In addition to everything that has been described many times on our BB forum regarding the positive effects of psychedelics, here's another strange and understudied prospect — psychedelics can actually treat severe chronic pain.
For Kevin, a former martial arts expert and Crossfit coach (as well as an active user of our forum), the most surprising thing about participating in a clinical trial with psilocybin and major depressive disorder at NYU 2020 was not only the disappearance of his long-standing depression, which he had been struggling with for over five years, but also the disappearance of old chronic pain unrelated to the study. He claims to have gone into complete remission and is pain free.
Browsing the internet and attending psychedelic conferences, one can find many similar stories. An estimated 51 million Americans suffer from chronic pain — such as migraines, phantom limb pain, or fibromyalgia — and often receive little relief from treatment. However, psychedelics such as psilocybin mushrooms and LSD seem to bring significant relief.
At least for those who have access. The Drug Enforcement Administration continues to consider these psychedelics illegal under Schedule I, meaning that federal laws prohibit their use as drugs (although some states are taking the risk and pushing for legalization, as has happened with marijuana).
Most clinical research in today's psychedelics world focuses on mental health disorders, which could lead to FDA approval of MDMA for the treatment of PTSD later this year. However, the fact that people suffering from chronic pain are forced to turn to the psychedelic underground for support is the downside of this attention.
The growing awareness of psychedelics as a potential treatment for mental health has increased interest in their use in other areas, such as pain relief. An important step along this path was the announcement by the National Institutes of Health of a nearly $22 million grant for clinical research on psychedelic therapy and chronic pain relief.
However, the path from funding more research to legalizing the prescription of psychedelics for pain relief by doctors will likely take many years. Many of those who suffer from chronic pain cannot afford to wait. The level of pain they experience is almost impossible to imagine.
«Society doesn't imagine this type of pain. Unless they've faced it themselves or seen someone close to them suffer, they can't even imagine this kind of despair» — says Wing, one of the co-founders of the Psychedelics and Pain Association (PPA)
When a new and relatively safe treatment, such as psychedelics in low and moderate doses, can alleviate such despair, it's hard not to want the regulatory process to move faster. But none of the necessary steps — obtaining funding, clinical trials, rescheduling the DEA, and designing an infrastructure of care — are characterized by speed.
We want to be careful. We don't want people to accidentally try this at home. But if we do it right, we can alleviate the suffering of millions of people. For some people, it's the difference between a life worth living or not.
One of the closely studied conditions in the field of psychedelic treatments for chronic pain is cluster headaches, also known as «suicidal headaches».
«Society doesn't imagine this type of pain. Unless they've faced it themselves or seen someone close to them suffer, they can't even imagine this kind of despair» — says Wing, one of the co-founders of the Psychedelics and Pain Association (PPA)
When a new and relatively safe treatment, such as psychedelics in low and moderate doses, can alleviate such despair, it's hard not to want the regulatory process to move faster. But none of the necessary steps — obtaining funding, clinical trials, rescheduling the DEA, and designing an infrastructure of care — are characterized by speed.
We want to be careful. We don't want people to accidentally try this at home. But if we do it right, we can alleviate the suffering of millions of people. For some people, it's the difference between a life worth living or not.
One of the closely studied conditions in the field of psychedelic treatments for chronic pain is cluster headaches, also known as «suicidal headaches».
It is one of the most excruciating conditions facing humanity. The headline of the actual study, based on a survey of 493 people with cluster headaches, begins with the phrase You'd eat shoe polish if you thought it would help.
Most people go about five years before they are properly diagnosed. Even after that, treatment choices are limited. The first FDA-approved treatment, Emgality, became available in 2019, and clinical trials confirmed that it cut the number of attacks by about half in 71% of patients. No known treatments have resulted in complete relief from cluster headaches.
However, back in 1998, someone on an internet forum claimed that LSD apparently helped him deal with cluster headaches. Later, the Cluster Breakers community began to rally around the idea that effective psychedelic treatment exists, even if most doctors don't know about it and can't prescribe it.
Today, the resurgence of psychedelic research is often attributed to a 2006 study of psilocybin and mystical experiences by the late Roland Griffiths. That same year, Yale University psychiatrist R. Andrew Sewell published an article that examined the cases of 53 patients with cluster headaches who self-administered psilocybin or LSD. 17 of 19 patients who used psilocybin during an attack reported cessation of attacks. In total, 25 of 48 patients who used psilocybin and 7 of 8 patients who used LSD reported that psychedelics completely stopped their cluster seizures.
Most people go about five years before they are properly diagnosed. Even after that, treatment choices are limited. The first FDA-approved treatment, Emgality, became available in 2019, and clinical trials confirmed that it cut the number of attacks by about half in 71% of patients. No known treatments have resulted in complete relief from cluster headaches.
However, back in 1998, someone on an internet forum claimed that LSD apparently helped him deal with cluster headaches. Later, the Cluster Breakers community began to rally around the idea that effective psychedelic treatment exists, even if most doctors don't know about it and can't prescribe it.
Today, the resurgence of psychedelic research is often attributed to a 2006 study of psilocybin and mystical experiences by the late Roland Griffiths. That same year, Yale University psychiatrist R. Andrew Sewell published an article that examined the cases of 53 patients with cluster headaches who self-administered psilocybin or LSD. 17 of 19 patients who used psilocybin during an attack reported cessation of attacks. In total, 25 of 48 patients who used psilocybin and 7 of 8 patients who used LSD reported that psychedelics completely stopped their cluster seizures.
Despite the lack of attention from medical professionals, the history of the study of psychedelics for pain relief has a long and interesting history.
The PPA database contains studies dating back to 1930 covering a variety of painful conditions such as fibromyalgia, phantom limb syndrome, and cancer pain. One of the reasons these studies have received little attention is the lack of randomization or placebo controls.
The debate over whether randomized placebo-controlled trials are the best methods for studying psychedelics is still ongoing (e.g., how do you «blind» someone to whether or not they are on acid?).
To date, research into psychedelics and pain is at a turning point. According to data from the PPA database, after studies in 1930, further research stopped until the 1960s, and it wasn't until the early 2020s that new studies began to appear about every ten years. That number grew to 16 in 2022, with 10 more studies in 2023. Thanks to the NIH grant, scientific interest in the topic could grow even more.
«We've made a tremendous effort over the past four years to bring attention to this issue» — said Wing, who founded PPA along with Psychedelics Today director Joe Moore and Clusterbusters founder Bob Wald.
The PPA database contains studies dating back to 1930 covering a variety of painful conditions such as fibromyalgia, phantom limb syndrome, and cancer pain. One of the reasons these studies have received little attention is the lack of randomization or placebo controls.
The debate over whether randomized placebo-controlled trials are the best methods for studying psychedelics is still ongoing (e.g., how do you «blind» someone to whether or not they are on acid?).
To date, research into psychedelics and pain is at a turning point. According to data from the PPA database, after studies in 1930, further research stopped until the 1960s, and it wasn't until the early 2020s that new studies began to appear about every ten years. That number grew to 16 in 2022, with 10 more studies in 2023. Thanks to the NIH grant, scientific interest in the topic could grow even more.
«We've made a tremendous effort over the past four years to bring attention to this issue» — said Wing, who founded PPA along with Psychedelics Today director Joe Moore and Clusterbusters founder Bob Wald.
https://onlinelibrary.wiley.com/doi/10.1111/papr.13203
A literature review conducted by anesthesiologist Selina van der Wal and colleagues in January 2023 examined a number of potential mechanisms of action. These ranged from activation of the brain's serotonin receptors (which are known to be involved in pain processing), changes in how brain regions communicate with each other and process pain perception, to the anti-inflammatory properties of psychedelics.
Wing is particularly interested in how psychedelics may update our understanding of how chronic pain works. In most cases, chronic pain lasts long after the underlying tissue damage has already healed. At this point, pain may no longer be a signal of damage to the body, but a stubborn prediction that the mind has learned to make about the body. From this perspective, chronic pain is like a haunting memory that the mind transforms into the present. This is why psychotherapy is one of the best tools we have for treating chronic pain, and can be a powerful combination with psychedelics.
Wing is particularly interested in how psychedelics may update our understanding of how chronic pain works. In most cases, chronic pain lasts long after the underlying tissue damage has already healed. At this point, pain may no longer be a signal of damage to the body, but a stubborn prediction that the mind has learned to make about the body. From this perspective, chronic pain is like a haunting memory that the mind transforms into the present. This is why psychotherapy is one of the best tools we have for treating chronic pain, and can be a powerful combination with psychedelics.
Many people believe that pain is simply a signal that is sent from the body to the brain to indicate the presence of an injury. However, this is not entirely true. In reality, pain is the result of central nervous system activity. This perception is part of the broad concept of predictive processing.
https://pubmed.ncbi.nlm.nih.gov/37015315/
Last August, oncologists at the National Cancer Institute, including Farah Zia, published a review identifying several directions for future research. Among them are exploring potential mechanisms of exposure, evaluating the efficacy of micro- and macrodoses, the need to include additional treatments, finding conditions that could benefit, and questions about the organization of treatment protocols.
Despite the importance of best practices in risk reduction and the value of communication with medical professionals, additional research is needed to prove the efficacy of psychedelics as a treatment for chronic pain. Rather than proving this anew, it should be established that this efficacy has already been proven.
For some conditions, such as cluster headaches, studies, including van der Wal's review, already recommend starting phase 3 trials to get FDA approval as soon as possible. But again, that's going to take a long time. And other conditions that lag behind cluster headaches will take even longer, causing people to suffer in the meantime.
One option is to recognize one fact: as far as psychedelics are concerned, the case is out of the bag...and given how many unmet needs people in pain have, people will use them.
State decriminalization efforts, along with investments in harm reduction and public education, can reduce the risks associated with punishing people seeking psychedelic treatment while the FDA approval process continues. Debates about medicine and decriminalization are artificial oppositions.
One option is to recognize one fact: as far as psychedelics are concerned, the case is out of the bag...and given how many unmet needs people in pain have, people will use them.
State decriminalization efforts, along with investments in harm reduction and public education, can reduce the risks associated with punishing people seeking psychedelic treatment while the FDA approval process continues. Debates about medicine and decriminalization are artificial oppositions.
A new book, Psychedelic Stories, describes the journey of the citizen science network Cluster Breakers, which continues to fill an important hole in knowledge and support due to a lack of professional leadership. The author explains that among the people she spoke to, the Clusterbusters Patient Network may have saved their lives, but they wanted to be able to consult with their doctors. Regulation would help them get standardized doses of treatment more easily and safely. And, of course, they hope that quality scientific research will help others find relief as well.
We have witnessed repeatedly that psychedelics have actually saved many people's lives. Have you, dear reader, witnessed this?
