Cannabis Had a Long History as a Headache Treatment Before Prohibition, With No Controlled Studies Since

What the researchers found

The review traced the historical use of cannabis for headache treatment, noting that it was a standard medicine for migraine before the 1937 prohibition. Cannabis was used both as an abortive (stopping a headache in progress) and prophylactic (preventing headaches) treatment.

Despite prohibition, patients continue to use cannabis for headache, supported by the growing number of medical marijuana states. Cluster headache patients in particular have increasingly used both cannabis and hallucinogens (psilocybin, LSD) outside of medical recommendation, with considerable anecdotal success for aborting cluster periods and maintaining remission. However, no blinded studies on headache have been conducted for either drug class.

Why it matters

Migraine and cluster headache are severely debilitating conditions with limited treatment options. The historical prominence of cannabis as a headache treatment, combined with ongoing patient use and anecdotal success, makes the absence of controlled research a significant gap.

The numbers in context

Schedule 1 classification since 1970. No blinded controlled studies on headache for either cannabinoids or hallucinogens. Cannabis was a standard migraine treatment before 1937.

How the study worked

Narrative review of historical and contemporary use of cannabinoids and hallucinogens for headache disorders. Covered pre-prohibition medical literature, patient survey data, and mechanistic rationale.

What this study cannot tell us

Narrative review without systematic methodology. Historical evidence is based on pre-modern medical standards. Anecdotal reports of efficacy cannot replace controlled trials. Patient self-medication introduces selection bias and placebo effects.

How to read the evidence

Narrative review of historical and anecdotal evidence; preliminary due to absence of controlled trials.

When this study was published

Published in 2013. Some observational and survey studies of cannabis for headache have appeared since, but controlled trials remain scarce.

The bigger picture

This review illustrates how drug scheduling can halt medical research for decades. A treatment that was widely used by physicians before prohibition has gone unstudied for nearly a century because researchers cannot legally access the substance for clinical trials.

Questions still open

• Would cannabis be effective for migraine or cluster headache in controlled trials? Is the current scheduling of cannabis justified given its historical medical use? Could cannabinoid-based medications be developed specifically for headache disorders?

Common questions

Read the original research

Cannabinoids and hallucinogens for headache.

Headache, 53(3), 447-58

Citation

McGeeney, Brian E. (2013). Cannabinoids and hallucinogens for headache.. Headache, 53(3), 447-58. https://doi.org/10.1111/head.12025

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