.
Cannabis should be consider a prophylactic when it comes to cluster headaches. I’ve been using it for over forty years. I have had cluster headaches my whole life. It was not properly diagnosed until I was 30 years old. I discovered on my own that if I smoke good quality cannabis (typically home grown or medical grade) it helps prevent them from occurring as often and also reduces the severity. After onset it has limited effect for me. It does reduce the pain but does not eliminate it. I would love to see real clinical trials of this done so that we could further refine the exact cannibiniods that effect this problem. It may lead to a better understanding of the cause and effect. I would love to be able to disrupt the cycle. My headaches are very cyclical. Any feed back would be appreciated.
Now add in how restrictive the price of Marinol is compared to marijuana. Add to this the real reaction time of Marinol, 5-15 minutes compared to marijuana, 1-3 minutes. Now add in undesirable side effects of Marinol. Which way would I go? I suffered Cluster Headaches (CH) for over 12 years while in the military due to drug testing. I finally said to heck with that in 1992 and have been CH free since.
Great post.
[...] Cluster headaches responsive to smoking cannabis use Marinol [...]