Concussions and Cannabis: Science for the Stoners

What Happens in the Brain During a Concussion?

Samba’s concussion went through 2 phases when hit his head:

Phase 1: Excitatory

When Samba hit his head on the concrete, it wasn’t the impact of his brain against his skull that caused damage, it was the stretching and shearing of the brain cells (neurons). This stretching messed up the electrical balance in his brain, causing millions of neurons to fire at once, which is why he initially saw stars (Bradford).

In other cases, people may have double vision, ringing in the ears, dizziness, or even blackout. Phase 1 usually lasts a few hours. During the electrical storm, the neurons release a lot of a chemical messenger called, “glutamate.” Glutamate is an excitatory neurotransmitter in the brain, and it has important functions in learning and memory, but too much glutamate is no bueno and can lead to cell damage or cell death.

Phase 2: Spreading Depression

Here comes the sciencey part: all of that extra glutamate in his brain opens up the doors to allow calcium to flood into the neurons. This calcium messes with the mitochondria, the part of the cell that makes energy, stopping them from making energy the brain needs. This is why Samba was tired for days after he caught the ground with his face.

It usually takes between 2 to 4 weeks for the brain’s energy levels to get back to normal, which is why about 70% of people who get concussions feel better in about a month. Unfortunately, the other 30% have symptoms that last much longer, sometimes for months or even years. The longer these symptoms last, the harder they are to get rid of (Bradford).

Since these changes are more about how the brain’s cells work and not about physical damage or bleeding, they weren’t seen on Samba’s CT scan and wouldn’t be seen on an MRI, if he had one.

Neuroinflammation and Oxidative Stress from Concussions

Following Samba’s concussion, something else happened in his brain: neuroinflammation and oxidative stress. Neuroinflammation is when the body’s defense system reacts to changes in the brain by sending out special molecules called cytokines. Oxidative stress happens when there are too many harmful particles called free radicals, which can damage brain cells.

During his injury, Samba’s brain released certain cytokines, which are like alarm signals in response to injury. These include:

• Interleukin-1β (IL-1β)
• Interleukin-6 (IL-6)
• Tumor Necrosis Factor-alpha (TNF-α)

A little bit of inflammation can actually be good for the brain, helping to keep things in balance. But too much inflammation, especially if it lasts a long time, can be harmful. It can lead to serious brain diseases, make you feel anxious or depressed, and cause other concussion symptoms that can last for months or even years (Rathbone et al.)

Cannabinoids to the Rescue

Knowing all these things were going on in his brain, and seeing it manifested through his symptoms of headaches, brain fog, and fatigue, I wasted no time in starting him on whole plant cannabinoids (the same formulation Gilbert Brown talks about in his interview). The goal was to reduce the neuroinflammation and protect his brain from the free radicals.

Right now, there aren’t any specific medicines for treating concussions. Some common pain relievers might help a bit, but using them too much can harm your organs.

To slow down Samba’s little neurons from releasing inflammatory cytokines, we gave him a formulation that included CBD and CBG, since preliminary research shows that CBG, CBD, and CBD+THC, (not THC alone) were effective in reducing the exact cytokines elevated in concussions (Henshaw et al.)

We also included the acids, CBDA and CBGA, because those cannabinoids (along with many others) have strong antioxidant properties, meaning they can scavenge free radicals, which are basically rogue molecules that can cause damage to our fragile brain cells (Dawidowicz et al.). Yes, there were also some terpenes and a small amount of THC in what we gave him. We’re all about that whole plant goodness.

When Samba took his Thrive xL, the cannabinoids worked to decrease that release of harmful cytokines, gobble up the free radicals, and in his words, “make my brain feel like normal.”

As far as dosing, this was very different from what Gilbert Brown did. Since Samba’s concussion was acute, we gave him relatively high doses at first (about 300mg of total cannabinoids per day), and slowly went down as his symptoms improved. Since Gilbert Brown’s head injuries were decades ago, he’s on more of a maintenance regimen of about 1 dropper, or 100mg per day.

Samba was symptom-free within 5 days and back out on the soccer field in 7, with the clearance of his neurologist. Two months later, he remains symptom-free.

Human Research on Concussions and Cannabis

It’s important to note that, like many conditions that people find cannabis effective for, we have very limited research on cannabinoids for concussions.

• A small study done in 2023 found that those who used cannabis had lower inflammatory markers and less eye movement impairment after inducing a minor concussive state with 20 headings of a soccer ball than controls who didn’t use cannabis (Kalbfell et al.)
• Another study from 2019 found that cannabis use was associated with less severe symptoms 3 and 4 weeks after a concussion than non-cannabis use (Lawrence et al.).