🫠 Psychonaut POV

Welcome to Tricycle Day. We’re the psychedelics newsletter that won’t overreact if you call us pal, buddy, or chief. But buster is where we draw the line. 😤

Bob Wold ain’t afraid of no headache. Not anymore at least. He survived cluster headaches (aka “suicide headaches”) for 20 brutal years before he found relief in psilocybin. Since 2002, he’s run Clusterbusters, a nonprofit whose patient-designed protocol made it into research at Yale.

We asked Bob what he’s learned talking to 10,000 cluster headache patients, which psychedelics beyond mushrooms pique his interest, and why he’s counting on New York to support his community.

Over 10 million U.S. adults microdosed in the past year.

Microdosing is the most popular way people use psychedelics today. Yet somehow this phenomenon has been mostly ignored by the big events in the space.

So on October 21, the nonprofit Microdosing Collective is hosting The Microdosing Summit in the Texas Hill Country just outside Austin.

They’ll have panels and presentations, of course. But beyond that, you can expect wellness activations, brand showcases, live music, and comic relief.

We’ll be there, and we got you the hookup.

I was diagnosed with cluster headaches close to 50 years ago, after four years of being misdiagnosed and mistreated. For the next 20 years, I saw a lot of doctors and used over 70 prescription medications in dozens of combinations. Only two or three of those provided any help at all, and they were difficult to get. 

In the early days of the internet, I joined a group of other people with cluster headaches online and formed the first online message board for us. Eventually a young man from Scotland came to the group asking if anyone had heard of LSD helping cluster headaches. A couple of us took interest, did some research, and found that Albert Hofmann had been working on headache disorders and vascular issues when he discovered LSD. Nobody could access LSD, so I decided to try psilocybin instead and had somebody mail me a couple of doses of magic mushrooms. 

At that point, I’d been sleeping on my couch for 30 days. I was having attacks 12 times a day, an hour long each, writhing in pain on the floor. I took about a gram and a half, and within 45 minutes my head was clearer than it had been in 20 years. The pain was completely gone. It was like a switch. I walked outside, and my family had this shocked look on their faces because they hadn’t seen me smile in such a long time.

It wasn’t just relief in the moment. My cluster headaches came in three-month cycles, and psilocybin ended the cycle early. I’d been spending $20,000 a year on hospitals and medications, and now I could grow a year’s supply of mushrooms for $100. I’d made so many friends online that I couldn’t just walk away. I needed to share what I’d found. That set me on this mission 25 years ago.

It took a lot of work by a lot of people, trying each other’s ideas and reporting back on what worked and what didn’t. We figured out that the best approach was a series of two or three doses taken five days apart.

We advise everybody to start with as low a dose as possible—typically half a gram of dried psilocybin mushroom—and adjust from there. Most people find relief between one gram and a gram and a half. But many prescription medications block the psilocybin, so some people can take a gram and a half and feel nothing at all. We keep a full list of all the things that can block psilocybin’s effects.

You’re better off at the lowest dose that works, because coming down from a high dose can trigger more attacks. Some people decide their headaches must be worse than anyone else’s, take one big dose, and then email me asking why it didn’t work. You’ve got to finish the protocol.

Our protocol is being used in research at Yale and other places. Clinical trials usually find one dose that works for 50 or 60 percent of people, and that’s the dose that gets approved for everyone. But in my experience, everybody’s a little bit different. I’ve personally talked to more than 10,000 people with cluster headaches, and every conversation is taken one person at a time.

We ran a small study in Germany on BOL-148, a modified LSD molecule, with fantastic results. A lot of people in the psychedelic community lost interest because the compound was non-hallucinogenic, and that cut some of our funding. A fight over the patent also stalled the research, because investors won’t fund something with no defensibility. Cluster headaches are also a small market, and bringing something through a Phase 3 trial costs millions of dollars. We’re still trying to get psychedelics or psychedelic-related compounds for cluster headache through the FDA. 

We did convince one pharma company to pursue research that will hopefully lead to FDA approval of psilocin. Even if something helps 30 percent of cluster headache patients in the U.S., that’s 100,000 people with names and faces. Our broader hope is that the companies working on their own versions of psilocybin and other classic psychedelics, like Compass and Usona, will start doing research on cluster headaches too.

The other psychedelic that we’re excited about is DMT. I wanted to try it myself before recommending it to anyone, so I got my hands on a vape pen. My clusters were triggered by REM sleep, so I’d go months without sleeping more than an hour straight. One night I woke up around 1 a.m. with an attack and took one inhalation from the pen while walking to my oxygen tank. The attack was gone before I got there. Once again, it felt like a switch was clicked off in my brain.

The effective dose of DMT is very low, with very little hallucinogenic effect, if any. You don’t need to talk to aliens. Now, DMT doesn’t seem to stop or prevent cycles like psilocybin can, but it treats attacks in under a minute for the vast majority of people who have been trying it. The hard part is getting it. We’re a nonprofit, so we can’t help people with sourcing. But we’re having a university lab test DMT vape pens from eight different manufacturers, so at least we can tell our community which ones are the purest.

We’ve advocated in probably a dozen states, and we get a lot of pushback trying to get cluster headaches and pain written into legislation. Oregon’s program ended up not working for people with cluster headaches at all. The facilitated model as it exists today doesn’t make much sense for this condition.

People with cluster headaches need to be able to take a dose when they know they need one. They spread their doses out as much as they can—anywhere from five days to a month apart—and they’re the ones who can tell when their clusters are getting worse. Waiting a month for a session with a state-licensed facilitator is not feasible. Having two psychiatrists in the room isn’t necessary either. The best person to be with them when they take a dose is their caregiver or someone who loves them. 

New York came through one of our board members, Joe McKay. He’s a retired New York firefighter who worked on the pile after 9/11. He got cluster headaches, had to medically retire, and kept struggling with what the healthcare system offered him until he found Clusterbusters and psilocybin. He connected us with the campaign in New York. The people trying to get this through are incredible. We are optimistic that, even with modest funding for a legislative campaign in 2027, this bill will become law in New York state.

People with cluster headaches still can’t get psilocybin legally, and we’re working to change that. It’s a long road. In New York, the bill is called the Medical Psilocybin Act. It covers five qualifying conditions, and the Department of Health can add more conditions without going back through the legislature.

The bill’s sponsor, Assemblywoman Amy Paulin, has told us it’s her top priority for 2027. It’s not a ballot measure, so we don’t need the millions of dollars that were spent on the ballot initiative in Massachusetts, which failed. Our lobbyists think there’s a better than 50-50 chance it becomes law by July 2027 if we can raise about a million dollars. That pays for lobbying and gets people up to Albany to tell their stories. 

What we want is for people to be able to buy psilocybin that’s regulated by the state, tested, and labeled, so they know what they’re getting and how strong it is and can use it at their own discretion. Psilocybin is going to be the first step. Hopefully DMT isn’t too far behind.

New York is a priority right now, but there is much more advocacy to do. People have used psychedelics to ease pain for thousands of years. Cluster headache has the strongest evidence of any pain condition so far, but it's not the only one. Clinical trials are slow and expensive, and there are people suffering now. The cluster headache community figured out psychedelics work for them by comparing notes with each other long before institutional research caught up, which is why we're launching a survey in the next few weeks. Citizen science may be the fastest way to understand how psychedelics are helping so many people who live with pain.

Find support at Clusterbusters.org, get notified about the Pain and Psychedelics Survey, or make a donation to advance psychedelic policy in New York.

That’s all for today, Cyclists! Whenever you’re ready, here’s how we can help.

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DISCLAIMER: This newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice. The use, possession, and distribution of psychedelic drugs are illegal in most countries and may result in criminal prosecution.