A systematic scoping review of clinical indications for psilocybin identified 193 published and 80 ongoing studies. Most studies had small sample sizes, with a median of 22 participants and 18 who had taken psilocybin. Only 12% were randomized controlled trials, while 37% were systematic reviews. The most common indication studied was depression (28%), followed by substance use (14%), mental health in life-threatening illness (9%), headaches (6%), depression and anxiety (6%), obsessive-compulsive disorder (3%), and anxiety disorders (3%). Thirty-eight percent of studies reported at least one potential conflict of interest. The authors conclude there is a need for high-quality randomized trials and to expand consideration to other promising indications, such as chronic pain.
In a survey of 295 adults with musculoskeletal pain attending a hospital orthopaedic clinic, most perceived psilocybin as moderately to highly effective for pain (76%) and expressed moderate-to-high willingness to try microdoses (58%) or macrodoses (53%) of psilocybin for pain. Prior non-therapeutic psychedelic use was the strongest predictor of willingness to try a macrodose (B=3.16) or microdose (B=2.82), while pain severity had a small but significant effect. Only 3% had discussed psychedelics with a healthcare provider, and health risks were the primary concern (33%). The findings suggest neutral-to-positive perceptions, with gaps in patient knowledge and health concerns as key barriers to address in future trials.