Are psychedelics the answer to chronic pain: A review of current literature
Pain Practice – January 04, 2023
Source: OpenAlex
Summary
Psilocybin, a potent hallucinogen, offers a non-addictive alternative for chronic pain management, a critical need in Medicine. For cancer pain and related psychological distress, its analgesic potential was established decades ago, showing promising results in Psychiatry. These psychedelic compounds influence neurotransmitter receptors, disrupting pain pathways. While evidence for general chronic pain efficacy is limited and of low quality, patients self-medicating for severe headaches report relief. Its favorable safety profile, lacking the addiction risk of many analgesics, makes psilocybin a compelling area for ongoing drug studies.
Abstract
Abstract Aims We aim to provide an evidence‐based overview of the use of psychedelics in chronic pain, specifically LSD and psilocybin. Content Chronic pain is a common and complex problem, with an unknown etiology. Psychedelics like lysergic acid diethylamide (LSD) and psilocybin, may play a role in the management of chronic pain. Through activation of the serotonin‐2A (5‐HT2A) receptor, several neurophysiological responses result in the disruption of functional connections in brain regions associated with chronic pain. Healthy reconnections can be made through neuroplastic effects, resulting in sustained pain relief. However, this process is not fully understood, and evidence of efficacy is limited and of low quality. In cancer and palliative related pain, the analgesic potential of psychedelics was established decades ago, and the current literature shows promising results on efficacy and safety in patients with cancer‐related psychological distress. In other areas, patients suffering from severe headache disorders like migraine and cluster headache who have self‐medicated with psychedelics report both acute and prophylactic efficacy of LSD and psilocybin. Randomized control trials are now being conducted to study the effects in cluster headache Furthermore, psychedelics have a generally favorable safety profile especially when compared to other analgesics like opioids. In addition, psychedelics do not have the addictive potential of opioids. Implications Given the current epidemic use of opioids, and that patients are in desperate need of an alternative treatment, it is important that further research is conducted on the efficacy of psychedelics in chronic pain conditions.