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The Cannabis Enigma Podcast: Migraines & cannabis

The Cannabis Enigma Podcast: Migraines & cannabis

“I deal with very sick patients that have been to multiple doctors and have tried everything that’s been approved or everything that’s been tried — and I have to offer them hope,” says Dr. Roni Sharon. “Very often I’ll offer them medical marijuana.”

In this episode of The Cannabis Enigma, we speak with Dr. Roni Sharon, a neurologist specializing in migraines and other head and face pain, about his experience treating patients with medical cannabis. At times, cannabis can be used to stop a migraine once it’s started, he says, but it can also work in more holistic ways to prevent them or make them less frequent by treating triggers like anxiety, stress, and insomnia.

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Dr. Sharon discusses how he doses cannabis with his patients (“start low and go slow”), what strains he recommends, why cannabis may not be right for everyone, and how it can help patients avoid opioids.

“The train has left the station. Medical marijuana is here to stay,” Dr. Sharon says. “More and more governments are adapting it. Now it’s a matter of regulation and how to institute it into our medical practice.”

Full transcript:

Varda Bachrach.:  Dr. Sharon, thank you so much for joining us today.

Dr. Roni Sharon:  Yeah, it’s my pleasure.

V.B.:  Historically cannabis was used to relieve migraine symptoms. Of course, it was then made illegal making it more difficult. Is cannabis making a comeback when it comes to treating migraines?

Dr. Sharon:  Well, I think cannabis is definitely making a comeback in chronic pain and a big, big part of chronic pain is pain in the head. Headache and migraine. Uh, in terms of whether it’s making a comeback, absolutely. We’re seeing in many, many countries, uh, in many states within the United States as well, chronic pain is a condition that marijuana has really made a lot of headways in. And I continue to see more and more patients that are really benefiting from medical marijuana.

V.B.:  And so that does that mean in the medical community is responding well to this? Is it being accepted that, uh, cannabis is a legitimate way to treat migraines and other pain?

Dr. Sharon:  That’s a really great question. I think that the medical community is a lot more conservative than people are used to or people know. It takes time for us to adapt new technologies and it takes time for us to accept new treatments. Marijuana is not a new treatment, but I can tell you that, uh, since my residency and fellowship, uh, in New York and Massachusetts in the United States, uh, I’ve been giving medical marijuana to patients, uh, who are eligible and who fit the criteria for it.

And when I first started talking about it, there was definitely a who is this clown. Uh, and that lasted a- a couple of years and then there was, “Oh, I don’t know anything about marijuana.” Which is actually a very big step forward in the medical community. From this is nonsense, this is stupid, this is voodoo medicine to okay, I don’t know enough about it so I’m not comfortable with it, but different reasons to reject. To now I want to know more about it, I’ve patients try it, I’ve had good experience with it. Even have had bad experiences with it, but they’re trying it or they have patients that have tried it.

So, there’s definitely been a very big step forward within the medical community. It’s not as fast as we always want, but it- it’s- it’s definitely moving forward.

V.B.:  And how did patients respond when you say to them that you think that they should be trying cannabis as a treatment?

Dr. Sharon:  Well, usually their telling me that they should use cannabis as a treatment. Um, you know, even me I was a little bit resistant to it for years because I work in an evidence-based medicine type of way meaning I want to see clinical studies showing that things work. Marijuana doesn’t have that because of its legal status and because we don’t have validated clinical studies for marijuana in migraine for instance.

The problem is is that I deal with very sick patients that have been to multiple doctors and have tried everything that’s approved or everything that’s been tried and I have to offer them hope. Very often I’ll offer medical marijuana, uh, but more often actually they’ll either come to me and say, “What about this? I’ve tried everything else.” Or, “I’ve actually been taking marijuana and it’s been very helpful for me for a long time, maybe we can do this in a medical way, uh, with specific dosing or taking it through a specific way.” And I’m open to that if they’ve tried other medicines.

V.B.:  So can you talk a bit about the beginning when you start ’cause you said it took you time to be convinced. So can you tell us a little bit, maybe focusing on migraines, first of all how did you come to the part where you said, yes I’m going to try this and then what was the- what were the results? What were the results you saw at the beginning?

Dr. Sharon:  All right, it’s a great question. So, I’m a pain doctor and a neurologist so every medicine I give is to improve someone’s quality of life. I’m actually not trying to reduce their migraines or reduce their pain, I’m trying to give them a better life. So if I give them medicines that cause a lot of side-effects, whether it’s sleepiness, weight gain, sexual side-effects, cognitive problems, I haven’t really helped them so much and that’s been a problem in the migraine treatment paradigm.

Medical marijuana is incredibly safe. That’s one thing and that’s very important. In terms of efficacy, I don’t think it’s a thousand times more efficacious or much more efficacious than our existing treatments, but it’s improving their quality of lives. Because it’s tolerable, it’s safe and for many patients it works. So when I put the risk benefit and how I’m doing for the patient, medical marijuana comes out on top very often for a lot of patients.

I just want to mention, for a lot of patients it doesn’t work. Because there’s so much hype about it, because they think that it’s the miracle cure and they’re not gonna have any pain. Some people are disappointed so this is not a treatment that works for everybody.

V.B.:  So are there risks around taking cannabis for migraine sufferers or other sufferers of pain?

Dr. Sharon:  So in terms of safety, hurting the patient, I don’t think so. I haven’t found marijuana to be a dangerous medication and neither has the literature and we’ve had many, many years of experience. But some people are disappointed when they have a lot of hope in a treatment and it doesn’t work so I always have to talk to people about their expectations.

Migraine is not just about giving one medicine and then getting better, migraine is about improving your life in terms of sleep, in terms of stress, in terms of the way you eat, in terms of what you put in your mouth, in terms of every aspect of your life. And that’s the true treatment for migraine. Giving marijuana or giving any other type of treatment is only part of the solution. People need to understand that.

V.B.:  So can you- can you break down ’cause for somebody that hasn’t experienced a migraine, they might not really understand wh- what is a migraine. Can you just break down what it is, um, and then a little bit about what you were speaking about the lifestyle changes that somebody who suffers with migraines needs to make in order to- to lessen their suffering?

Dr. Sharon:  Sure. So, migraine is a neurological disease. It’s not just a headache, it’s one of the leading causes of disability in the world. Actually, the World Health Organization calls it the sixth leading cause of disability and it’s because it’s so common and for many people who suffer from migraine, about 10% of them, it takes over their life completely. Whether it’s not being able to go to work, not being able to pick up the kids, not being that friend who needs to be there, not being that daughter, very often it’s women so I usually use the women instead of men.

Uh, it really impacts every part of their life. Now, we give treatment to stop a migraine when it comes and when they have it, often enough we give treatment to prevent it from even coming in the first place and most importantly we recommend lifestyle changes. My job is really just to make people live healthier so I really give them a lot of recommendations on how to sleep better, how to eat better, how to deal with stress, anxiety, depression. How to improve their posture when they’re sitting at work, not looKing at computer screens and all night.

Marijuana can help with a lot of those things. So, in terms of an abortive treatment, when people have a migraine, some people really benefit from taking marijuana and it stops their headaches. Other people we use it as a preventative treatment meaning they take it on a regular basis and it helps reduce either the frequency or the intensity of the migraines they have.

So, in terms of for preventative treatment what we can do is we can give someone marijuana either on a daily basis or something like that and we’ll watch how many headaches they have over the coming weeks and months. And if it’s decreased, I think it’s wonderful. Now, I don’t know if it works directly on the migraine itself or it works on everything around migraines. Because when people have chronic migraines, they don’t sleep well. They have a lot stress and anxiety and marijuana can also alleviate those symptoms so it might be working from the side and then entering the center of the problem which is migraine.

V.B.:  So how do you and I’m- I’m wondering if you’re doing this with your patients, uh, manage the dose. So you- you mentioned you might recommend taking marijuana every day, how do- how do you figure what sort of dosage is right for each patient?

Dr. Sharon:  It’s a really good question and the jury is still out because we don’t have specific dosing and recommendations and guidelines. But with a lot of experience, you kinda develop techniques. The most important thing and this is with marijuana for every single person who ever gets it, is start low and go slow. Meaning you start at the lowest dose and you work your way up because … and I do that with a lot of other medicines because if I g- if I make it dangerous for someone in terms of them taking too much and not being able to function or things like that, I’ve really harmed their confidence in that medicine whether it’s marijuana or something else.

So, there’s a couple of things we do. Number one, specifically for migraine there’s different ways of taking marijuana, but I recommend to take it in, uh, in- in terms of, uh, in terms of either a vaporizer or an oil tincture or smoking because migraine comes with a lot nausea and vomiting. And if you take it through the GI tract, a lot of it doesn’t even enter the system. So by taking it in through and absorbing it through the lungs or early part of the GI tract, a lot more gets absorbed and it’s a lot more effective.

V.B.:  GI tract, what- what does that mean?

Dr. Sharon:  Pill, capsule, tablet, uh, how we normally take medicine. So the most common way to take a medicine is to take a pill.

V.B.:  Mm-hmm [affirmative].

Dr. Sharon:  And actually there are pills and capsules and tablets for- for medical marijuana. But I think that I recommend that a lot less often just because of that nausea. For instance, the most common medicine that we give for migraine it’s called sumatriptan. As a pill, we can give a 100 milligrams. As a nasal spray we give 20 milligrams and as an injection we give 4 milligrams because 90% of it can be lost when you’re nauseous. It doesn’t get absorbed in the system. Obviously when you vomit, it’s much worse.

V.B.:  And when you’re- when you’re giving your patients, um, cannabis there’s different strains within the cannabis plant, what is that you’re recommending and- and what are the side-effects?

Dr. Sharon:  So it’s a really great question. In general, uh, my general rule is that what I’ll do is I’ll give CBD in the morning and afternoon, usually through an oil tincture because I want them to be able to function, uh, 100%, uh, not be overly tired or loopy or anything like that. Uh, we start at one drop and then every day or two they can go up by one drop as tolerated.

At night, in terms of specific strains it’s a little bit difficult. Um, I generally recommend indica, I find it to be more soothing. It helps them sleep more which is very, very, very important for them. Um, and I’ll do either a blend of THC and CBD or more THC and less CBD. But it’s very personal. Sometimes we have to trial and error a little bit till we find the optimal dose.

V.B.:  So CBD, if I get this right, does not have any side-effects, the THC is the part of the plant that can somebody to have- to feel different. Can you- can you talk about what the- what the effects are on the patients?

Dr. Sharon:  Sure. So nothing is without side-effect. Everything has side-effects, from a cookie that you put in your mouth to an IV medication to a pill, everything has side-effects. CBD tends to have very, very, very little side-effects. Sometimes it can cause constipation, sometimes it can cause a little bit of fatigue in people. And then it’s very individual, people react in different ways, but it doesn’t, uh, cause any psychotropic changes, uh, people can generally function in a very high level way on it.

That being said, a lot of people can function on THC in a high level way, but in general it could be a lot more tiring. Um, there’s a little bit more cognitive problems with doing- taking THC. Uh, it causes a lot of fatigue, appetite, um, so I don’t think- I think for people that are naïve to medical marijuana I don’t give THC in the morning or afternoon in the beginning.

V.B.:  And the- and for anybody that’s taking it for the first time, have they- when they’ve come back to you what have they said about the- the sensation for them? How do they manage that?

Dr. Sharon:  So we do it in a responsible way. When someone takes marijuana for the first time we recommend that they do it in the comfort of their home with someone they love, uh, in a controlled and relaxed environment and at a low dose. And generally I recommend indica instead of sativa, though the strains have kind of mixed together over the years. Um, I do think that the sativa strains can cause a little bit more anxiety or paranoia while the indica strains cause less of that, but it’s very individual. You know you- the questions you’re asking me are really great questions and I hope we’ll have more definitive answers for that in the future.

V.B.:  And, uh, um, I wanted to touch on something, a bit of research that I think is quite recent that would be really interesting for you to break down for us, explain what does it mean. And that’s recent research that says that, um, problems with the endocannabinoid system within people might be affect- might be a cause of actually migraines, what does this mean?

Dr. Sharon:  So, we know that migraines are multi-factorial meaning there’s not just one thing that causes migraines. In general it’s a genetic disease so the apple doesn’t fall far from the tree and if your mother had migraines you have a good chance of having migraines yourself, our first degree relatives. Uh, beyond that, a lot of people, uh, have found different other factors in- in terms of vi- environmental factors and there is a theory that the endocannabinoid system does play a part.

I think that there’s good evidence that what we call the endocannabinoid system plays an important part, but I don’t think it’s the whole part and I don’t think it’s the main cause of migraines.

V.B.:  Okay, so from your experience, I’m slightly changing track here. So in your terms it is- it seems very comfortable, uh, using cannabis, it sounds that your patients are very comfortable using it, that they’re coming to you and asking for it. Have you met with resistance within the medical community?

Dr. Sharon:  Absolutely. Um, whenever there’s a new treatment there’s resistance especially one that was illegal. Um, that was, uh, considered a hoax for many years. Um, I think that the medical community is definitely taking a lot of strides forward. Um, but nonetheless, it’s something that we deal with every day. The one thing that I think I have a benefit for is that I deal with patients that have really tried everything else.

So, you know, my patient is not usually a 26-year-old woman who has never seen a doctor and has four migraines a year. It’s usually someone who’s seen three neurologists, has been to multiple emergency rooms, has been to multiple doctors, has tried everything, is disabled because of her migraines. So, you know, acceptable treatment is different for that patient than someone else.

V.B.:  And in- in terms of treating, um, migraines, where in the order of hu- I mean, I understand you’ve got a very holistic, um, approach. Would- would cannabis come at the beginning of the treatment or I- I know, um, for example we had a conversation where in the UK cannabis is for- if we’re allow- we are allowed, doctors are allowed to prescribe it, um, as a last resort. Where does it stand for you in terms of your treatment?

Dr. Sharon:  Whenever I give any type of treatment whether it’s surgery or a medicine or medical marijuana there’s three things I look at. One is efficacy which is very easy to understand, does it work. Two is tolerability, it does not cause damage, headache, nausea, vomiting, diarrhea. Safety, I’m not causing any harm. And the third thing which is no less important is access. So, in different places whether I’m In Israel or New York or Massachusetts, I have to follow guidelines that the government or the state of the medical boards gave me.

So, I actually am limited in how I can give medical marijuana. So for chronic pain sufferers which is what I would give people with migraine me- medical marijuana for, I have to make sure that they suffer from severe debilitating pain and that they’ve tried multiple other medications. So, just that limit means that I would never give it first line or second line or a third line. I really have to make sure that they’ve tried other things. Um, so that’s an important part of my equation when I give medicine.

V.B.:  If you weren’t limited or maybe I’ll ask this in a different way. My question is if you weren’t limited, would you change that, but maybe what I’ll ask instead is do you anticipate this changing as attitudes to medical marijuana change and as the stigma is removed?

Dr. Sharon:  So I think that it’s already changing. If we look at, uh, the, you know, a majority of American states, a majority of American people now have access to medical marijuana. Uh, in Europe it’s changing dramatically, in Israel, uh, the government actually is giving recommendations on even how to give the medical marijuana in terms of dosing and concentrations which is a revolution. Um, I think that we’re moving forward.

Now, if I had the option to give it earlier to patients, I think that I would for certain patients. I still want to go with what works best, I don’t think medical marijuana works best for every patient. Um, but there are some patients that come to me and say, “I haven’t tried so many medicines but this works perfectly and when I, you know, take marijuana once a week or twice a week I have zero migraines.”

That’s a patient I can’t give medical marijuana to according to the rules. And perhaps I would be giving them something earlier on, medical marijuana, in- instead of something else that I would have to give, uh, because I’m limited. So, there are some patients that I would give it earlier.

V.B.:  And how do you- how do you recognize who these patients are? Is there something that’s … or is it more trial and error?

Dr. Sharon:  Um, honestly a lot of patients come to me and they’ve already tried medical marijuana or marijuana. It’s not the hardest thing to get. Um, patients often know better than- patients know better than most doctors what works for them in terms of marijuana because they’ve tried it, they’ve experienced it. Um, and for those patients specifically, uh, I let them guide me in terms of dosing and- and- and strains and concentrations. Naïve patients where I hope we’re gonna do studies on, I have my own experience with which I think is not bad, but there’s a lot more that can learn from and I adjust accordingly.

V.B.:  So how many years have you been medical marijuana as a solution?

Dr. Sharon:  Six years.

V.B.:  And in that six years have you seen, um, in that six years have you seen more patients coming to you and asking for it, has- has there been a change attitudes that you’ve noticed?

Dr. Sharon:  Absolutely. Uh, more and more patients are coming to me asking for medical marijuana. On top of that, one alternative, opiates, which have used for pain relief, has caused a serious epidemic all around the world. Uh, it’s unbelievable. So more people are dying of opioid overdoses than traffic accidents which is crazy. Uh, tens of thousands of people alone in America are dying because of us. Because of doctors like me that are, you know, innocently giving pain relief with opioids like Percocet and Vicodin and then these patients get addicted to them. And then they need more and they don’t have access to it and heroin’s a lot cheaper and they start injecting until we have the epidemic that we have in America and in other places now and it’s- it’s sad.

And medical marijuana is a great alternative to that and I think as the public has become more, uh, knowledgeable about the dangers of opiates, patients have been coming more and more asking for alternatives such as marijuana.

V.B.:  And is that something that the medical community is aware of? So, I imagine for- for doctors in particular in the United States where there’s a real crisis around this, um, if- are they- is there, like, across the board, like, awareness that there is an alternative? That there is a way to help their patients maybe come- if they’re ready to come of the opioids? Is that something that there’s awareness around?

Dr. Sharon:  Absolutely. Even, you know, for New York for instance, opioid use, opioid overuse is an indication to give medical marijuana for. And there’s ongoing studies showing, uh, testing whether medical marijuana can reduce people’s dependence of opioids. And it’s actually not just the United States, Scotland, Scotland actually has, you know, they had a famous movie that brought everything out, uh, I forget the name of it.

V.B.:  Wait, which movie? [laughs]

Dr. Sharon:  I can’t believe I forgot the name, uh, in Glasgow where there’s a bunch of drug dealers and then they-

V.B.:  Wait, you mean Trainspotting?

Dr. Sharon:  Trainspotting.

V.B.:  Edinburgh, Edinburgh.

Dr. Sharon:  I remember it, wait, it was in Glasgow?

V.B.:  Not Glasgow [laughs].

Dr. Sharon:  But uh, so basically, um, so actually I just read about the increasing awareness of opioid overuse in Scotland and how there was an awareness and then it went down and sometimes it even takes a movie to bring it up. But definitely the medical community with opioid overuse is looking for alternatives and fast. So, a medical community which usually moves in a glacial pattern has moved very quickly with medical marijuana.

V.B.:  The one thing that keeps popping into my mind is that there are pharmaceutical companies that may not- not like this because this is going to affect their profits. Is that something that there is conversation around, is there- is there something happening in that area?

Dr. Sharon:  Absolutely, I think that, um, you know it’s interesting, I went to a medical school called Sackler. Uh, right now if you read the news, you’ll read all about the Sackler family and their, uh, their- their settlement with the government and Purdue Pharmaceuticals and the- the billions of dollars they’re gonna be paying because of the opioid crisis. Um, we live in a capitalist world and I think that pharmaceutical companies, uh, definitely make a good amount of revenue from certain medications, but it’s also an opportunity to look for other alternatives or to invest in the pharmacological aspect of giving medical marijuana.

Uh, so I think while there’s always resistance to change from people who are succeeding in the beginning, uh, there’s also opportunities. And I don’t want to vilify the pharmaceutical community, I think that they really, um, are- play a part in the fact that we’re living longer and healthier than we ever have before.

V.B.:  So where do- how do anticipate if- if you’ve seen the past six years, um, changes in attitudes, um, doctors, patients, pharmaceutical companies, governments, um, where do you see the next six years or beyond that in terms of using cannabis, medical marijuana as a treatment?

Dr. Sharon:  Yeah, it- it’s a great question. I- I just want to tell you the train has left the station, medical marijuana is here to stay. More and more governments are- are adapting it. Um, now it’s a matter of regulation and how to institute it into our medical practice. Uh, there’s- I don’t think there’s any chance that it’s going anywhere. Um, I think the recreational question is more of a controversy and I think that the last six years there’s really been a huge change and the next six years is gonna be even more.

Um, we’re gonna see a lot more doctors not only adapting it and giving but also accepting it as a- as a- as a great treatment for patients that have failed other medi- medical treatment. So I think that, um, I think we’re in the right track.

V.B.:  And do you see cultural differences ’cause you work in different places, uh, different countries and different states for example in- in the United States. Do you feel there are differences based on, like, culture or habits or so on?

Dr. Sharon:  No absolutely there are. Uh, the only thing is I work in New York City and I work in Tel-Aviv and very often even though they are thousands of miles apart, they’re more similar to each other than a small town a hundred miles away from either one of them. So, you know, very often it’s the- the urban or rural environment that you work in, I think there’s a lot of similarities between Tel-Aviv and New York. But working in more suburban or exurban communities, um, there definitely is difference in terms of the access to medical care, in terms of, uh, even access to dispensaries for medical marijuana or how they’re gonna get marijuana, the types of, uh, illicit substances they’ve used in the past so there are differences.

V.B.:  Where do you- where do you think- where did you think the- there was most resistance from your experience?

Dr. Sharon:  It’s a good question, I mean, I- I- New York- New York is a very liberal state. Um, and Tel-Aviv is a very liberal city and Israel has really, um, spearheaded medical marijuana reform. The- I think they’ve done a wonderful job. So, I haven’t worked in Europe as a doctor, I don’t really know. It’s a good question.

V.B.:  And I want to a little bit- a little bit more about your patients and understand how their lives have changed. The- the- the where the- where you seen the- the greatest, um, I guess successes and most compelling evidence that this has really make a difference. Uh, if you just think of one or two of your patients, what was their life like before, um, integrating medical marijuana into it, uh, compared to when it’s part of their lifestyle.

Dr. Sharon:  Mm-hmm [affirmative]. Yeah, I mean, I- I- I can even read emails of patients that have emailed me four or five months later, uh, where I haven’t heard from them. And when you don’t hear from a patient for a couple of months, either you failed.

V.B.:  [laughs]

Dr. Sharon:  And they don’t want to see anymore, they want to see another doctor or you’ve really succeeded. Um, and, you know, the emails that I’ve received or- or text message I have received or phone calls to the office or … you’ve changed my life and the fact that I’m not longer missing the bar mitzvah of my son. I’m going to work, my relationship with my husband is much bi- I’m a different person. I’m leaving my bed, I’m able to exercise, I’ve lost weight, I’m enjoying my life. I’m not suffering. Um, it’s just a- a matter of quality of life. They actually don’t often mention how much less headaches they have. They talk about all the opportunities to actually live their lives that they have now.

V.B.:  I don’t know if I’m being too optimistic, it just- it feels like this could- it feels like this is really good news for people that suffer from severe chronic pain.

Dr. Sharon:  I think it’s good news for many patients who severe- who have severe chronic pain. Not for all of them. Again, just like I do with every patient, I want to set expectations. Marijuana is not the optimal treatment for every single patient. For many patients it will not work. There’s a lot of different factors involved in chronic pain, but for many patients it could be life changing. It can be really, really helpful.

V.B.:  And when you compare it to other treatments that were used in, you know, until now?

Dr. Sharon:  It depends. There’s some great treatments out there. The best treatment for migraine and the best treatment for neck pain and back pain and chronic pain in general is lifestyle changes. It’s the way we wake up, it’s the way we go to sleep and everything we do in between. From sitting the right way, from eating the right way, from reducing all the- the painful things that can be in life, when we do those things that’s the best treatment. But in terms of pharmacological treatments, I think marijuana is equivalent to many other treatments we use. Sometimes it’s better, sometimes it’s worse.

V.B.:  So what would you recommend to somebody, um, sitting at home listening to this who’s- who’s suffering from pain. I’m not necessarily talking about a migraine or something very extreme, but they have back pain or- or leg pain, sciatic or whatever it is. Um, and the advice they’re getting is- is to manage it through- through pain killers. What was your advice, what would you recommend they can do to relieve the pain?

Dr. Sharon:  Stop taking painkillers. That’s the worst thing that they can do. The solution is not just by popping pills and certainly not by popping opioids. The most important thing to do is for them to get up, start walking, start moving, start stretching, start swimming, start physically exerting themselves. Working on the environment that they’re in all day, getting out of bed more, sleeping better and then actually optimizing what medications they’re taking. Focusing on what the other problems are and tackling those and if they’re on opioids and have tried other medications then medical marijuana can definitely be a possibility for them.

V.B.:  What else would you- somebody listening to this podcast, um, they’ve got a member of their family where they’re concerned about it, what would you- what else can you- is there anything else you can recommend?

Dr. Sharon:  Well, I mean, first of all, migraine has- has gone through a tremendous change. There are so many new treatments whether it’s pills or injections. People used to have to take pills twice a day every day and now there are certain injections you can take once a month, it’s amazing. There’s new abortive treatments, there’s new types of, uh, electric treatments and helmets and- and bands that people can wear, uh, it’s amazing.

So the first thing to do is to either go to a doctor, educate themselves on new treatments available including medical marijuana. Seeing if they’re living in a place that it’s legal, uh, finding out more about it. You know, knowledge is power. Just learning more about your condition can be very helpful.

V.B.:  Dr. Sharon, that was amazing. That was so interesting. Is there anything else that you want to add before you go?

Dr. Sharon:  Yeah, for chronic pain sufferers I want them to know that there’s hope. They should never think that they’re at the end of the line, they’ve tried every treatment, nothing’s available, there’s nothing more they can do because it’s wrong. It’s not true, there’s always more we can do.

V.B.:  Thank you very much. I’m Varda Bachrach. This episode was produced and edited by Michael Schaeffer Omer-Man with technical assistance from Yoav Morder. If you enjoyed this episode, please hit subscribe and leave us a rating or review on iTunes and check back for new episodes every two weeks.

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