I posted recently on the EA forum about the Organisation for the Prevention of Intense Suffering (OPIS) initiative on access to psilocybin for cluster headaches. Our policy paper has now been published. Policy recommendations include allowing doctors to prescribe currently restricted substances such as psilocybin, LSD, DMT and 5-MeO-DALT to patients with cluster headaches and ensuring that these substances can be readily produced or imported for such medical use. It is also recommended to modify regulations to ensure that patients who purchase or possess small amounts of psychoactive substances for personal therapeutic use cannot be charged with a crime or offence.
Some of the arguments we make:
- Randomised controlled trials are not the only form of strong evidence in determining whether a substance is effective. Although we don't go into detail in making probability estimates, we state that "it is vanishingly improbable that the dramatic effect observed independently by so many patients was due to chance or artefact."
- Aside from their efficacy, psilocybin and related substances are probably safer to use than many standard cluster headache treatments.
- It is an imperative to alleviate extreme suffering according to any mainstream ethical framework.
- When standard medical options are unsatisfactory, it is entirely reasonable for a patient in excruciating pain to seek alternatives. Criminalising reasonable behaviour is unreasonable.
- A shift in drug policies towards general decriminalisation/legalisation would lead to harm reduction.
Our paper was co-signed by several neurologists, ethicists and other experts, including Peter Singer, Julian Savulescu, Brian Earp and David Nutt, and has been promoted by the International Drug Policy Consortium (IDPC).
In order to convey the seriousness of cluster headaches and the need for legalising access to effective treatments, we also produced a 2-minute animated video.