Could Psychedelics Treat Neuropathic Chronic Pain?

Chronic pain conditions are a major health problem, and new treatments are needed. Classical psychedelics such as psilocybin may be one such treatment. The authors introduce the pharmacology of psychedelics and existing human data on their side effects, safety, and abuse liability. They systematically review the existing data on using psychedelics to treat pain, predominantly chronic and neuropathic pain. They discuss psychological and psychiatric aspects of chronic pain and the effects of psychedelics, culminating in an integrated hypothesis that psychedelics affect high-level priors that compound chronic pain, alongside possible direct nociceptive effects. A clinical trial is proposed to test this hypothesis.

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Abstract

Chronic pain conditions are a substantial health problem and there is a strong need for new treatments.We hypothesise that classical psychedelics such as psilocybin may be one such treatment for chronic pain states.We introduce the pharmacology of psychedelics and existing data on their use in humans, including side effects, safety and abuse liability.We systematically review and explore the existing data on the use of psychedelics to treat pain, predominantly chronic and neuropathic in type.A discussion of the psychological and psychiatric aspects of chronic pain and the effects of psychedelics on these aspects follows, culminating in an integrated hypothesis that psychedelics effect high level priors that compound chronic pain, alongside putative direct nociceptive effects.Finally, we propose a clinical trial to test our primary hypothesis.