Can marijuana (cannabis) cause headaches?

From the Guidelines

Yes, marijuana (cannabis) can cause headaches in some users, as evidenced by symptoms of cannabis withdrawal, which include headaches, as noted in a 2024 position paper from the American College of Physicians 1. Headaches can occur both during cannabis use and as a withdrawal symptom when regular users stop consumption. During active use, some people experience tension headaches or migraines, particularly with high-THC strains or excessive consumption. When regular users discontinue cannabis, withdrawal headaches typically begin within 24-48 hours after the last use and may persist for 1-2 weeks, gradually decreasing in intensity. These headaches result from changes in cerebral blood flow, neurotransmitter fluctuations, and the endocannabinoid system's adjustment to the absence of external cannabinoids. For those experiencing cannabis-related headaches, staying hydrated, using over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours), and gradually tapering cannabis use rather than stopping abruptly may help reduce symptom severity. Some users find that CBD-dominant cannabis strains with lower THC content may produce fewer headache symptoms than high-THC varieties, although this is not conclusively proven and more research is needed to fully understand the relationship between cannabis use and headaches, as noted in the 2024 study 1. Key points to consider include:

• Cannabis use disorder (CUD) is a condition that can develop with regular cannabis use, and symptoms of withdrawal, including headaches, can occur when use is stopped 1.
• The therapeutic use of cannabis and cannabinoids, such as Epidiolex, has been approved by the FDA for certain conditions, including epilepsy, but the potential for misuse and side effects, including headaches, must be carefully considered 1.
• The American College of Physicians has issued a position paper on the regulatory framework for cannabis, highlighting the need for further research and caution when using cannabis, particularly in vulnerable populations, such as older adults and pregnant women 1.

From the Research

Marijuana and Headaches

• The relationship between marijuana and headaches is complex, with some studies suggesting that marijuana can help alleviate headache symptoms, while others indicate that it may exacerbate them 2, 3, 4, 5.
• Research has shown that medical cannabis can decrease migraine duration and frequency, as well as headaches of unknown origin 2.
• Patients utilizing medical cannabis for migraine have reported improvement in migraine profile and common comorbidities, with reduction in prescription medication, especially opioids 3.
• However, side effects of marijuana use for headache treatment do exist, with the majority being mild 3.
• The effects of cannabidiol (CBD) and tetrahydrocannabinol (THC) in pain pathways have been significantly elucidated, with an increasing number of retrospective studies showing a decrease in pain scores after administration of cannabinoids 4.

Studies on Marijuana and Headaches

• A study published in 2021 found that inhaled cannabis reduces self-reported headache and migraine severity by approximately 50% 5.
• However, the same study found evidence of tolerance to these effects, with patients appearing to use larger doses across time 5.
• Another study published in 2020 found that men reported larger reductions in headache than women, and use of concentrates was associated with larger reductions in headache than flower 5.
• The American Heart Association has issued a statement on the use of medical marijuana, recreational cannabis, and cardiovascular health, highlighting the need for further research on the therapeutic and medicinal properties of cannabis 6.

Key Findings

• Medical cannabis can be an effective treatment modality for chronic pain, including headache 4.
• THC and CBD appear to mediate the observed effects of marijuana on headache symptoms 3.
• More research is needed to determine the long-term effects and limitations of marijuana use for headache treatment 4, 5.