Alfredo Parra 🔸

• Alfredo Parra 🔸 1 Dec 2025 8:55 UTC

  2 points

  0 ∶ 0

  in reply to: AlephNull’s comment on: An­nounc­ing ClusterFree: A cluster headache ad­vo­cacy and re­search ini­ti­a­tive (and how you can help)

  Thanks so much for your comment and your support! :) And yes, we definitely want to engage with representatives at all levels, both ourselves as well as in a decentralized manner (e.g., by empowering patients and other volunteers to take action locally). Any efforts are welcome. Get in touch if you’d like to coordinate somehow or if you need any advice. :)

• Alfredo Parra 🔸 26 Nov 2025 15:40 UTC

  10 points

  1 ∶ 0

  in reply to: NickLaing’s comment on: Dona­tion Elec­tion Dis­cus­sion Thread

  Thanks for the shoutout and for the vote! :)

  I’m not convinced that the number of sufferers isas high as claimed. In 13 years as a doctor in Uganda and treating a few thousand patients, I’ve never seen a convincing case of cluster headache here.

  This is indeed quite surprising! The relatively low prevalence and the lack of recognition of the disease /​ misdiagnosis may explain it to some extent, but zero patients in 13 years is still very surprising.

  (Consider that even an average neurologist only ever sees a few dozen CH patients during their entire career. I asked Opus 4.5 and Gemini 3.0 to estimate how many CH patients an average neurologist in the US sees per year, assuming an annual prevalence of 1/​2000 adults, and their responses were 1–2/​year and 1/​year, respectively. They also think that the average neurologist sees 3–5x (5–10x resp.) more CH patients than the average primary care doctor, but the odds of not encountering a single patient in 13 years should still be very, very low. Will look into this!)

  Also, there’s almost no epidemiological data on the prevalence of CH in African countries, so the prevalence error bars are large. (In our paper, we included a sensitivity analysis of the most uncertain variables to add some nuance.)

• Alfredo Parra 🔸 12 Nov 2025 19:55 UTC

  8 points

  2 ∶ 1

  in reply to: Vasco Grilo🔸’s comment on: Cause prio cruxes in 2026?

  Thanks for your answer! :)

  If so, why not generalise, and conclude you would avert 2^N h of pain of intensity 0.999^N instead of 1 h of pain of intensity 1?

  I think the procedure might not be generalizable, for the following reason. I currently think that a moment of conscious experience corresponds to a specific configuration of the electromagnetic field. As such, it can undergo phase transitions, analogous to how water goes abruptly from liquid to gas at 100°C. Using the 1-dimensional quantity “temperature” can be useful in some contexts but is insufficient in others. Steam is not simply “liquid water but a bit warmer”; steam has very different properties altogether.

  To extend this (very imperfect) analogy, imagine we lived in a world where steam killed people but (liquid) water didn’t (because of properties specific to steam, like being inhalable or something). In this case, the claim “reducing sufficiently many units of lukewarm water would still be better than reducing a unit of steam” would miss the point by the lights of someone who cares about death.

  (Here are some thoughts on phase transitions in certain altered states of consciousness.)

  Do you know how much funding is spent globally per year on preventing human torture?

  I don’t! That’s the sort of question I’d like to see more research on (or discussed more on the Forum if such research already exists), as well as which torture-prevention orgs/​programs are most cost-effective, etc.

• Alfredo Parra 🔸 12 Nov 2025 9:35 UTC

  19 points

  6 ∶ 6

  in reply to: Vasco Grilo🔸’s comment on: Cause prio cruxes in 2026?

  As a panpsychist and suffering abolitionist, I’m one of the most sympathetic people in the world to the cause of reducing suffering even in the smallest beings. And yet, I do not want to see more research on how to increase the welfare of microorganisms on the margin (or at least not with EA resources).

  I probably won’t change your mind about meta ethics, but I strongly disagree with the aggregationist QALY approach to comparing the welfare of humans vs e.g. soil animals (e.g. here). I hope to write more about this at some point, but as an intuition pump, I think there’s a good chance that the problem of reducing soil animal or microorganism suffering is somewhat analogous to the problem of reducing, say, pin pricks in humans. I would not support EA efforts to reduce the number of pin pricks in humans, no matter how vast, given that we also have humans who are actually being tortured right now.

  As much as I care about insects and other small organisms, I’m really sad that the EA community invests far more resources into their well-being than to reducing torture in humans (e.g. there are 120 EA Forum posts on Invertebrate Welfare and only 7 on cluster headache; and there isn’t even an EA Forum tag for “Torture” despite it still being a huge problem globally (Claude estimated 1–2m people tortured per year, ChatGPT estimated 500k–2m)).

  I really appreciate your work, and I think we should absolutely think about these problems. But, on the margin, I’d rather see other work being done.

• Alfredo Parra 🔸 3 Nov 2025 9:12 UTC

  4 points

  0 ∶ 0

  on: How Open Phil uses back-of-the-en­velope calcu­la­tions for GHW

  Thanks so much for sharing these resources!!

  Like many experts and institutions in global health, we use “disability-adjusted life years” (DALYs) as a way to measure the burden of a health condition. An intervention that improves health will thereby reduce DALYs.

  It’d be awesome for OP to explore in parallel other cause areas and interventions that the DALY misses, such as less prevalent conditions inflicting very severe suffering. Otherwise, we risk neglecting those who are worst off.

  I make this case in my paper “The Heavy Tail of Extreme Pain Exacerbates Health Inequality: Evidence from Cluster Headache Underinvestment” (forthcoming in “Nature: Humanities & Social Sciences Communications”). My post “How much should we value averting a Day Lived in Extreme Suffering (DLES)?” also touches on some of these themes.

• Alfredo Parra 🔸 3 Nov 2025 9:00 UTC

  5 points

  1 ∶ 0

  on: Emerg­ing ev­i­dence on treat­ing cluster headaches with DMT

  Related video by Andrés Gómez Emilsson (@algekalipso): “The Case for DMT for Cluster Headaches: Practical Tips & Why It Deserves Urgent Scientific Attention”

• Alfredo Parra 🔸 29 Oct 2025 7:24 UTC

  5 points

  4 ∶ 0

  on: Mod­ern­iz­ing the EA Funds website

  I found it insightful to read your criticisms of the old website! And I really like the new website. Congrats on the launch! 🎉

• Alfredo Parra 🔸 21 Oct 2025 10:43 UTC

  2 points

  0 ∶ 0

  in reply to: SiebeRozendal’s comment on: Emerg­ing ev­i­dence on treat­ing cluster headaches with DMT

  This is helpful, thanks! (It would have come in handy for our kidney stone project, where we did something very similar!)

• Alfredo Parra 🔸 21 Oct 2025 8:25 UTC

  2 points

  0 ∶ 0

  in reply to: Alistair Stewart’s comment on: Emerg­ing ev­i­dence on treat­ing cluster headaches with DMT

  Thanks for the encouragement, Alistair! ❤️

• Alfredo Parra 🔸 21 Oct 2025 8:24 UTC

  3 points

  0 ∶ 0

  in reply to: Cameron.K’s comment on: Emerg­ing ev­i­dence on treat­ing cluster headaches with DMT

  Thank you, Cameron! You might be interested in the work of the Psychedelics & Pain Association.

• Alfredo Parra 🔸 21 Oct 2025 8:23 UTC

  4 points

  0 ∶ 0

  in reply to: Manuel Allgaier’s comment on: Emerg­ing ev­i­dence on treat­ing cluster headaches with DMT

  Thanks a lot! I’ll reach out again soon, once we launch our advocacy initiative (for which we’re also gathering video testimonials :)).

• Alfredo Parra 🔸 17 Oct 2025 11:09 UTC

  2 points

  0 ∶ 0

  on: An­nounc­ing: Draft Amnesty Week Oc­to­ber 13-19

  Thanks for organizing this! :)

  Minor thing, but this post says the week ends on October 19 while the banner on the Forum homepage says it ends on October 18. I assume it’s fine to post on October 19?

• Alfredo Parra 🔸 31 Jul 2025 9:10 UTC

  2 points

  0 ∶ 0

  in reply to: RobertDaoust’s comment on: How much should we value avert­ing a Day Lived in Ex­treme Suffer­ing (DLES)?

  Thank you for your feedback, Robert, and for your commitment to reducing suffering! I’ll stay tuned!

• Alfredo Parra 🔸 31 Jul 2025 9:04 UTC

  4 points

  1 ∶ 0

  in reply to: Vasco Grilo🔸’s comment on: How much should we value avert­ing a Day Lived in Ex­treme Suffer­ing (DLES)?

  Thanks, Vasco!

  Would you still believe this under expectational total hedonistic utilitarianism?

  Someone who is fully bought into expectational total hedonistic utilitarianism and nothing else would probably not agree with that conclusion, no. (I don’t endorse such a form of utilitarianism. My views align much more closely to something like xNU+.)

  I do, however, hope that people across the ethical spectrum can acknowledge that we could be doing much more to relieve extreme suffering without necessarily making significant compromises elsewhere. We already managed to provide universal access to anesthesia (at least in developed countries), so we could do much more for those who are still being left behind at a small fraction of the cost.

• Alfredo Parra 🔸 17 Jul 2025 11:48 UTC

  3 points

  0 ∶ 0

  in reply to: Cody Albert’s comment on: Quan­tify­ing the Global Bur­den of Ex­treme Pain from Cluster Headaches

  All testimonials we’ve heard about DMT are crazy. Some people report being able to abort 100% of their attacks with low doses and no apparent loss of effectiveness with continued use. Here’s a relevant interview: DMT for Cluster Headaches: Aborting and Preventing Extreme Pain with Tryptamines and Other Methods

  Dr. Emmanuelle Schindler at Yale (top expert in psychedelics for cluster headache) is planning to run a survey on DMT usage. (We’re helping her fundraise, so anyone reading this with $150k to spare, let me know. :))

• Alfredo Parra 🔸 17 Jul 2025 7:06 UTC

  7 points

  2 ∶ 0

  in reply to: David_R 🔸’s comment on: 80,000 Hours is pro­duc­ing AI in Con­text — a new YouTube chan­nel. Our first video, about the AI 2027 sce­nario, is up!

  >1.7 million views in 7 days! B-A-N-A-N-A-S!

• Alfredo Parra 🔸 2 Jul 2025 6:28 UTC

  24 points

  8 ∶ 2

  on: De­bate: De­pop­u­la­tion Matters

  Depopulation is Bad

  I remain unconviced by the arguments in the book (based on this post). My main disagreement is that it assumes that the main downside of a larger population is climate change (which I don’t think it is), and then goes on to focus exclusively on all the great things we could have with more people. Perhaps not surprisingly, I think this debate is not complete without bringing up the problem of extreme suffering:

  More Good is Better. It’s better if there is more good in the world, other things being equal, and worse if there is less. That includes good lives: It’s better if there are more good lives.

  The above begs the question. Sure, more good is better, but the book title is not “the case for happy people.” Doubling the population would mean:

  • 560 million people living with depression instead of 280 million.

  • 1.4 million people committing suicide every year instead of 700k.

  • Doubling the number of people being tortured in prison camps, living in totalitarian regimes, living in war zones, living with cluster headaches, etc.

  • Doubling the consumption of chicken, fish, etc.

  Maybe one could argue that growing the population would also help us fix all of the above faster, but I seriously doubt it (and it would seem to me more like an instance of suspicious convergence).

  The book authors seem to be basically saying “wouldn’t it be awesome to have more people like us? Healthy, wealthy, happy-go-lucky, living in a free democracy, and with such high IQ that we might invent a new vaccine?” (Sorry, this might be unfair, but that’s at least the vibe I get from this post.) But I think we absolutely need to think about those living in agony too. Until then, I’m unconvinced.

  Maybe less importantly (because it may be rather a matter of aesthetics), I’m also not moved much by the argument “aren’t you glad to have more books, magazines, high-speed streaming, etc., and wouldn’t it be great to have more of that?” There’s something hungry ghost-y about it that goes against my striving to be content with less. Like, yes, I admit I really like vaccines, but maybe our goal should be “let’s shift our societal priorities such that fewer people go on to become TV producers and instead become vaccine researchers.”

  Something similar applies to this:

  Imagine that half the people you know and love never existed.

  I think the thought experiment is trying to evoke a feeling of sadness at the thought of never having met half the people in your life, but to me it also implies that, right now, I should be sad that I don’t have twice the friends I have. I reject this implication.

  Anyway, I still appreciate the book summary and will be thinking about the topic more as a result. And I’m still open to changing my mind if there are other arguments related to the problem of extreme suffering.

• Alfredo Parra 🔸 27 Jun 2025 8:45 UTC

  2 points

  0 ∶ 0

  in reply to: Vilfredo's Ghost’s comment on: Please re­con­sider your use of adjectives

  Thanks! I think we probably agree much more than your comment suggests. I wholeheartedly agree with this, for example:

  But better still would be “I would like more examples of what these budget numbers mean for our day to day operations” or “expert consensus is that people will pay more attention if you sound excited when you give a presentation”.

  Those are the kinds of indisputable facts that I think should be used instead of judgments (no one can dispute that you would like more examples for the budget).

  I think there’s a caricature version of NVC in a lot people’s minds where NVC is all about talking about feelings or something, in a way that feels insincere or naive. And perhaps justifiably so—I’ve seen people weaponize NVC to just mask their judgments behind a veil of seemingly nonviolent language, but their intentions are all too obvious, which often leads to even worse outcomes. So yeah, basically I’m fully on board with the idea of speaking/​writing in a way that will most clearly convey meaning.

• Alfredo Parra 🔸 24 Jun 2025 15:56 UTC

  3 points

  2 ∶ 0

  on: The Need to Op­ti­mize EA Con­tent to Show Up in AI Chats

  Nice, thanks for sharing this! I’d been thinking about this topic for a while. It seems like something for the EA Forum team to invest some resources into (maybe they already are).

• Alfredo Parra 🔸 22 Jun 2025 7:10 UTC

  7 points

  4 ∶ 0

  in reply to: Larks’s comment on: Please re­con­sider your use of adjectives

  Thanks! With “such as,” I meant “among others.” I agree that “makes me sad” wouldn’t do the job here, but I think the other examples I mentioned would, no? (“I disagree”, “I doubt”, etc., which aren’t really feelings but they’re still not judgments).