When the law can be painful

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Until recently, I had never heard of cluster headaches, and neither had my friend Bob, which isn't his name for reasons that will soon be evident.

Bob was in his late 40s with no medical problems.

Out of nowhere he began having headaches. These were not the two-aspirin kind, or even migraines. They were monsters. I realized this one night at his house. For an hour he lay on the floor, screaming. We're not talking moaning and grousing. Screaming.

Clueless, he went to the Web and discovered cluster headaches. They are hideous. His symptoms were par for the course.

Nobody knows what causes them. They are fairly rare, which is why many people have not heard of them. To those who have them, they are a huge deal. Various Web sites describe them: Clusterheadaches.com and Clusterheadaches.org, for example.

Clusterbusters.com has a video file of an attack in progress. "Click below to see a short example of the typical effects of a cluster headache attack in progress ... WARNING: file is very graphic." Yep.

Bob went to doctors, who didn't know what to do but prescribed migraine medications, some of them very expensive and all of them largely ineffective. He was having several of these things a week. He began pondering suicide. I'm not kidding and neither was he.

He then discovered Clusterbusters.com, maintained by people who have the headaches. It reported that sufferers who took small doses of psilocybin no longer had the headaches. At this point he was willing to inject cobra venom if he thought it might help. He got psilocybin, a hallucinogenic found in mushrooms, and the headaches stopped.

Let me emphasize that Bob was not a druggie. In college he had experimented with hallucinogens and didn't like them at all. The dose he took for his headaches was subrecreational: It didn't produce, or barely produced, the effects for which most people take psilocybin.

He got some spores and began growing the mushrooms secretly in his basement. Psilocybin is illegal. He was a criminal. Yet for him, and for a lot of other people, having it was perhaps literally a matter of life or death.

As it turned out, heavyweight neurologists had run into anecdotal evidence of the effectiveness of psilocybin and had undertaken studies, including Dr. R. Andrew Sewell, Dr. John H. Halpern and Dr. Harrison G. Pope Jr. of McLean Hospital/Harvard Medical School.

From Neurology, the magazine of the American Academy of Neurology: "The authors interviewed 53 cluster headache patients who had used psilocybin or lysergic acid diethylamide (LSD) to treat their condition.

"Twenty-two of 26 psilocybin users reported that psilocybin aborted attacks; 25 of 48 psilocybin users and seven of eight LSD users reported cluster period termination ..."

My question: When a seriously painful medical condition is cured by an illegal substance, the cure being substantiated by premier researchers at as good a medical institution as exists, what do we do? Nobody here is looking for a legal excuse to use illegal drugs. They just don't want to roll on the floor, screaming.

When medical technology and the law are in conflict, human decency suggests making medical exceptions to the law. A great many potentially abusable drugs -- Demerol, morphine, codeine, what have you -- are used medically under control by prescription.

Why not psilocybin? If you ever listen to someone with a cluster headache, you will agree. I promise.