Does Frequent Marijuana Use Cause Migraines?
No, frequent marijuana use does not cause migraines—in fact, the available evidence suggests it reduces migraine frequency and duration. However, withdrawal from regular cannabis use can trigger headaches as a withdrawal symptom, which should not be confused with cannabis directly causing migraines 1.
Understanding the Relationship Between Cannabis and Headaches
Cannabis as Migraine Treatment
The research consistently demonstrates that cannabis reduces rather than causes migraines:
Medical marijuana decreases migraine frequency from 10.4 to 4.6 headaches per month (p<0.0001), with 39.7% of patients reporting positive effects including migraine prevention and abortion 2.
Among headache patients using medicinal cannabis, 88% were treating probable migraine, with hybrid strains (particularly high THC/THCA strains like "OG Shark") being most preferred for their analgesic, anti-inflammatory, and anti-emetic properties 3.
Multiple systematic reviews confirm that medical cannabis demonstrates significant clinical response by reducing both the length and frequency of migraines without severe adverse effects 4, 5.
The Withdrawal Headache Caveat
The only mechanism by which cannabis is associated with headaches is through withdrawal syndrome, not active use:
Symptoms of cannabis withdrawal include irritability, insomnia, and headaches when regular users abruptly stop 1.
Approximately 47% of regular cannabis users experience cannabinoid withdrawal syndrome (CWS) after cessation of heavy and prolonged use, with headaches being one component 6.
This withdrawal phenomenon occurs with cessation, not during active use, making it mechanistically distinct from cannabis "causing" migraines 6.
Clinical Implications
What This Means for Practice
If a patient reports headaches with cannabis use, consider alternative diagnoses rather than assuming causation, particularly cannabinoid hyperemesis syndrome (which presents with cyclic vomiting, not primarily headaches) 1.
Withdrawal headaches occur when stopping cannabis, not when using it regularly—this temporal relationship is critical for accurate diagnosis 1, 6.
Patients may be using cannabis specifically to treat pre-existing migraines, as chronic pain (including headache) is the most common qualifying condition for medical cannabis enrollment 1, 3.
Common Pitfall to Avoid
Do not confuse cannabinoid hyperemesis syndrome with migraine causation. CHS presents with stereotypical episodes of cyclic vomiting, not headaches as the primary symptom, though it can occur in the context of heavy cannabis use 1. The association between cannabis and various vomiting syndromes (CVS, CHS, CWS) is well-established, but these are distinct from migraine pathophysiology 1.
The Evidence Quality
The guideline evidence from the American College of Physicians (2024) addresses cannabis withdrawal symptoms including headaches but does not identify cannabis use itself as causing migraines 1. The research evidence, while limited by cannabis's Schedule I status restricting rigorous trials, consistently shows therapeutic benefit for migraine rather than causation 4, 7, 2, 3, 5.