This report from 2006 has similarly high numbers of surveyed people saying that psilocybin or LSD aborted their headaches https://pubmed.ncbi.nlm.nih.gov/16801660/
That's 19 years for someone to do a controlled trial of cessation of cluster headaches using psilocybin or LSD vs placebo or triptan control. Wouldn't have to very big numbers either if the anecdotes are to be believed.

I guess your theory is that there have been too many funding and legal blocks to get this done in that 19 years. Seems hard to believe. Terrible if true.

If it is true, would recommend you focus on this as your core advocacy point: we need a placebo-controlled cluster cessation trial of psychedelics (rather than just prophylaxis). Saying "The Best Treatment for the Most Painful Medical Condition Is Illegal" is an unproven statement and makes you seem unserious

Inspiring

I saw so many people who wanted a “job in EA”. They wanted to directly do the good. Have they really thought through the bitter truth? Why do you believe you are uniquely good at an EA job, why ignore the simple premise of earning to give?

I think there's a large number of EAs who earn to give and spend their time focusing on their career rather than spending time reading another 5,000 word forum article on shrimp or going to EA meetups. This is probably the right move if the goal is to earn as much as possible.

People who want "EA jobs" are more likely to be involved in the forum and in community events.

Then it should be quite easy to show this benefit in clinical trials and it's suspicious that it hasn't happened

I think the fact that the term didn't add anything new is very bad because it came with a great cost. When you create a new set of jargon for an old idea you look naive and self-important. The EA community could have simply used framing that people already agreed with, instead they created a new term and field that we had to sell people on.

Discussions of "the loss of potential human lives in our own galactic supercluster is at least ~10⁴⁶ per century of delayed colonization" were elaborate and off-putting, when their only conclusions were the same old obvious idea that we should prevent pandemics, nuclear war and SkyNet (The idea of humans not becoming extinct goes back at least to discussions of nuclear apocalypse in the 40s, Terminator came out in 1984).

patients can report going from experiencing the worst possible pain to being completely pain free within seconds of inhaling DMT

If that were reliably true then it wouldn't be hard to show it in a clinical trial. Instead the results seemed to show a little reduction in attack frequency, rather than episode cessation.
 

Other factors that skew anectodes to be unreliable:

• The placebo effect is powerful and everyone underestimates it
• People tend to exaggerate for effect (even when not intending to deceive). Someone saying "it got better in seconds" they might mean they started to feel it getting better within seconds but it didn't totally resolve for minutes or hours.
• people tend to take things when symptoms are especially bad, which means whatever they do, things are likely to get better afterwards (regression to the mean, peaks and troughs)

From a medical perspective this seems a bit daft

"Patients have reported anecdotally that vaporized DMT, another psychedelic drug, aborts attacks seconds after they begin (there are no published studies of this effect)".

In medicine you quickly learn that anectode is extremely unreliable and the average person is positively busting to attribute cause and effect to whatever they just experienced. Every homeopathic remedy/energy healer/prayer/crystal/snake oil has its die-hards who will give you convincing anectodes of immediate success, so doctors become rightly extremely skeptical about these stories.

The actual evidence he provides is this review of some case studies and surveys and 4 clinical trials but which have pretty low numbers. The review itself says:

"The small number of participants in each study limits reliability and generalizability of the findings. Even with ongoing work, differences in dosing regimens and outcomes among studies will limit the consolidation of findings"

Combined with the small risk of psychosis from psilocybin I understand why health systems wouldn't want to rush into mainstreaming them as treatment.

Great question

Based on conversations I've had, I believe the focus in EA on longtermism has been off-putting for a lot of people and has probably cost a lot of support and donations for other EA causes.

Was it all a terrible waste?

Environment is an interesting example because you go from complete poverty (no environmental impact) to middle income (rampant growth, environment not a priority, think Brazil/Indonesia and their rainforests, or manifest destiny USA and their forests) so impact worsens, then at high income concerns about environment become more of a priority so you get  environmental protections.

Unless the goal is to prevent people rising out of poverty entirely (it shouldn’t be) the best outcome comes from faster development