1,958 karma · joined April 15, 2015
The side-effect profile seemed a whole lot better than anything I'd tried, and it seemed far far easier to concentrate while it was doing its thing. It's also legal to travel with, and absolutely nobody seemed to know what it was by name.
But the funniest part was that the pharmacists seemed to be aware that the DEA scheduling was BS – I got carded for the bottle of wine I bought on the way out for a dinner, but not for the <ominous voice> DEA Schedule II controlled substance.
Mine ended up never self-resolving and they had to use a blood injection to produce a clot and "plug" the hole. Before that they tried IV caffeine – apparently that not only exists, but is actually indicated for spinal headaches. Trip report: meh, drinking coffee is much more fun.
Aside: there have to be better user interfaces for attaching dates to articles. Make the date more prominent/visible as it ages or something like that. The color of the date on that page is rgb(170, 170, 170) and seems very easy to accidentally skip over.
Actually, this is pretty interesting. I'd be really curious if NSAIDs like ibuprofen or naproxen have the same effect. APAP has a novel mechanism of action at the cannabinoid receptor type 1, because it's a prodrug for AM404. That's the only target that I've ever found that kills my migraines (N.B. prescribed synthetic, not so much smoking joints or anything).
It's possible OP has a more mild presentation or something, but what was described is pretty damned atypical – and also about a half-micron away from "I can, so why can't you?".
Out of curiosity, is that a professional medical opinion, or is that yours?
The reason I ask: the pain from cluster headaches is legendarily terrible. The pain has been described as "remarkably greater" than migraine, and probably _at least_ on par with a spinal headache.
I don't have cluster headaches, but I've had a (diagnosed) week-long spinal headache exactly once before. A spinal headache is where your CSF fluid leaks out your back and your brain physically begins to "hang" in your skull. It lasted for a week, I was shot full of so much hydromorphone I couldn't physically coordinate my legs, and I was still in tears from the pain, begging doctors to knock me out. I honestly think I would have died by my own hands had it gone on for another week. It was unbearable.
I would suggest that the odds of someone managing cluster headache without medication – i.e. the headache that's earned the nickname "suicide headache" and causes people to carry around emergency inhalers of hardcore pain killers like butorphanol – is very, very low.
The worst part: you pretty much have to pay a $1000 tax if you present at the ER with a migraine, because they will not believe you. People will be in a rush, they will not examine the giant history in the EHR spanning years and years, and you will be likely be suspected of drug seeking. So you have to say yes. $250 for a useless injection of sumatriptan and $750 for an hour of continuing to lie in pain on a bed until they hopefully realize you're telling the truth.
I have taken intranasal capsaicin to try to stop the pain because a paper on the internet said it might work. It didn't even hurt. I'll repeat that: I snorted the active ingredient in habaneros and pepper spray and didn't even feel it because it was so far overshadowed by the pain in my skull.
Approximately ten minutes before my pain starts, I begin to sneeze uncontrollably and vomit even with a completely empty stomach. This continues throughout the pain, and has lasted in excess of 72 hours before. They are spontaneous and there is no identifiable trigger, even after 25 years of looking.
How do you suggest I think my way out of this one?
I was prescribed a very expensive synthetic CB1 agonist for migraine nausea (nabilone) by my primary care MD, and the effect was instantaneous and miraculous. Killed the nausea outright, took a solid 80% off of the pain (it was doing the morphine-type "I can feel it but it doesn't hurt" thing), and there was no euphoria/high or noticeable drug craving or reinforcement that I could detect.
The bad news: it's $50 per milligram (almost $1500 for 10 days worth), Schedule 2 (the same schedule as fentanyl, cocaine, and methamphetamine), and technically approved by the FDA only for nausea caused by chemotherapy. The first FDA approval date for the drug was 1985.
I'd previously tried so many prescribed anti-migraine drugs I couldn't even list them all here in the time I have. The side effects were as debilitating as the migraines themselves in some cases. Some were just wildly inappropriate (e.g. a resident wanted to write opiates). Anyway, I fought with an insurance company for seven days on a $20k/year policy and they still wouldn't cover it.
Given the experience of trying to do this the right way, I'm utterly unsurprised that people in intense pain end up trying to DIY it.
I suspect it's tolerance and not addiction, but docs see this and code it as "medication overuse headache" all the time.