The use of illicit drugs as self-medication in the treatment of cluster headache: results from an Italian online survey
In an Italian online survey of 54 cluster headache patients, a substantial proportion reported using illicit drugs—most commonly cannabinoids, but also cocaine, heroin and psychedelics such as psilocybin, LSA and LSD—for self‑medication after dissatisfaction with conventional treatments. Many sourced recommendations online, often ceased medical care, underestimated legal and safety risks and did not inform their physicians.
Authors
- Di Lorenzo, C.
- Di Lorenzo, G.
- Coppola, G.
Published
Abstract
Background
Cluster headache (CH) patients often receive unsatisfactory treatment and may explore illicit substances as alternatives. We aimed to explore this use of illicit drugs for CH treatment.
Methods
We invited CH patients from an Internet-based self-help group to complete a questionnaire regarding their therapeutic use of illicit substances.
Results
Of the 54 respondents, 29 were classified as chronic and 39 were drug-resistant cases. Fifty patients had previously tried subcutaneous sumatriptan, 40 had tried O2, and 48 had tried at least one prophylactic treatment. All 54 patients specified that they were dissatisfied with conventional treatments. Thirty-four patients had used cannabinoids, 13 cocaine, 8 heroin, 18 psilocybin, 12 lysergic acid amide (LSA), and 4 lysergic acid diethylamide (LSD).
Discussion
Some patients with intractable CH decided to try illicit drugs concomitantly with cessation of medical care. Most of these patients found suggestions for illicit drug use on the Internet. Many patients seemed to underestimate the judicial consequences of, and had an overestimated confidence in the safety of, such illicit treatments. Physicians are often not informed by patients of their choice to use illicit drugs. This leads to questions regarding the true nature of the physician-patient relationship among dissatisfied CH patients.
Research Summary of 'The use of illicit drugs as self-medication in the treatment of cluster headache: results from an Italian online survey'
Introduction
Cluster headache (CH) patients commonly seek both conventional and unconventional therapies and appear more prone than average to experimenting with illicit substances. Lorenzo and colleagues recount an unsolicited request from a CH patient for a prescription of an illicit hallucinogen and note that anecdotal literature has suggested benefit from hallucinogens, although randomised controlled trials are lacking. Initial local interviews of 110 CH patients identified only a small number who had used illicit drugs therapeutically, prompting the investigators to widen recruitment. To explore therapeutic use of illicit substances in a larger sample, the study team posted an invitation on the timeline of an Italian Facebook self‑help group for CH (more than 800 members) asking members to report experiences of using illicit drugs specifically to treat CH rather than for recreation. The stated aim was to identify which substances were used and what motivated patients to try these alternative treatments.
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Study Details
- Study Typeindividual
- Journal
- Compounds
- Topics
- APA Citation
Di Lorenzo, C., Coppola, G., Di Lorenzo, G., Bracaglia, M., Rossi, P., & Pierelli, F. (2016). The use of illicit drugs as self-medication in the treatment of cluster headache: results from an Italian online survey. Cephalalgia, 36(2), 194-198. https://doi.org/10.1177/0333102415583145
Cited By (6)
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Schindler, E. A. D., Sewell, R. A., Gottschalk, C. H. et al. · Journal of the Neurological Sciences (2024)
Butler, M., Seynaeve, M., Bao, J. et al. · Journal of Clinical Psychiatry and Clinical Neuroscience (2023)
Rusanen, S. S., Schindler, E. A. D., Artto, V. A. et al. · Current Pain and Headache Reports (2022)
Basedow, L. A., Kuitunen-Paul, S. · Drug and Alcohol Review (2022)
De Coo, I. F., Naber, W. C., Wilbrink, L. A. et al. · Cephalalgia (2018)
Andersson, M., Persson, M., Kjellgren, A. · Harm Reduction Journal (2017)
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