Substance Use Disorders (SUD)Chronic PainHeadache Disorders (Cluster & Migraine)Safety & Risk ManagementLSDPsilocybin

Psychoactive substances as a last resort-a qualitative study of self-treatment of migraine and cluster headaches

This qualitative study (2017) examined self-reports from online forums about psychoactive substance use for treating migraines and cluster headaches, and found that psychedelic tryptamines, primarily LSD and psilocybin, were frequently reported to lessen both their frequency and intensity of pain at sub-psychoactive doses.

Authors

  • Andersson, M.
  • Persson, M.
  • Kjellgren, A.

Published

Harm Reduction Journal
individual Study

Abstract

Background

Treatment resistant cluster headache and migraine patients are exploring alternative treatments online. The aim of this study was to improve comprehension regarding the use of non-established or alternative pharmacological treatments used by sufferers of cluster headaches and migraines.

Methods

A qualitative thematic analysis of the users’ own accounts presented in online forum discussions were conducted. The forum boards https://shroomery.org/, http://bluelight.org, and https://clusterbusters.org/ met the inclusion criteria and were used for the study.

Results

The analysis resulted in six themes: a desperate need for effective treatments; the role of the forum-finding alternative treatments and community support; alternative treatment substances; dosage and regimens; effects and treatment results; and adverse effects. The results provide an insight into why, how, and by which substances and methods sufferers seek relief from cluster headache and migraines.

Conclusions

These patients are in a desperate and vulnerable situation, and illicit psychoactive substances are often considered a last resort. There appeared to be little or no interest in psychoactive effects per se as these were rather tolerated or avoided by using sub-psychoactive doses. Primarily, psilocybin, lysergic acid diethylamide, and related psychedelic tryptamines were reportedly effective for both prophylactic and acute treatment of cluster headache and migraines. Treatment results with cannabis were more unpredictable. No severe adverse events were reported, but it was observed how desperation sometimes spurred risky behavior when obtaining and testing various treatment alternatives. The forum discourse mainly revolved around maximizing treatment results and minimizing potential harms.

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Research Summary of 'Psychoactive substances as a last resort-a qualitative study of self-treatment of migraine and cluster headaches'

Introduction

Migraine and cluster headache (CH) are common, often chronic and disabling headache disorders for which many patients find conventional therapies ineffective or intolerable. Migraine affects nearly 15% worldwide and CH, though rarer (about 1 in 1,000), is among the most intensely painful conditions known. There are no pharmacological treatments developed specifically for CH, and roughly 20% of chronic CH cases are resistant to standard therapies. Dissatisfaction with established treatments and the rise in interest in complementary and alternative medicine have led some sufferers to explore illicit psychoactive substances—principally psychedelic tryptamines such as psilocybin and LSD—and cannabis, supported by anecdotal reports and a small number of studies suggesting possible benefits. The illegal status of many of these compounds has limited clinical research, leaving online patient communities as an alternative source of experiential data. The researchers set out to improve understanding of how people with CH and migraines use non-established or alternative pharmacological treatments. Specifically, they aimed to characterise why sufferers pursue these options, which substances and regimens are discussed and used, reported effects (acute and prophylactic), and adverse experiences, by analysing first‑person accounts posted on Internet discussion forums where sufferers exchange information and support.

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Study Details

References (4)

Papers cited by this study that are also in Blossom

Indoleamine Hallucinogens in Cluster Headache: Results of the Clusterbusters Medication Use Survey

Schindler, E. A. D., Gottschalk, C. H., Weil, M. J. et al. · Journal of Psychoactive Drugs (2015)

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Psilocybin dose-dependently causes delayed, transient headaches in healthy volunteers

Johnson, M. W., Sewell, R. A., Griffiths, R. R. · Drug and Alcohol Dependence (2012)

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Schindler, E. A. D., Wallace, R. M., Sloshower, J. A. et al. · Frontiers in Pharmacology (2018)

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