Our objective was to examine prevalence and experience of patients who self-reported marijuana use for headache pain management in a University-based headache clinic

Despite increased interest in marijuana use, there is paucity of research for headache disorders. Marijuana is legal in Washington and multiple states of the USA.

All new patients at a tertiary headache clinic complete a patient intake questionnaire prior to the first visit. This questionnaire contains a section on marijuana use. After seeing the patient face-to-face, clinicians update the database with the headache diagnosis using IHS-3 criteria. Then, a detailed IRB approved questionnaire is sent to patients which includes additional questions about marijuana frequency of use, perceived effectiveness, side effects, age of first use, and safety perception.

Only 437 patients out of 4386 patients surveyed prior to intake identified trying marijuana. More than 75% of the patients had diagnoses of chronic migraine (315, 77.6%). 215 reported that they tried using marijuana daily for headache prevention, 85.6% of them were currently still taking marijuana daily, 60% found it helpful. From our detailed survey responses of 244 patients, the average frequency of use was 15 days per month. 148 (69.8%) found it helpful. The majority were not able to abort headache fully (19, 10.9% were able to fully relieve pain). Most patients reported reduction in the pain severity (112, 64.4%). Participants also reported using marijuana for other conditions commonly comorbid with migraine: sleep (137, 57.6%), anxiety (107, 45%), mood (63, 26.5%), nausea (85, 35.3%), and other pain (147, 61.8%).

Results suggest that marijuana use for headache treatment is generally uncommon (10% of survey participants).  Most patients who have tried marijuana for headache reported some relief of pain, but rare full relief of headache. Many questions remain, including type and frequency of cannabis use. Randomized controlled studies are needed.