How Medical Cannabis Helped Me Break Free from Rebound
Five years ago, I landed in the hospital on day 14 of the worst intractable migraine I had ever experienced. They kept me for three days, trying and failing to break through my pain with a cocktail of various medications. I ended up on a morphine drip.
I consider that experience and the subsequent weeks to be my “rock bottom”… but also a rebirth of sorts. The catalyst to a string of breakthroughs that led me to become a patient advocate with a new lease on life.
My Journey Begins…
Though I’d been experiencing complex migraines since the age of 11, I didn’t develop chronic migraine and chronic daily headache until I was 29. Life as I knew it came to an abrupt halt. My longtime job as a music librarian (which I love) became increasingly difficult to manage due to the unrelenting pain and the sheer number of medical appointments I had to attend.
It put a strain on my marriage as my husband watched me sequester myself, withdrawing from our busy social life and descending into a deep depression. His entire life changed too, of course. He was thrust into the role of a caretaker, unsure how to handle a partner who is constantly crying and resentful that he doesn’t understand what it’s like to be in pain 24/7.
Seeking proper diagnosis and treatment became a full-time job in itself. I saw specialist after specialist, ruling out everything we could think of as a cause. I tried everything from mindfulness to acupuncture to craniosacral therapy. Cocktails of medications… sometimes up to 7 medications a day. The side effects stacking until my hands were numb, my hair was falling out, I was dizzy, nauseous, gaining weight, constipated, my tastebuds didn’t work properly and my libido had all but vanished. But I continued taking whatever I needed to, to get through each day.
Early on in my diagnosis, I was warned about the risk of medication overuse headache (MOH) otherwise known as rebound headache.
MOH is a secondary disorder that can develop when we use certain medications too frequently. It can be caused by triptans, ergots, NSAIDS, narcotics and even some over-the-counter analgesics.
When used too frequently, these medications become less effective over time, leading us to take more in order to sustain relief. Each time the medication wears off, the headache returns (often worse than before) prompting you to take even more. Eventually, the medication that was supposed to be helping you is now making your condition worse. It is a desperate, vicious cycle that many of us find ourselves caught in.
Many of us have been warned against taking too many acute medications per week. But we are also told that the earlier we take an abortive during an attack, the more effective it will be. Which means we are constantly second-guessing ourselves. Is my pain bad enough to take a pill? How many pills have I taken this week? This month? Many of us end up suffering through pain because we fear medication overuse headache.
I didn’t know I was in rebound until I was out of it.
By the time I hit “rock bottom”, I was tracking 29 migraine days per month. I had failed Botox, nerve blocks, topiramate, propranolol, amitriptyline, indomethacin, and countless other treatments. I was being treated by a neurologist and a pain specialist at a clinic for “last resort” cases… Neither of whom came to assess me during my three days at the hospital, despite being located four floors above me.
It was disheartening to feel like I didn’t matter and had no options left. I began to lose confidence in my medical team. I decided that I needed to take a much larger role in my own treatment because things could not continue the way they were. I also knew that I needed to make some significant changes to my life in order to take control back from this disease.
By that point, I was certain I was dealing with MOH, but I just kept on taking medication out of sheer desperation. When I got home from the hospital, I began reading a book by Dr. David Buchholz which suggested abstaining from all acute meds for several weeks. It was a daunting task… but I was determined.
Taking control back with the help of medical cannabis…
The two weeks that followed were among the most difficult I’ve ever endured. I experienced withdrawal symptoms from the opioids I’d been on for several days in the hospital and withdrawal headaches from discontinuing the medications that had been keeping my pain in check for months. The headache and migraine attacks were relentless. I felt hopeless.
All I would allow myself to use for the pain was dried cannabis, which I vaporized using a small herbal vaporizer. I should mention here, that vaporizing flower is much different than vaping the e-liquid additives that have been causing severe illness in recent months.
There were moments where I was so desperate – crying and in agony. Ready to give in to that bottle of pills in my dresser drawer. Thank goodness for the support of my husband, who held firm and handed me my vaporizer each time, saying, “use this instead”.
So I’d take a few puffs here and there.. it didn’t take much but I used it frequently. It didn’t take my pain away completely, but it did alleviate it. It felt like it targeted the pain and dissolved it. Masked it. Dulled it.
It took about two weeks to notice a change. First, there were short breaks from the pain, which slowly grew into hours. My headache attacks gradually lifted until I experienced a FULL day without pain. And then two! I felt so relieved… and hopeful for the first time in years.
I was able to avoid triptans and analgesics for a full month. At that point, I found that I could get through a migraine without reaching for pills every single time. I still used them for emergencies, of course, but I noticed that lower grade headache attacks would often resolve on their own, which raised my confidence in my own resilience and ability to cope. Being in a better place also allowed me to start a migraine elimination diet which helped immensely.
I had always been a believer in cannabis, but after my experience with MOH I wanted to shout about it! I began learning everything I could about the plant. I asked my doctor to authorize a medical license which gave me access to many different forms and strengths of cannabis. Each migraine was an opportunity to try a new strain or oil. Or perhaps an edible I made at home. I made notes before and after I took a dose. Occasionally I tried something too strong which made for some interesting stories. Eventually, I got better at understanding dosage and what helped each type of migraine I experienced.
I was eager to compare notes with others, but the subject was still considered taboo in many groups I belonged to online and information about cannabis specific to migraine was sparse. That’s what prompted me to start MigraineBuds Chat, which exists for the sole purpose of educating patients about medical cannabis and supporting them through their journey. This group is a community of amazing migraine warriors from all over the world who inspire me every day with their success stories and willingness to help each other.
Medicating with cannabis involves a great amount of trial and error.
Cannabis can be used both as a preventative and an acute pain reliever. The vast array of products available can make it a daunting task to know where to begin and figure out what works for you and what doesn’t.
Whether you are looking to try a CBD oil, a new strain, or those gummies your friend raves about, it is not uncommon to have to try several different products before finding something that works for you. And that might be very different from what is helping someone else with the same diagnosis. So be patient, always research a company before making a purchase, and ask lots of questions!
For some practical tips on medicating with cannabis, we’ve compiled some on our website!
Medical cannabis is so often regarded as a last resort treatment. Many patients aren’t given the option to try it unless they’ve failed everything else available. But I would like to challenge this approach. Cannabis (in its many forms) has become my first line of defense in a tiered approach to pain management that I’ve adopted. It has allowed me to take far fewer acute medications each month. Based on my experience, along with the anecdotal data we’ve collected in our patient support group, I believe that medical cannabis could be a way to prevent the overuse of medications that lead to MOH.
A hotly contested theory…
There are many who will point out that there is not enough evidence to support this. That cannabis itself can cause rebound, or at least contribute to MOH.
The truth is there is very little scientific data on this topic. To my knowledge there are only three studies that have touched on it:
One of them is an observational study that analyzed data from 20,000 patient reports. It showed that peoples’ baseline headache and migraine severity rating did not increase over time. This could indicate that MOH did not develop for these patients, or that they tend to medicate with cannabis once their headache/migraine reaches a specific critical threshold. They concluded that they found no evidence that cannabis causes MOH.
Another study shows that people with migraine and MOH have deficiencies in the endocannabinoid and serotonergic systems. This could support the theory that targeting these systems with cannabinoids may be beneficial to us!
The third study conducted a test on rats (which may not generalize to humans) and suggests that “overuse of cannabinoids may increase the risk of MOH in vulnerable individuals.”
I have to agree that there is a lack of scientific evidence to state either way that cannabis does or does not contribute to MOH. We need controlled studies on larger groups of people. But it’s a very complicated topic to conduct a study on… believe me, I’ve tried!
For now, all I have is my own story and some fantastic data gathered from our patient group. Anecdotal evidence may be easy for healthcare professionals to disregard, but as someone who speaks to hundreds of these patients on a daily basis, their lived experience is impossible to deny.
It has been more than five years since that fateful stay in the hospital. I am somewhat ashamed to admit that I’ve been back in rebound two or three times since then. On those occasions, I turned to cannabis each time and was able to come out the other end.
This is the experience that led me to become an enthusiastic advocate for both cannabis and migraine. It is how I found a new purpose in life, and the passion to destigmatize, educate and advocate for new research that proves what I, along with many other migraine patients, have experienced.
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Assistance with interpreting study findings provided by Dr. Carrie Cuttler, Ph.D.
Cuttler, Carrie, Alexander Spradlin, Michael J. Cleveland, and Rebecca M. Craft. “Short- and Long-Term Effects of Cannabis on Headache and Migraine.” The Journal of Pain, 2019. https://doi.org/10.1016/j.jpain.2019.11.001.
Rossi, Cristiana, Luigi Alberto Pini, Maria Letizia Cupini, Paolo Calabresi, and Paola Sarchielli. “Endocannabinoids in Platelets of Chronic Migraine Patients and Medication-Overuse Headache Patients: Relation with Serotonin Levels.” European Journal of Clinical Pharmacology 64, no. 1 (2007): 1–8. https://doi.org/10.1007/s00228-007-0391-4.
Kopruszinski, Caroline M, Edita Navratilova, Barbora Vagnerova, Juliana Swiokla, Amol Patwardhan, David Dodick, and Frank Porreca. “Cannabinoids Induce Latent Sensitization in a Preclinical Model of Medication Overuse Headache.” Cephalalgia 40, no. 1 (2019): 68–78. https://doi.org/10.1177/0333102419865252.
MEET THE AUTHOR
Jodie Epstein is a patient advocate, an educator and the proud Founder of MigraineBuds – an initiative that provides cannabis education and support to a community of over 6000 migraine patients from all over the world!
Jodie’s passion for advocacy stems from her own experience as a legal cannabis patient in
Toronto, Canada. Through education, she aims to raise migraine awareness, destigmatize
medicinal cannabis and empower patients to make informed choices.
Jodie is a partner of the Association of Migraine Disorders, and a proud recipient of their 2019 Advocacy Award! She is a recognized international speaker who appeared at both Barbados Medical Cannabis Conferences as well as the 2019 Migraine Symposium in Rhode Island, USA. Jodie was a nominee for the 2018 Canadian Cannabis “Cannabis Crusader” Award and has welcomed collaborations with Shades For Migraine, GrowWise Health, Canadians for Fair Access to Medical Marijuana, the Canadian Institute of Medical Advancement, the Association of Migraine Disorders and the Michener Institute’s Cannabis Education Advisory team.
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