Experts at Integro Clinics explain how cannabis medicines can help alleviate and manage the excruciating pain of migraine.
Migraine can be a devastating and utterly miserable condition that can have a profound effect upon the patient’s quality of life, but medical cannabis can offer an effective, side-effect free treatment option.
A migraine is categorised as a moderate or severe headache felt as a throbbing pain on one side of the head. It is generally accompanied with symptoms such as feeling sick, vomiting and increased sensitivity to light or sound.
It’s a common health condition, affecting around one in every five women and around one in every 15 men and they usually begin in early adulthood.
No-one knows exactly what causes migraines, although they’re thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain.
Many patients find they have a specific trigger such as certain food or drink, stress, tiredness or hormonal changes such as starting your period. Around half of all people who experience migraines also have a close relative with the condition.
There are several types of migraine, including:
- migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights
- migraine without aura – the most common type, where the migraine happens without the specific warning signs
- migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop
The frequency of the occurrence of migraines really depends upon the individual. It can be several times a week to every few years.
There’s no one specific cure for migraines. Patients try pain medicines such as paracetamol and ibuprofen and triptans to help with the pain but these medicines are often ineffective
If you suspect a specific trigger is causing your migraines, such as stress or a certain type of food, avoiding this trigger may help reduce your risk of experiencing migraines. It may also help to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, as well as ensuring you stay well hydrated and limiting your intake of caffeine and alcohol.
Cannabis medicines have been found by certain patients to be incredibly helpful in the management of pain.
Dr Anthony Ordman, senior clinical adviser and hon. clinical director of Integro Clinics explains: “Recent medical scientific research is showing that cannabis medicines can have several useful roles in the prevention of migraine, and also reducing pain if a migraine attack does occur.
“It is likely that substances in cannabis medicines (plant-derived CBD, THC and terpenes) all have roles to play, and that they supplement the activity of the brain’s naturally occurring endocannabinoid system. This system may be under-active in people prone to migraine.
“There are three likely mechanisms by which cannabis medicines may be effective. Firstly, the natural stabilising or anticonvulsant effect of the cannabinoids suppresses the spreading abnormal wave of voltage depression in the brain’s cortical neurones. This wave precedes all migraine attacks and causes the aura familiar to migraine sufferers. Secondly, cannabis substances are thought to stabilise the mast cells of the immune system.
“In migraine, mast cells are involved in dilatation, or opening up of the blood vessels of the brain’s lining (dura), causing that familiar pulsating headache. Cannabis medicines may prevent this process from occurring.
“And finally, as in other painful conditions, if a migraine does occur, cannabis medicines are likely to block the transmission of pain messages in nerves running from the brain stem to the pain centres of the brain, to reduce pain itself. A recent study showed that cannabinoids may reduce migraine severity by 49.6 percent, without causing the ‘overuse headache,’ that other pain medicines such as paracetamol may cause.”
The patient’s story
Mike is a physically fit 37-year-old South African who first experienced migraines as a teenager. The pain he suffered was agonising and totally debilitating. It disturbed his vision, caused nausea and deep pain. Prior to the onset he experienced the aura of lights and would go blind in one eye.
An attack could wipe out days of his life whilst he recovered. For several days after the attack, he would feel befuddled and that his brain was not working properly.
Initially he looked into what could be causing the migraines worrying that he might have a brain tumour, but MRI scans thankfully showed that this was not the case. It was through luck and circumstance he stumbled upon cannabis as a medicine for his condition.
Mike was out playing golf in the hot sun and he became dehydrated. He felt the first symptoms of the headache begin so he paused for a rest under a tree and consumed some cannabis.
Instantly, he felt the pain begin to recede and he knew he had found a solution to his condition. He also wanted to point out that he was able to finish his round of golf and win. He came to the realisation that dehydration and hot sun were his major triggers.
Using cannabis would also mean that when a migraine did come it would last for a much shorter period of time and there was none of the post attack brain fog.
“I cannot recommend medical cannabis highly enough as treatment for migraine,” Mike adds.
“It addresses all of the symptoms of the loss of vision, nausea and deep pain by addressing the inflammation in the blood vessels of the brain.”
Integro Medical Clinics Ltd always recommend remaining under the care and treatment of your GP and specialist for your condition, while using cannabis-based medicines, and the Integro clinical team would always prefer to work in collaboration with them.
If you would like further information, or to make an appointment for a medical consultation, please contact us Integro Clinics: www.integroclinics.com
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Royal Society of Medicine and Integro Clinics announce pain and cannabis medicines event
The event takes place on October 11 from 8:30 to 17:30. It will explore the potential of cannabis medicines in the field of pain medicine in the UK
The Royal Society of Medicine has announced a collaborative event, Pain and cannabis medicines: Everything you want to know (but were too afraid to ask) in association with Integro Medical Clinics.
The event takes place on October 11 from 8:30 to 17:30. It will explore the potential of cannabis medicines in the field of pain medicine in the UK
Since the legalisation of cannabis medicines on prescription in November 2018, patients and clinicians alike have been awaiting more data or information regarding these medicines.
The event aims to provide those attending with a comprehensive understanding of the uses of cannabis medicines and the practicalities of using them in their own practice. It will consist of presentations on the history, regulatory environment and pharmacology of cannabis medicines including the use of different cannabis-based medical preparations in treating pain and related symptoms in a wide variety of clinical fields in the context of the current UK regulatory framework.
The day will feature presentations from international leaders in cannabis medicines such as Professor Raphael Mechoulam, the chemist who discovered the endocannabinoid system and THC, Dr Anthony Ordman, Leading UK Consultant in Pain Medicine and previous President of the Pain Medicine Section of the Royal Society of Medicine and Dr Arno Hazekamp PhD, who worked as Head of Research and Education at Bedrocan, the first European company to produce EU GMP grade cannabis medicines.
Dr Anthony Ordman, Consultant in Pain Medicine
Founder of the highly respected Chronic Pain Clinic at London’s Royal Free Hospital, he is one of the UK’s most experienced specialists in the treatment of pain. For his contributions to Pain Medicine, Dr Ordman was awarded a Fellowship of the Royal College of Physicians in 2005, and he is the Immediate Past President of the Pain Medicine Section of the Royal Society of Medicine. Dr Ordman is also Senior Medical Consultant and Lead Clinician at Integro Medical Clinics and has a special interest in the potential benefits of cannabis medicines in pain medicine.
Alex Fraser, Patient Access Lead at GrowPharma
Alex Fraser is a leading medical cannabis patient advocate. He is a patient himself having been diagnosed with Crohn’s Disease in 2010 at 19 years old. In 2014 he founded the United Patients Alliance and has since appeared on mainstream media multiple times, including on the BBC and ITV, to highlight the urgent need for access to cannabis medicines for the many patients who may benefit from them. He has taken delegations of patients to parliament to give testimony to politicians at the highest levels and organised educational events, rallies and protests calling for law change on medical cannabis. In February 2019 Alex joined Grow Pharma, one of the leading suppliers of cannabis medicines in the UK, as their patient access lead. He utilises his extensive knowledge of medical cannabis, his understanding of patient needs and his network in the industry to ensure patient voices are heard and represented. His work includes informing top-level policymakers, educating healthcare professionals and conceiving and running projects that increase general awareness and provide practical help for patients.
Professor Raphael Mechoulam, Professor of Medicinal Chemistry at the Hebrew University of Jerusalem in Israel
Most well-known for the total synthesis of delta-9 tetrahydrocannabinol (THC) and the discovery of the Endocannabinoid System. Since the inception of his research in the 60s, Professor Mechoulam has been nominated for over 25 academic awards, including the Heinrich Wieland Prize (2004), an Honorary doctorate from Complutense University (2006), the Israel Prize in Exact Sciences – chemistry (2000), the Israel Chemical Society Prize for excellence in research (2009) and EMET Prize in Exact Sciences – Chemistry (2012
Dr Sally Ghazaleh, Consultant Pain Specialist
Dr Sally Ghazaleh, is a Pain Management Consultant at the Whittington Hospital, and the National Hospital of Neurology and Neurosurgery, London. She qualified from the University of Szeged Medical School, Hungary in 2000, and then completed her specialist training in the Anaesthesia and Intensive Care Medicine at Semmelweis University in 2007. She went on a fellowship at University College Hospital, London, to gain her higher degree in Pain Medicine
During her time at the pain management Centre at University College Hospital, she gained extensive experience in dealing with and managing patients with complex multiple pain problems. She is accomplished at a variety of interventional and non-interventional treatments for this specific patient group. Sally specializes in managing patients with lower back pain, neck pain, neuropathic pain, abdominal pain, cancer pain, complex regional pain syndrome, post-stroke pain and Fibromyalgia. She has a particular interest in bladder and abdominal pain in women, and women’s health in general.
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Cancer patients interested in CBD, but lack understanding on benefits or risks
Two studies show patients with spine-related pain and cancer are reporting benefits from CBD but are still unsure if it’s safe to take it
A new survey by Vanderbilt University at a cancer care clinic revealed interest in CBD but patients are still unsure.
The survey of 100 patients at an oncology care clinic showed participants were interested in CBD as a way to alleviate symptoms. They listed their main symptoms as uncontrolled pain, depression and anxiety.
When asked about their understanding of CBD, 45 percent said they were unsure if there were any risks. A further 17 percent believe there was no or low risks but 25 percent “reported uncertainty of the alleged benefits of using CBD.”
Some of the patients were concerned about the potential for drug interactions, a lack of FDA regulation and unlabelled substances in CBD products.
The most common perceived benefits of CBD were decreased pain, eased anxiety and cancer-related nausea relief.
When it came to learning about CBD, only 13 percent said they learned of CBD through a healthcare provider. The majority at 47 percent said a family member or friend told them about it. A further 36 percent said social media and 13 percent reported television was their main source of information on CBD.
Cancer, cannabis and education
The research was recently published in the Clinical Journal of Oncology Nursing.
Researchers wrote: “Oncology nurses are well-positioned to educate patients about the lack of evidence to support popular uses of CBD, possible contaminants, misleading advertising, and legal issues.”
“Absolute conclusions about the effects of CBD cannot be made.”
Another survey on spine-related pain, not cancer pain revealed that patients are turning to cannabis for help with their symptoms. Data published in the International Journal of Spine Surgery reported that an estimated one in four patients with spine-related pain admits using CBD to combat symptoms.
Researchers anonymously surveyed patients at a spinal surgery clinic in New York for over a month. The survey was distributed by one out of nine spine surgeons at a single institution upon registration.
A quarter said they had either tried CBD or were currently using it for symptom management. Almost half of the users at 46 percent said that it may have mitigated their pain. A further 66.7 percent said they used it for spine-related back pain, 37 percent for neck pain, 35.2 percent for leg pain and 9.3 percent for arm pain. While this is for spine related pain instead of cancer related pain, the percentages show that CBD may also work for cancer pain.
Users turned to CBD with help sleeping with 25.9 percent said it improved their insomnia. A further 33 percent reported it had improved their sleep and 20 percent said it reduced their anxiety.
Both of the surveys on cancer and spine pain show that more education is needed while CBD may have effects on pain.
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