Why Patients Treat Cluster Headache With Illegal Drugs

Researchers from Italy wanted to understand why patitents chose to treat cluster headache with illegal drugs instead of prescribed treatments. At first, they interviewed 110 patients. Only 6 admitted to using marijuana to treat cluster headache. Next, they surveyed 800 patients from a Facebook group. Fifty-four patients (6.75%) reported using at least one illegal drug to treat cluster headache.

Results:

Demographics

  • No one used recreational drugs within the last year.
  • 34 men and 19 women responded.
  • 23 were married.
  • 8 had college degrees.
  • 46 were employed.
  • 43 had household income of less than 36,000€ per year.
  • 29 had chronic cluster headache.

Prior treatment

  • failed preventive treatment (39)
  • visited at least three headache specialists (41)
  • 10+ doctor visits for cluster headache (40)
  • sumatriptan injections (50)
  • oxygen (40)
  • 1 or more preventive therapies (48)
  • 3 or more preventive therapies (25)

Patients’ reasons

  • Prescribed treatments were ineffective.
  • Side effects were intolerable.
  • Doctor recommended it (5.6%).
  • Other patients recommended it (94.4%).

Illegal drugs used


Abortives

  • cannabis (34 patients)
  • cocaine (13 patients)
  • heroin (8 patients)

Preventives

  • psilocybin (18 patients)
  • LSA (lysergic acid amide) (12 patients)
  • LSD (lyseric acid diethylamide) (4 patients)

Patient reactions

  • More than half had never used illegal drugs before.
  • 40.7% told their doctor. All continued to use illegal drugs despite their doctor’s urging to stop.
  • 33.3% never consulted a doctor about cluster headache before starting to use illegal drugs.
  • 55.6% chose to stop seeing a doctor.
  • 35.2% were dismissed by their doctor once they told about their illegal drug use.
  • No one stopped using illegal drugs in order to keep seeing their doctor.
  • 85.7% didn’t think illegal drugs were riskier than prescribed treatment.
  • 55.6% thought illegal drugs were safer. They would recommend them to other patients.
  • Only 7.4% were worried about potential legal consequences.

Researcher observations

“Our results describe a discouraging scenario in which patients with CH, despite a high consultation rate, did not receive all the first-line treatments, and reported feeling abandoned by their physicians after learning of their illicit substance use.”

“….patients reported a significant prophylactic effect from hallucinogenic agents even if consumed only one to three times per year, usually at subhallucinogenic doses.”

“…individuals were not trying to experience the psychotropic effects of these drugs, but were trying to evaluate their effectiveness in terms of treatment of CH.”

“It is worrying that a patient would trust a stranger on the Internet rather than a well-known physician. This leads to several unanswered questions regarding the interactions of physicians with CH patients, and the approach taken to such discussions regarding illicit drug use.”


Source:

  1. Di Lorenzo C, Coppola G, xDi Lorenzo G , et al. “The use of illicit drugs as self-medication in the treatment of cluster headache: Results from an Italian online survey,” Cephalagia, 22 April 2015, DOI: 10.1177/0333102415583145.

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