Are psychedelics the answer to chronic pain: A review of current literature

📖 Top 30% JournalJan 4, 2023Pain practice : the official journal of World Institute of Pain

Psychedelics as a possible treatment for long-term pain: a review

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Abstract

Psychedelics like LSD and psilocybin may disrupt functional connections in the brain associated with chronic pain.

Chronic pain has an unknown cause and is a complex medical issue.
Psychedelics may activate serotonin receptors, leading to neurophysiological changes that could help manage chronic pain.
Evidence of the effectiveness of psychedelics for chronic pain management is currently limited and of low quality.
Historically, psychedelics have shown analgesic potential in cancer-related pain and psychological distress.
Patients with severe headache disorders report both immediate and preventative relief from migraines and cluster headaches when using psychedelics.
Psychedelics are generally safer than opioids and do not carry the same risk of addiction.

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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.

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