Concussion

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Does Cannabis Aid in Recovery from Concussions?

Using-Medical-Cannabis-to-Alleviate-the-After-Effects-of-Concussions

Concussions, considered a type of traumatic brain injury (TBI), are often considered an acute injury, but it can also be considered lethal if it is not taken care of properly and in a timely manner. The initial impact of force, caused typically by accidents in which the head is hit or impacted (causing head trauma), damages brain cells and interrupts the blood flow in the brain (7).  

The concern is that the initial injury can cause a cascade of molecular events that lead to ongoing (or “chronic”) impairments, including dizziness, balance problems, headaches, brain fog, sensitivity to light or noise, nausea, and double or blurry vision (4). When such symptoms last for weeks to months, it is called post-concussion syndrome (11). 

When the initial injury occurs, the brain releases a large amount of the excitatory neurotransmitter glutamate and overproduces free radicals (oxidative damage) and other inflammatory compounds.  This leads to microvascular injuries in the brain, as well as brain swelling, neurotoxicity and cell death (7).  

Preliminary research shows that cannabidiol (CBD) and tetrahydrocannabinol (THC) act like antioxidants in the brain, reducing oxidative damage as well as or better than other antioxidants in the body’s chemical system. In addition, CBD and THC protect the brain against glutamate toxicity damage (6). 

New research has started to focus more on CBD’s potential to influence the residual changes caused by concussions (15). More research is needed to understand the benefits and risks of marijuana for concussions and traumatic brain injuries (12). To better understand cannabinoids and the endocannabinoid system, check out our article here

concussion-and-cannabis

Concussion Symptoms and Cannabinoids

THC and CBD have not been extensively studied in concussions, but there are researched pathways in which they may provide relief for the following symptoms:

According to the Dent Neurologic Institute and the Concussion Alliance, there are several cannabis options that may be beneficial for patients suffering from concussion symptoms.  

  • To prevent pain symptoms, a 1:1 CBD to THC tincture with around a 1.5 ml dose can be used (8). 
  • A 20:1 CBD to THC vape pen can be used effectively for acute pain (8).
  • For quick-acting relief of headaches, a 5:1 CBD to THC ratio is helpful and can be useful during the day, because it is not psychoactive for most people (3).
  • Using a 2:1 CBD to THC ratio product may be used before bed to help with sleep (10). 
  • CBD and THC have been shown to work the best when they are used together (1). 

The Concussion Alliance notes that for sharp or severe post-concussion pain, patients respond better to a dosage with more THC and that patients experience relief faster when inhaling cannabis or smoking weed as opposed to taking edibles (3). For patients who are not comfortable inhaling cannabis, taking it orally through edibles or sublingually with tinctures is also a viable option. It is also possible to use topical products for neck pain and other concussion symptoms.

It is recommended that you speak with your physician about concussion treatment before using medical marijuana as some conditions and medications may cause adverse effects.

Using Cannabis Instead of Hemp for Concussions 

The Concussion Alliance recommends that patients use CBD products that come from cannabis as opposed to hemp if you live in a state that has legalized use of medicinal marijuana in some capacity because:

  • In states that have legalized cannabis, there are independent labs that sometimes test cannabis products to ensure purity and that they are free from molds, bacteria, pesticides, and heavy metals (1). When you are purchasing these products, make sure you look for the COA, or certificate of analysis, on products you are interested in before purchasing in order to verify that it meets your needs.
  • Secondary cannabinoids and terpenes extracted from cannabis can provide enhanced medical benefits when using CBD (1) (14). 

Please check out our guide on CBD for more information. 

What Does the Science Say?

An ongoing retrospective analysis at the Dent Neurologic Institute suggests that medical cannabis is a promising treatment option for chronic and painful headaches for TBI patients who have suffered from concussions (8). Though this study is in progress, it shows promising results from the review of 66 out of 100 medical charts.  

80% of patients experienced significant improvement in their activity levels and symptoms. In the study, patients rated the improvements they experienced from medical cannabis in relation to their mood, sleep, and reduction in headaches (8). Patients rated these areas of improvement with the Quality of Life After Brain Injury Score’s (QOLIBRI) numerical rating system. None of the patients discontinued medical cannabis due to side effects. The results of this study suggest that cannabis may be used as a viable treatment for concussion-related chronic pain.  

According to the study, the Dent Neurologic Clinic has treated almost 3,000 patients with marijuana for chronic pain and another 142 for concussion-related symptoms (8). This study shows that there is a need for more high-quality studies on cannabinoid therapy for patients who have suffered concussions.

A 2020 review on CBD use in patients with concussions and TBIs also calls for more research specifically on its use for concussions. It has been shown to influence the blood-brain barrier, cognitive capacity, cardiovascular physiology, and neurogenesis, which are all areas that are altered by concussions. In addition, it can help protect the brain (neuroprotection) by reducing inflammation as well as protecting the brain against free radicals (15). 

Ongoing CBD and Concussion Research

Researchers from the University of Miami are currently conducting a large-scale, five-year study set to end in 2021. This study is being conducted by a multidisciplinary team and is led by researcher Dr. Gillian Hotz who aims to see if cannabinoids can be used in pill form to treat cognitive and emotional consequences of TBIs, such as post-traumatic stress disorder (PTSD) (5). The pill includes a combination of CBD and dexanabinol (HU-211), a synthetic cannabinoid (2). 

 

Note: Veriheal does not intend to give this as professional medical advice. Do not attempt to self-diagnose, or prescribe treatment based on the information provided on this page. Always consult a physician before making any decision on the treatment of a medical condition.

 

References

1. CBD from Hemp Vs Marijuana. (n.d.). Retrieved November 30, 2020, from https://www.concussionalliance.org/cbd-hemp-vs-marijuana

2. CBD Research and Clinical Trials. (n.d.). Retrieved November 30, 2020, from https://www.concussionalliance.org/cbd-research

3. Concussion Alliance. (2019, February 23). Study finds medical marijuana improves concussion symptoms. Retrieved November 30, 2020, from https://www.concussionalliance.org/blog/2019/2/22/study-medical-marijuana-improves-concussion-symptoms

4. Concussion Signs and Symptoms. (2019, February 12). Retrieved November 30, 2020, from https://www.cdc.gov/headsup/basics/concussion_symptoms.html

5. Could a Pill Treat Concussions. (2020, November 22). Retrieved November 30, 2020, from https://news.miami.edu/stories/2016/10/could-a-pill-treat-concussions.html

6. Hampson, A. J., Grimaldi, M., Lolic, M., Wink, D., Rosenthal, R., & Axelrod, J. (2006). Neuroprotective Antioxidants from Marijuana. Annals of the New York Academy of Sciences, 899(1), 274-282. https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.2000.tb06193.x

7. Lee, M. A. (2018, May 02). No Brainer: CBD & THC for Head Injuries. Retrieved November 30, 2020, from https://www.projectcbd.org/medicine/no-brainer-cbd-thc-head-injuries

8. Mcvige, J., Bargnes, V. H., Shukri, S., & Mechtler, L. (2018). Cannabis, concussion, and chronic pain: An ongoing retrospective analysis at Dent Neurologic Institute in Buffalo, NY. Neurology, 91(23 Supplement 1). https://n.neurology.org/content/91/23_Supplement_1/S18.3

9. Symptoms of post-concussion syndrome. (n.d.). Retrieved November 30, 2020, from https://www.concussionalliance.org/symptoms-postconcussion-syndrome

10. CBD Products from Marijuana. (n.d.). Retrieved November 30, 2020, from https://www.concussionalliance.org/cbd-products-marijuana

11. Persistent Post-Concussive Symptoms (Post-Concussion Syndrome). (2020, October 06). Retrieved April 02, 2021, from https://www.mayoclinic.org/diseases-conditions/post-concussion-syndrome/symptoms-causes/syc-20353352

12. Maurer, G. E., Mathews, N. M., Schleich, K. T., Slayman, T. G., & Marcussen, B. L. (2020). Understanding Cannabis-Based Therapeutics in Sports Medicine. Sports health, 12(6), 540–546. https://pubmed.ncbi.nlm.nih.gov/32936058/

13. Millar, S. A., Stone, N. L., Yates, A. S., & O’Sullivan, S. E. (2018). A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans. Frontiers in pharmacology, 9, 1365. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275223/

14. Russo E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British journal of pharmacology, 163(7), 1344–1364. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165946/

15. Singh, J., & Neary, J. P. (2020). Neuroprotection Following Concussion: The Potential Role for Cannabidiol. The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 47(3), 289–300. https://pubmed.ncbi.nlm.nih.gov/32029015/

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Content Medically Reviewed By: Dr. Abraham Benavides, MD
Content Medically Reviewed By: Dr. Abraham Benavides, MD
Contributors: Sarah Walker and Samantha Velez Learn More About The Experts

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