Increased use of illicit drugs in a Dutch cluster headache population

People with cluster headache in the Netherlands use illicit drugs more often than the general population: 31.7% reported lifetime use compared to 23.8% in matched controls. Among psilocybin mushroom users, 56% reported a reduction in attack frequency, and 46% reported shorter attacks. Lysergic acid diethylamide users reported frequency reduction in 60% of cases, and heroin users in 50%. Amphetamine users reported shorter attacks in 36% of cases. The authors suggest the higher drug use may reflect genuine symptom relief, placebo effects, personal conviction, or a shared biological basis between cluster headache and addictive behaviors.

Study at a glance

Abstract

Introduction Many patients with cluster headache report use of illicit drugs. We systematically assessed the use of illicit drugs and their effects in a well-defined Dutch cluster headache population. Methods In this cross-sectional explorative study, 756 people with cluster headache received a questionnaire on lifetime use and perceived effects of illicit drugs. Results were compared with age and sex-matched official data from the Dutch general population. Results Compared to the data from the general population, there were more illicit drug users in the cluster headache group (31.7% vs. 23.8%; p < 0.01). Reduction in attack frequency was reported by 56% (n = 22) of psilocybin mushroom, 60% (n = 3) of lysergic acid diethylamide and 50% (n = 2) of heroin users, and a decreased attack duration was reported by 46% (n = 18) of PSI, 50% (n = 2) of heroin and 36% (n = 8) of amphetamine users. Conclusion In the Netherlands, people with cluster headache use illicit drugs more often than the general population. The question remains whether this is due to an actual alleviatory effect, placebo response, conviction, or common pathophysiological background between cluster headache and addictive behaviours such as drug use.