Psychedelics and Chronic Pain

Chronic pain often occurs as a result of nerve damage, injury, or an underlying condition. The symptoms of chronic pain manifest as:

  • An increased pain sensitivity (hyperalgesia)
  • Finding non-painful stimuli painful (allodynia)
  • Ongoing painful sensations

Recent statistics have indicated that more than 1 in 5 adults in the US experience chronic pain. Having chronic pain can be highly debilitating. It is the leading cause of disability worldwide and often results in various psychological problems.

The harmful nature of current treatments means there is an urgent need to find new ways to treat chronic pain.

Currently prescribed medication to manage chronic pain consists primarily of antidepressants and opioids. However, these medications often come with numerous side effects and can be addictive. The harmful nature of current treatments means there is an urgent need to find new ways to treat chronic pain conditions.

Psychedelics have become of recent interest in modern medicine by showing they can have an impact on mental health conditions. Researchers are now beginning to question whether psychedelics may be effective in treating chronic pain.

Current Research on Chronic Pain and Psychedelics

Psychedelics are beginning to become of greater interest to researchers looking to manage and treat various chronic pain conditions.

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Although the research so far is limited, some published studies, to date, highlight the potential of psychedelics to treat chronic pain.

LSD and Analgesia

The most recent study published in 2020, completed by the Beckley Foundation and Maastricht University, showed that microdosing LSD reduced pain perception in healthy volunteers.

Volunteers underwent something called a cold pressor test, a measure of pain tolerance. Taking 20 mg of LSD reduced the volunteers’ perception of pain significantly compared to if the volunteers had taken a placebo.

Psilocybin and Phantom Limb Pain

Phantom limb pain occurs when somebody has lost a body part and feels painful sensations from the missing limb.

A case study published in 2018 showed that combining mirror therapy with psilocybin caused an immediate and sustained reduction in a phantom limb pain patient. Mirror therapy creates an illusion of a limb in phantom limb patients to develop positive visual feedback of a pain-free limb.

Psychedelics and Cluster Headaches

Cluster headaches are characterized by ongoing severely painful headache attacks, which can happen multiple times a day for weeks at a time.

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A study published in 2006 showed that in 90% of cluster headache patients who had used psilocybin or LSD to treat their condition, psychedelics extended the pain-free period between headache attacks. Psilocybin also halted headaches in 80% of patients.

Ketamine

Ketamine has been used for its pain-relieving effects in surgery since the 1960s. Ketamine is available for medical use, and certain clinics in the US are already offering ketamine infusion (IV injection) as a therapy for pain conditions.

Ketamine infusion has proven beneficial in treating several chronic pain conditions. These include:

Ketamine infusion therapy is proven to help provide relief from depression, which is a common psychological symptom of chronic pain.

Mechanisms of Psychedelics to Treat Chronic Pain

Neuroplasticity

Scientists suggest that a re-organization of nerve networks in the brain can cause pain to go from being acute to chronic.

Neuroplasticity is the ability of networks of nerve cells in the brain to reorganize and grow. Psychedelics promote neuroplasticity in the brain by increasing the growth of new nerve cells and increasing the number of potential connections from existing nerve cells through activating various signaling molecules.

By activating neuroplasticity, psychedelics may be able to reorganize the brain patterns which are involved in the underlying causes of chronic pain.

Serotonin

Classical psychedelics, like LSD and psilocybin, work by activating a type of serotonin receptor (5-HT2A) in the brain. Serotonin is one of the key neurotransmitters involved in carrying messages across different brain networks and has functions in mood, sleep, and eating.

The 5-HT2A receptor is involved in physiological processes related to pain. As psychedelics activate 5-HT2A, this suggests psychedelics could relieve pain by interfering with these processes.

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One study on rats showed that 5-HT2A activation is responsible for the pain-relieving mechanism of the antidepressant tramadol, which is a current pain-relief treatment for chronic pain.

Some evidence has suggested LSD acts on various serotonin receptors in the dorsal raphe, a brain area involved in creating signals which decrease pain perception.

Inflammation

Overactivation of the immune system has been linked to chronic pain. Human and animal studies have shown that psychedelics can decrease inflammatory markers (molecules involved in inflammation), which explains a potential mechanism by which they could decrease pain levels in people with chronic pain.

Effects of Psychedelics in Management of Pain

As well as the potential to possibly treat the pain itself, the effects of psychedelics could positively impact the wellbeing of people with chronic pain, improving the management of their condition.

The impact chronic pain can have on someone’s everyday life means people with chronic pain often share symptoms with various other disorders. These include depression, anxiety, disturbed sleep, lack of energy, and changes in cognition.

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The most significant comorbidity in chronic pain is depression. Clinical research suggests that up to 85% of chronic pain sufferers are likely to be diagnosed with severe depression.

Recent clinical studies have shown that psilocybin effectively improves depression symptoms in patients and symptoms of anxiety in patients with both cancer and OCD.

Furthermore, microdosing studies have indicated that the benefits of microdosing psychedelics could help improve some of the comorbid symptoms of chronic pain. These benefits include:

  • Improved energy
  • Cognitive benefits
  • Improved mood

The studies also highlighted microdosing could improve motivation. Increased motivation could encourage people with chronic pain to partake in activities like yoga, which has proved to assist with chronic pain management, and other activities that may increase connection and decrease depression.

A recent study showed that psilocybin could help relieve the demoralization experienced by long-term AIDS survivors. Demoralization is characterized by feelings of helplessness and giving up and is associated with health conditions, such as chronic pain.

Psychedelics and Chronic Pain: The Bottom Line

The debilitating effects of chronic pain on physical and psychological function mean finding effective treatments is urgent.

Some research highlights how psychedelics could theoretically decrease pain in people with chronic pain disorders and perhaps even provide a solution to some of the underlying causes. However, the research is very limited, so more studies are needed.

Chronic pain is linked to numerous different conditions, and multiple different mechanisms lead to chronic pain.

Chronic pain is linked to numerous different conditions, and multiple different mechanisms lead to chronic pain. This means the benefits of psychedelics in reducing pain may only apply to particular chronic pain groups.

An individual’s response to psychedelics can vary; this also means for some people with chronic pain, large doses of psychedelics may be required to help with pain, whereas other people may only require microdoses.

Although there are different underlying causes and symptoms of chronic pain, psychological impacts are shared across different chronic pain groups. As psychedelics can help with positive wellbeing, they may assist in reducing depression and other psychological disorders which coincide with chronic pain and may help people better manage their condition.

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