Alleviative effects of Cannabis flower on migraine and headache

Stith, Sarah S.; Diviant, Jegason P.; Brockelman, Franco; Keeling, Keenan; Hall, Branden; Lucern, Storri; Vigil, Jacob M.

doi:10.1016/j.joim.2020.07.004

Cited by 19 publications

(30 citation statements)

References 54 publications

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“…Given this, it remains unclear whether the perceived therapeutic effects are a result of the individual components of cannabis products or the combined effects of interacting cannabinoids and terpenes. Although strain categories are largely arbitrary, many researchers continue to examine their perceived effects to better understand consumer choices [16,24,[44][45][46][47]. The nature of our data allowed us to do the same, providing insight into the naturalistic setting of cannabis use.…”

Section: Limitationsmentioning

confidence: 94%

The Use of Cannabinoids for Insomnia in Daily Life: Naturalistic Study

Kuhathasan¹,

Minuzzi²,

MacKillop³

et al. 2021

J Med Internet Res

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Background Insomnia is a prevalent condition that presents itself at both the symptom and diagnostic levels. Although insomnia is one of the main reasons individuals seek medicinal cannabis, little is known about the profile of cannabinoid use or the perceived benefit of the use of cannabinoids in daily life. Objective We conducted a retrospective study of medicinal cannabis users to investigate the use profile and perceived efficacy of cannabinoids for the management of insomnia. Methods Data were collected using the Strainprint app, which allows medicinal cannabis users to log conditions and symptoms, track cannabis use, and monitor symptom severity pre- and postcannabis use. Our analyses examined 991 medicinal cannabis users with insomnia across 24,189 tracked cannabis use sessions. Sessions were analyzed, and both descriptive statistics and linear mixed-effects modeling were completed to examine use patterns and perceived efficacy. Results Overall, cannabinoids were perceived to be efficacious across all genders and ages, and no significant differences were found among product forms, ingestion methods, or gender groups. Although all strain categories were perceived as efficacious, predominant indica strains were found to reduce insomnia symptomology more than cannabidiol (CBD) strains (estimated mean difference 0.59, SE 0.11; 95% CI 0.36-0.81; adjusted P<.001) and predominant sativa strains (estimated mean difference 0.74, SE 0.16; 95% CI 0.43-1.06; adjusted P<.001). Indica hybrid strains also presented a greater reduction in insomnia symptomology than CBD strains (mean difference 0.52, SE 0.12; 95% CI 0.29-0.74; adjusted P<.001) and predominant sativa strains (mean difference 0.67, SE 0.16; 95% CI 0.34-1.00; adjusted P=.002). Conclusions Medicinal cannabis users perceive a significant improvement in insomnia with cannabinoid use, and this study suggests a possible advantage with the use of predominant indica strains compared with predominant sativa strains and exclusively CBD in this population. This study emphasizes the need for randomized placebo-controlled trials assessing the efficacy and safety profile of cannabinoids for the treatment of insomnia.

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Section: Limitationsmentioning

confidence: 94%

The Use of Cannabinoids for Insomnia in Daily Life: Naturalistic Study

Kuhathasan¹,

Minuzzi²,

MacKillop³

et al. 2021

J Med Internet Res

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“…All analyses used the total potential THC (hereon THC). Following other research (Stith et al 2019;Stith et al 2020), tests reporting higher than 35% THC (biologically dubious levels) are dropped, though this does not change results. The main analytic dataset included 142, 847 Chemotype-1 (those with a THC:CBD ratio exceeding 5) products in Washington and 55,523 in Nevada.…”

Section: Methodsmentioning

confidence: 99%

The frequency distribution of reported THC concentrations of legal cannabis flower products increases discontinuously around the 20% THC threshold in Nevada and Washington state

Zoorob

2021

J Cannabis Res

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Background Cannabis laboratory testing reliability is a scientific and policy challenge in US states with legal cannabis. Greater reported THC concentration yields higher prices, and media reports describe a well-known consumer and dispensary preference for flower products containing a minimum 20% THC content—an economically meaningful but biologically arbitrary threshold. This paper examines the frequency distribution of reported THC concentration in legal cannabis flower products in Nevada and Washington state for unusual shifts around the 20% threshold suggestive of potential manipulation of reported THC results. Methods THC concentration test results for 142,000 Chemotype 1 flower products from Washington state between June 2014 and May 2017 and 55,000 flower products from Nevada between December 2017 and January 2020 were analyzed for changes in the frequency distribution around the 20% threshold using the McCrary density test. Analyses were performed among all labs in each state, the highest volume lab in Washington, and two labs in Washington which had their licenses suspended for testing irregularities during the study period. Results Comparing just above the 20% THC threshold with just below it, the frequency of test results increased by about 43% in Nevada (z = 15.6, p < 0.001) and by about 17% in Washington (z = 11.0, p < 0.001). In Washington’s highest volume testing lab, frequency increased by only about 1% (z = 0.39, p = 0.70), while it increased by about 47% (z = 12.7, p < 0.001) among the two suspended labs. Subset to those growers which sent products to both sets of labs, frequency of flower products just above the 20% threshold increased by 2% in Washington’s largest lab (z = 0.50, p = 0.62) and by 52% among the two suspended labs (z = 12.8, p < 0.001). Discussion There is a statistically unusual spike in the frequency of products reporting just higher than 20% THC in both states consistent with economic incentives for products to contain at least 20% THC. This “bunching” of reported THC levels exists among some, but not all, cannabis testing labs, suggesting that laboratory differences (rather than precise manipulation by growers) drive this potential manipulation in reported THC content. These findings elaborate on prior research highlighting unexplained interlaboratory variation in cannabis testing results and highlight ongoing irregularities with legal cannabis testing. Conclusion These findings highlight the need for industry oversight and cautions researchers working with reported cannabis THC concentration data, which may be biased by economic incentives to report higher THC.

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“…Regardless of whether clinicians actively engage in certifying patients for medical cannabis, they always need to have at least a basic knowledge of cannabis safety, factors related to pregnancy/lactation, cannabis-drug interactions, and cannabis abuse. Adverse events associated with medical cannabis primarily involve THC and include coughing fits, anxiety, feeling off-balance/unsteady, feeling light-headed/headrush, dizziness, body humming and paranoia [81].…”

Section: Cannabis Safetymentioning

confidence: 99%

“…Patients and clinicians may also consult a number of available portals to better monitor cannabis therapies (including side effects and benefits), and contribute to data sets by sharing relevant details from their own experiences. Bigger and better data sets will further improve cannabis therapies in the future [15,68]. Notably, an increasing number of research teams invite patients-especially those interested in pursuing medical cannabis as a therapy-to participate in clinical trials.…”

Section: Follow-upmentioning

confidence: 99%

Medical Cannabis for Headache Pain: a Primer for Clinicians

Duarte

Dahmer

Sanguinetti

et al. 2021

Curr Pain Headache Rep

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Purpose of Review Public acceptance of Cannabis sativa L. (cannabis) as a therapeutic option grows despite lags in both research and clinician familiarity. Cannabis-whether as a medical, recreational, or illicit substance-is and has been commonly used by patients. With ongoing decriminalization efforts, decreased perception of harms, and increased use of cannabis in the treatment of symptoms and disease, it is critical for clinicians to understand the rationale for specific therapies and their medical and practical implications for patients. In view of the opioid crisis, overall patient dissatisfaction, and lack of adherence to current chronic pain and headache therapies, this review provides up-to-date knowledge on cannabis as a potential treatment option for headache pain. Recent Findings Research into the use of cannabinoids for disease treatment have led to FDA-approved drugs for seizures, nausea, and vomiting caused by cancer chemotherapy; and for decreased appetite and weight loss in people with HIV/AIDS. For a wide variety of conditions and symptoms (including chronic pain), cannabis has gained increasing acceptance in society. The effects of cannabidiol (CBD) and tetrahydrocannabinol (THC) in pain pathways have been significantly elucidated. An increasing number of retrospective studies have shown a decrease in pain scores after administration of cannabinoids, as well as longterm benefits such as reduced opiate use. Yet, there is no FDA-approved cannabis product for headache or other chronic pain disorders. More is being done to determine who is likely to benefit from cannabis as well as to understand the long-term effects and limitations of the treatment. Summary Cannabis can refer to a number of products derived from the plant Cannabis sativa L. Relatively well-tolerated, these products come in different configurations, types, and delivery forms. Specific formulations of the plant have been shown to be an effective treatment modality for chronic pain, including headache. It is important for clinicians to know which product is being discussed as well as the harms, benefits, contraindications, interactions, and unknowns in order to provide the best counsel for patients.This article is part of the Topical Collection on Hot Topics in Pain and Headache * Robert A. Duarte

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Alleviative effects of Cannabis flower on migraine and headache

Cited by 19 publications

References 54 publications

The Use of Cannabinoids for Insomnia in Daily Life: Naturalistic Study

The Use of Cannabinoids for Insomnia in Daily Life: Naturalistic Study

The frequency distribution of reported THC concentrations of legal cannabis flower products increases discontinuously around the 20% THC threshold in Nevada and Washington state

Medical Cannabis for Headache Pain: a Primer for Clinicians

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