CHRONIC PAIN | +80 articles

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Imperial College London

Can psychedelics reduce chronic pain?*

by Evan Lewis-Healey | PSYCHEDELIC SPOTLIGHT | 30 Nov 2021

Nine out of the 11 chronic pain sufferers interviewed say they experienced some kind of lasting pain reduction while self-medicating with psychedelics.

Psychedelics are proving to be a wonder drug for applications beyond treating anxiety and depression, and chronic pain may be no exception.

A recent publication by Imperial College London has investigated the effects of self-medicating psychedelics for chronic pain. Although the study was not conducted to assess the effectiveness of psychedelics in the treatment of chronic pain, the research opens the door to a number of clinical trials that are planning to be conducted in the next several years.

Chronic pain can come in many forms, but is broadly characterized as lasting pain for more than three months. The condition is more commonplace than you may think — around 20% of the global population has to live with it.

More serious and debilitating chronic pain conditions, such as fibromyalgia, have been causing doctors to scratch their heads for decades now; there is no explicit underlying cause of the condition, which means that treatments are rarely very successful.

Some patients are treated with antidepressants or opioids if the pain is relatively low-level. However, treatment can go as far as invasive neurosurgery — something that many patients would hope to avoid.

Despite the intensity of these more drastic treatments, many chronic pain patients are unable to feel long-lasting relief, which can have a huge impact on their quality of life.

“I just remember feeling really frustrated that I was in this situation. ‘When will it end, when will I feel normal again?'” said one chronic pain sufferer featured in the study. “I felt like my pain was controlling my life. There’s some hopelessness in that… legitimately thought I was probably never going to get better, or that I would never feel true happiness again, or comfort, or any of those things.”

With no known cure for chronic pain, many patients, in this dark sense of hopelessness, turn towards self-medication.

Psychedelics for chronic pain?

The burgeoning interest in the use of psychedelics has been brewing online for years now. There are huge forums that document people’s journey with psychedelics to treat chronic pain, many testifying to its great success.

For example, over 10,000 people have actively participated with “Clusterbusters”, a website and organization dedicated to using psychedelics to treat cluster headaches (a debilitating condition characterized by cycles of excruciating headaches).

While this may seem like there could be strong placebo effects at play here, the science of psychedelics argues otherwise. LSD, and other psychedelics, have been shown to have strong analgesic effects, with research going as far back as 1964. Another study has even investigated the effects of LSD on phantom limb pain, a mysterious condition where patients perceive severe pain in an amputated limb.

Building on this, researchers at Imperial College London decided to conduct a series of interviews on those that self medicate with psychedelics for chronic pain. The aim of the research was to pave the way for future clinical trials, informing them about optimal dosing, and to see how psychedelics may change a patient’s perception of their own debilitating pain.

In the study, PhD student Julia Bornemann, the lead researcher of the study, had an open conversation with 11 chronic pain sufferers who had self-medicated with psychedelics. Each patient was also asked to retrospectively rate how their pain levels had changed after their psychedelic session.

Many patients testified to the analgesic effects of psychedelics, with nine out of 11 saying that they had complete or at least partial analgesia during the experience.

One patient highlighted this sudden and drastic change: “I remember getting up… and just being absolutely painless… I was standing up, perfectly upright, straight. Normally I can’t put any pressure whatsoever on the right side of my body… I use crutches and canes most of the time, but I haven’t for a few days.”

This patient quote also shines a spotlight on another finding from the study — again, nine out of the 11 patients experienced some kind of lasting pain reduction. This is a remarkable finding considering these patients had suffered from pain for an average of around 10 years.

Moving forward with caution

The results here, however, need to be taken with a pinch of salt — the study was not intended to confirm whether psychedelics are effective in the treatment of chronic pain. Rather, it was to lay the groundwork for future clinical trials.

James Close, honorary clinical research fellow at the Psychedelic Research Centre and author of the study, highlights that a new study is to be conducted very soon, which will more rigorously assess the effectiveness of psychedelics for chronic pain. “Julia Bornemann and I are heading the team for a small mechanistic study looking at brain activity in people with fibromyalgia undergoing psilocybin assisted therapy. We’ve passed ethics and are due to start in Q1 of 2022.”

Close also sees promise in the use of psychedelics and is hopeful for the future. “As a specialist pain therapist working with these patients every day in the NHS, I hope this intervention will be able to help some people who’ve run out of treatment options for what can be a horrendous condition.”

*From the article here :

Can Psychedelics Cure Chronic Pain? | Psychedelic Spotlight

A promising study exploring the possibility of psychedelics treating chronic pain lays the foundation for future clinical research.

psychedelicspotlight.com

 

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Self-medication for chronic pain using classic psychedelics

Julia Bornemann, James B. Close, Meg J. Spriggs, Robin Carhart-Harris, Leor Roseman [2018]

This PPI venture was undertaken to involve people with lived experience (“contributor”) in the design phase of a future trial investigating the effects of psilocybin in people with fibromyalgia. The fibromyalgia population was chosen for potential psychedelic application because of its relatively common occurrence, central nervous system involvement, and high rates of mental health co-morbidities.

Those living with chronic pain report feeling misunderstood and invalidated. This highlights the need for intentional communication at early stages of research to ensure thoughtful design that prioritizes the specific needs of people with chronic pain. The accordingly selected methods of in-depth, open-ended discussions and the thematic analysis thereof are widely used in PPI. Further, such conversations effectively facilitate early involvement at the design stage of research. The product is a nuanced exploration of the chronic pain experience and warrants the following background to adequately contextualize.

Roughly 20% of the global population live with chronic pain, and it is considered one of the global leading causes of disability. Chronic pain is defined as pain lasting over three months and may remain even if the original injury has formally healed. Common chronic pain conditions include Chronic Low Back Pain, Headache, and Chronic Widespread Pain e.g. Fibromyalgia Syndrome. Living with chronic pain significantly impacts a person's ability to work, resulting in high levels of lost productivity, reportedly costing the UK economy £10.7 billion annually. The social implications of chronic pain are also considerable; over half of pain patients report that their condition has prevented them from seeing family and friends and that their pain contributes to significant social anxiety. Such increases in social isolation, as well as the general stress from constant pain, directly impact patients' psychological wellbeing; it is estimated that 20% of people with chronic pain experience comorbid depression, with rates up to 60% in conditions such as Fibromyalgia Syndrome. This well observed bidirectional relationship links stress to an increased likelihood of developing chronic pain.

Current guidelines recommend education, physical therapy and pharmacological interventions, such as non-steroidal anti-inflammatory drugs (NSAIDs), weak opioids, and antidepressants or anticonvulsants off-label. Second line treatments graduate to invasive procedures such as neurosurgery, neuromodulation, nerve blocks and radiofrequency denervation. However, several problems with the current strategies for treatment of chronic pain remain. Firstly, existing medications carry a number of unwanted side effects and can be habit forming, for example long-term opioid use is linked to dependence and has directly contributed to the ongoing international opioid crisis. Secondly, conventional interventions, both pharmacological and invasive, have high Number-Needed-to-Treat values and are only effective in up to 80%, leaving ~1 in 5 sufferers without pain relief. Finally, these treatments either neglect or fail to adequately address the psychological impact of chronic pain conditions, leading to growing numbers seeking alternative treatments and experiment with self-treatment. In cases where pain persists, patients can be referred to multidisciplinary pain management programmes (PMPs), which aim to support individuals to effectively manage and live with their pain through education, physical therapy and psychological therapies such as Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT). CBT and ACT are well-established trans-diagnostic behavior-based psychological therapies which aim to improve awareness and reduce harm caused by negative thought patterns. Their shared foundation focuses upon Cognitive Reframing/Restructuring, a process in which thoughts and beliefs are identified, examined, their relative importance is reviewed, and maladaptive beliefs are updated with therapeutically useful, often positive, ones. Evidence suggests such cognitive reframing is transdiagnostically useful, resulting in improved outcomes in healthy populations, depression, Post-Traumatic Stress Disorder (PTSD), and chronic pain. While PMPs are the sole treatment option to directly address the prevalent mental health comorbidities associated with chronic pain, their efficacy is largely limited to the short term and attrition/relapse rates remain high.

Used in combination with psychological support, LSD, psilocybin, and DMT appear to exhibit promising therapeutic effects in conditions such as depression, addiction, and end-of-life anxiety. The safety profile of psychedelics is well-established as largely physiologically benign, though psychologically challenging periods are common during acute experiences. Case reports of persisting perceptual changes exist, though these are rare. Historically, there has been interest in using psychedelics to treat chronic pain; preliminary studies from the 1960s and 70s suggest that psychedelic drugs may be therapeutically useful, specifically for cancer pain and phantom limb pain. Although the results of these historical trials all show promising results, they lacked the methodological rigor of modern trials making it difficult to draw strong inferences on their findings. Contemporary studies suggest that psychedelics may be therapeutically useful in treating intractable headaches such as migraine and cluster headaches, and two recent reviews hypothesize potential mechanisms and applications for psychedelics in chronic pain. Pharmacologically, this concept is plausible. The primary mechanism of action of classic psychedelics is via the 5-HT2A serotonin receptor, which is integral to inflammatory pain. Data suggests that psychedelics reduce inflammation via the downstream effects of 5-HT2A agonism such as TNF regulation, and may result in desensitized central pain responses (66). The acute effects of psychedelics may also contribute toward an analgesic response by reorienting attention away from unpleasant sensations toward altered perceptions, e.g., visual hallucinations.

While research has stalled for decades due to the legal status of psychedelic drugs, public interest has not. Psychedelic self-medication has grown in popularity in recent years, reportedly making up 14.8% of self-reported psychedelic substance use and first time LSD-use having increased ten-fold in 10 years in adults over 26. Methods of use range from the semi-regular taking of sub-perceptible doses (known as “microdosing”) to isolated high dose sessions emulating clinical contexts to address mental health concerns. Notably, anecdotal reports of effective management of chronic pain have been prevalent; online forums such as Erowid and Reddit contain hundreds of reports of effective treatment for chronic pain conditions such as Fibromyalgia (ErowidFMS), Chronic Back Pain (ErowidCBP), and Rheumatoid pain (RedditEDS). The largest group of reports concern chronic cluster headaches and migraines, with over 10,000 people participating in the organization “Clusterbusters,” dedicated to the treatment of headaches with psychedelics.

*From the article (including references) here :

Self-Medication for Chronic Pain Using Classic Psychedelics: A Qualitative Investigation to Inform Future Research

Background: Chronic Pain is among the leading causes of disability worldwide with up to 60% of patients suffering from comorbid depression. Psychedelic-assisted therapy has recently been found effective in treating a host of mental health issues including ...

www.ncbi.nlm.nih.gov

 

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How to use CBD for pain

LA Weekly

The pain-relieving properties of CBD are well recognized in different parts of the world. A large number of people are now using this compound for dealing with pain. CBD is now replacing the prescription medicines that are commonly used for pain. This hemp-derived compound can be useful for avoiding the side effects associated with opioids and other medicines which are prescribed for controlling chronic pain. We are listing some of the important pain-relieving properties of CBD that can help you to find out whether you can also use CBD for pain.​

Can you use CBD for chronic pain?​

CBD can be used for reducing chronic pain that is associated with many diseases. Our body has a system called the endocannabinoid system (ECS), which manages different functions in the body. It can regulate pain, immune responses, appetite, mood changes, etc.

Researchers suggest that CBD interacts with the endocannabinoid receptors that are distributed all across your body. Receptors are tiny proteins that are attached to the cells in your body. These receptors have the ability to receive signals from different stimuli and will help your cells to respond.

These responses can create pain-relieving and anti-inflammatory effects that are useful for pain management. Hence, using CBD oil or other CBD products can help people to deal with chronic pain. Studies suggest that CBD can be useful in dealing with neuropathic pain, cancer pain and pain associated with fibromyalgia. Therefore, CBD can be effective for overall pain management without causing much side effects.​

How can CBD help with arthritis pain?​

Arthritis, which is a common autoimmune disease, can result in severe pain and inflammation in your joints. Arthritis cannot be cured, but controlling its symptoms can be helpful in preventing this disease from getting worse.

A study conducted in 2019 for finding out the effectiveness of CBD for arthritis showed promising results. This study used rats with arthritis as subjects and administered different doses of CBD for each rat. The researchers noted that there was a considerable reduction in pain and inflammation in the joints of affected rats. Hence, it was concluded that CBD can be useful for reducing pain, inflammation, and swelling associated with arthritis in humans too.​

Can you use CBD for cancer pain?​

Cancer and its treatments can often result in severe pain in patients. Patients who have undergone cancer treatments like chemotherapy and radiation suffer from different side effects including pain, inflammation, nausea, etc. Even though there are a lot of prescribed medicines available for controlling them, they all come with a large number of side effects. But now CBD can be a great relief for cancer patients for reducing the pain associated with cancer and its treatments.

Most of the studies used THC along with CBD for controlling pain associated with cancer. THC is the psychoactive compound in cannabis that is known across the world for its intoxicating effects. Hence, more studies are needed to find out the effectiveness of CBD alone for controlling the pain associated with cancer.​

Can CBD help with migraine? ​

A lot of people are using CBD for controlling migraines. This is a neurological condition that can result in a large number of symptoms including headache, vomiting, nausea, sensitivity to light, etc. This is a condition that affects a large number of people across the world.

Migraine can cause powerful headaches which can be unbearable at times. As CBD is found to be useful for controlling this pain, many people are choosing this natural compound over other prescribed medications.

Studies conducted for finding out the effectiveness of CBD for migraine used a combination of CBD and THC. It is found that this combination was helpful in reducing the pain associated with migraine by a considerable amount. However, more studies are needed in this field for finding out the effect of CBD for pain caused by migraine.​

How to use CBD for pain​

You can choose a variety of methods for consuming CBD for pain. If you want immediate results it is better to choose smoking/vaping, where you will get the results in a few minutes itself. The sublingual method can also give you fast relief, but not as fast as vaping/smoking.

If you are not comfortable with these methods, you can choose a product that can be taken orally. There are a lot of CBD pills, capsules and edibles available in the market that can help you to consume CBD easily.

In addition to this, you may also choose CBD topicals that you can apply directly to the infected areas for reducing the pain and inflammation. Different topicals including CBD lotions, creams, salves, ointments, balms, etc. are available in the market that you can use based on your convenience.

The large number of CBD products available in the market helped users to choose a method that is comfortable for them. This compound might also be useful for you, if you are searching for a natural product that does not cause much side effects and can effectively control pain.

How To Use CBD For Pain - LA Weekly

The pain-relieving properties of CBD are well recognized in different parts of the world. CBD is now replacing the prescription medicines that are commonly used for pain.

www.laweekly.com

 

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: Image credit to Julia at Hinterland
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Medicinal cannabis shown to reduce pain and the need for opiate painkillers among cancer patients

Frontiers | 20 May 2022

Most cancer patients who used medical cannabis reported a significant improvement in pain measures and a decrease in some other cancer-related symptoms. Additionally, medical cannabis use reduced the consumption of traditional, opioid-based pain killers for those with cancer.

A comprehensive assessment of the benefits of medical cannabis for cancer-related pain found that for most oncology patients, pain measures improved significantly, other cancer-related symptoms also decreased, the consumption of painkillers was reduced, and the side effects were minimal.

Published in Frontiers in Pain Research, these findings suggest that medicinal cannabis can be carefully considered as an alternative to the pain relief medicines that are usually prescribed to cancer patients.

Pain, along with depression, anxiety, and insomnia, are some of the most fundamental causes of oncology patient’s disability and suffering while undergoing treatment therapies, and may even lead to worsened prognosis.

“Traditionally, cancer-related pain is mainly treated by opioid analgesics, but most oncologists perceive opioid treatment as hazardous, so alternative therapies are required,” explained author David Meiri, assistant professor at the Technion Israel Institute of Technology.

“Our study is the first to assess the possible benefits of medical cannabis for cancer-related pain in oncology patients; gathering information from the start of treatment, and with repeated follow-ups for an extended period of time, to get a thorough analysis of its effectiveness.”

Need for alternative treatment

After talking to several cancer patients, who were looking for alternative options for pain and symptom relief, the researchers were keen to thoroughly test the potential benefits of medicinal cannabis.

“We encountered numerous cancer patients who asked us whether medical cannabis treatment can benefit their health,” said co-author Gil Bar-Sela, associate professor at the Ha’Emek Medical Center Afula. “Our initial review of existing research revealed that actually not much was known regarding its effectiveness, particularly for the treatment of cancer-related pain, and of what was known, most findings were inconclusive.”

The researchers recruited certified oncologists who were able to issue a medical cannabis license to their cancer patients. These oncologists referred interested patients to the study and reported on their disease characteristics.

“Patients completed anonymous questionnaires before starting treatment, and again at several time points during the following six months. We gathered data on a number of factors, including pain measures, analgesics consumption, cancer symptom burden, sexual problems, and side effects,” said Bar-Sela.

Improved symptoms

An analysis of the data revealed that many of the outcome measures improved, with less pain and cancer symptoms. Importantly, the use of opioid and other pain analgesics reduced. In fact, almost half of the patients studied stopped all analgesic medications following six months of medicinal cannabis treatment.

“Medical cannabis has been suggested as a possible remedy for appetite loss, however, most patients in this study still lost weight. As a substantial portion were diagnosed with progressive cancer, a weight decline is expected with disease progression,” reported Meiri.

He continued: "Interestingly, we found that sexual function improved for most men, but worsened for most women.”

Meiri would like future studies to dig deeper and look at the effectiveness of medicinal cannabis in in different groups of cancer patients.

“Although our study was very comprehensive and presented additional perspectives on medical cannabis, the sex, age, and ethnicity, as well as cancer types and the stage of the cancer meant the variety of patients in our study was wide-ranging. Therefore, future studies should investigate the level of effectiveness of medicinal cannabis in specific subgroups of cancer patients with more shared characteristics.”​

Effectiveness and safety of medical cannabis in treating cancer-related symptoms

The use of medical cannabis (MC) to treat cancer-related symptoms is rising. However, there is a lack of long-term trials to assess the benefits and safety of MC treatment in this population.

In this work, we followed up prospectively and longitudinally on the effectiveness and safety of MC treatment. Oncology patients reported on multiple symptoms before and after MC treatment initiation at one-, three-, and 6-month follow-ups.

Oncologists reported on the patients’ disease characteristics. Intention-to-treat models were used to assess changes in outcomes from baseline. MC treatment was initiated by 324 patients and 212, 158 and 126 reported at follow-ups.

Most outcome measures improved significantly during MC treatment for most patients. Specifically, at 6 months, total cancer symptoms burden declined from baseline by a median of 18%. Reported adverse effects were common but mostly non-serious and remained stable during MC treatment.

The results of this study suggest that MC treatment is generally safe for oncology patients and can potentially reduce the burden of associated symptoms with no serious MC-related adverse effects.

Original Research: Open access.
“The Effectiveness and Safety of Medical Cannabis for Treating Cancer Related Symptoms in Oncology Patients” by Joshua Aviram et al. Frontiers in Pain Research

Medicinal Cannabis Shown to Reduce Pain and Need for Opiate Painkillers Among Cancer Patients - Neuroscience News

Most cancer patients who used medical cannabis reported a significant improvement in pain measures and a decrease in some other cancer-related symptoms. Additionally, medical cannabis use reduced the consumption of traditional, opioid-based pain killers for those with cancer.

neurosciencenews.com

 

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Gabapentin helped my chronic pain – but it's also killing people*

by Abi Palmer | Vice | 1 Apr 2022

At the end of my first week using gabapentin, I awoke butt naked, face down, in a diamanté choker. The night before, I’d been celebrating a friend’s birthday in the secret lounge above a wood-panelled strip club in east London. The party was full of ladies holding apples and wrapped in live snakes. “It feels like a party one of the Kennedys would have been photographed at,” I texted my boyfriend.

While a lot was unusual about the evening, strangest of all was the fact I had been in attendance. For the entire year before, I’d barely been able to function, crashing into out-of-body experience and paralysis with so much pain and fatigue that I had to drop out of university to attend a physical rehabilitation programme. The entire act of attending a party, and casually falling asleep afterwards, was alien to me.

I was prescribed gabapentin in 2013, as an inpatient at a sleep clinic. My consultant observed that I was waking 17 times an hour and diagnosed neuropathic pain, a side effect of my many other musculoskeletal conditions. Apparently the hallucinations and paralysis I was experiencing are common side effects of extreme sleep deprivation. The consultant told me that the medication was usually used to treat epilepsy and that I was being offered an off-label usage, emphasising that it might not work – and if it did, we wouldn’t know why.

Within weeks of taking gabapentin, my hallucinations and paralysis had settled down. A strange side effect was that I stopped having to stretch my legs excessively before bed. Previously, I’d required between one to three hours of physiotherapy to ease the cramping.

Beyond partying, by the end of 2013 my newfound energy allowed me to return to university for two more years. But I also learned that gabapentin was not a drug to be messed with. The first time I missed a dose, I woke at 4AM, sweating profusely, hallucinating little spiders running over my skin. To avoid withdrawal, I made sure I always had several additional months’ worth of prescription in my cupboard. During uni, when I found my fatigue increasing, I wondered if it might be the old restless legs playing up again. A doctor gave the OK for me to increase my gabapentin dosage to 900mg from 600mg. After all, I’d initially been told it was harmless.

Shayla Love’s 2019 VICE article about the gabapentinoid scandal sent ripples of shock through the sick and disabled community. “GABAPENTIN IS A PLACEBO AND IT’S DANGEROUS,” one of my friends posted on Facebook. “Be careful out there.”

The article details the manner in which gabapentinoids – anticonvulsant medications such as pregabalin and gabapentin – had been aggressively marketed as an off-label treatment for multiple hard-to-treat and poorly researched conditions, including chronic pain, anxiety and phantom limb syndrome. In most cases, there was little clinical evidence to suggest that the drugs provided any medical advantage. In some trials, they were less effective than placebo. Worse still, they had been connected to higher risk of death, suicidality and opioid misuse (gabapentinoids proved popular among heroin users, due to their ability to increase highs and make the lows more manageable).

Meanwhile, deaths in the UK attributed to gabapentinoids had increased dramatically – particularly among prison populations – jumping from tens to hundreds in the six years between 2012 and 2018. Just a few months before I was aware of any potential harm, they had been urgently upgraded to a controlled class 3 substance in the UK, meaning tighter prescription regulations. NHS guidance stated in bold: “It is not helpful or appropriate for anyone to stockpile these medications.”

In the wake of this news, I found myself questioning my use of gabapentin. Was my initial energy due to finally sleeping through the night, or was it simply the drug’s euphoric side effects? It was possible, but my late-night googling also suggested that gabapentinoids might have a positive impact on my particular brand of nerve pain, and that alternative treatment options were limited. It seemed to have helped – it had changed my life – and I didn’t know what else to do.

The medical community was also reacting to the drug’s updated profile. A new GP approached my prescription with an unexpected hostility. “If you want to keep on taking this medication, we’re not the surgery for you,” she said. When I explained the basis for my gabapentin use, she rolled her eyes. “It’s a prison drug. For all I know, you could be selling your medication to prisons.”

Rather than address the issue I was there to discuss, I ended up spending the best part of my appointment attempting to persuade her that I was a responsible patient, followed by two panicked weeks where I was unsure whether my repeat prescriptions would continue. Eventually, I was able to return to the surgery and discuss my situation with a more empathetic doctor, who honoured my prescription immediately and helped me consider a longer-term pain management strategy.

The gabapentinoid scandal is fuelled by a history of chronic pain patients being underserved. A 2017 New England Journal of Medicine article suggests that the increased prescription of gabapentinoids is a direct response to the opioid epidemic, with practitioners looking for a fast and effective alternative solution to chronic pain conditions, which can be complex and need time to manage. Chronic pain patients are often reminded that there’s no magic pill to completely cure a chronic pain condition, but it doesn’t feel like the medical system has caught up with this fact, or really addressed how it might change its procedures.

Recently, new NICE guidelines were issued to propose that doctors offer absolutely no pain relief medication to patients with chronic pain, instead advising treatments such as exercise, CBT and acupuncture. The guidance focuses on the risk of addiction, even with medications such as paracetamol and aspirin. Whilst these guidelines primarily focus on chronic pain without an “underlying condition,” it’s worth acknowledging how long it takes for pain to be taken seriously by a medical professional, how little funding or research there is into chronic pain, and how ill-equipped medical services are to deal with ongoing conditions.

Navigating pain is becoming an increasingly traumatic minefield, with doctors “correcting” their colleagues’ prescription choices in ways that punish the patient. In the US, 70 percent of respondents to a survey by Pain News Network reported that doctors had reduced or simply cut off their prescriptions, with reports of no withdrawal plan being offered. In response to the UK’s new NICE guidelines, a statement issued by the Faculty of Pain Medicine lists the risk of “the potential withdrawal of useful medications from patients by GPs” as one of their primary concerns.

Within a decade, gabapentinoid users like myself have had to adjust from having cupboards overflowing with too much medication, to being treated with suspicion and threat. No symptoms are improved by this experience of panic, stress and stigma.

The constant fear of having our bodies policed by medical professionals under constantly changing guidelines leads to so much mistrust in the patient/doctor relationship that we are more likely to end up making risky or unsafe decisions for ourselves with little oversight. Although gabapentinoids require a prescription, patients who are frantic and at risk of withdrawal are more likely to turn to fake and illegal versions, which are easily accessed online.

For my part, I’m well aware that gabapentin is far from a perfect drug. My brain is often very foggy, and it’s unclear if this is due to my strange body or the well-charted side effects of the medication. I am uncomfortable with my dependency and terrified of the consequences of stopping. The GP who threatened to turn me away from her surgery did not have a positive impact on my gabapentin usage, but requesting my prescription each month now provokes a spiral of anxiety, guilt and shame. I also still don’t really understand my alternative options.

Instead of the substantial medical research and funding we deserve, we are faced with a reality where every medical interaction we have is at the mercy of the crimes that came before us: a marketing scandal, overprescription, pills in lieu of adequate trauma therapy, all the way back to the still-too-common accusation that pain is a symptom of hysteria.

If medical practitioners want to help their chronic patients, and avoid becoming part of the next wave of scandal and repercussions, it is important to attempt to remove their biases: to offer patients a space where they are able to speak honestly about their present needs and experiences, time to review medication, ask questions and explore alternatives. In the long run, better funding for research and long-term treatment options is essential, but right now, the best way for doctors to support their chronically ill patients is through collaboration and dialogue: to offer them trust, and seek to earn it.

*From the article here :

This Drug Helped My Chronic Pain – But It's Also Killing People

The messy fallout of the gabapentin scandal.

www.vice.com