• Psychedelic Medicine
  • Psychedelic Medicine Moderator: mr peabody
  • Bluelight HOT THREADS
  • Let's Welcome Our NEW MEMBERS!

News CHRONIC PAIN | +100 articles | Can Psychedelics Treat Pain?

mr peabody

Moderator: Music Discussion, PM
Staff member
Joined
Aug 31, 2016
Messages
5,295
Location
Frostbite Falls, MN

Researchers report 20 micrograms of LSD delivers similar analgesic results
to opioids such as oxycodone and morphine in an acute pain test.

First-of-its-kind LSD microdosing trial for acute pain relief reports remarkable results

by Rich Haridy | NEW ATLAS | 26 Aug 2020

An incredible, first-of-its-kind trial testing the pain-killing properties of LSD microdoses has delivered the compelling suggestion that tiny, non-psychedelic doses of this infamous drug could serve as an effective analgesic.

Back in the 1960s, during the original heyday of psychedelic science, one of the more fascinating research areas for LSD was its unexpected efficacy as an analgesic. Researcher Eric Kast was one of the pioneer investigators on the topic, publishing over a dozen key papers exploring the ways pain perception is influenced by LSD.

Kast’s work was primarily with active psychedelic doses of LSD, and he consistently found the drug produced effective, and protracted, analgesic effects. Unfortunately, Kast’s work with LSD ended, as most psychedelic research did, when access to the drug was restricted in the late 1960s.

Decades later, as the freeze on psychedelic research begins to thaw, the idea of LSD as a pain-reliever still sits on the fringes of psychedelic science. No modern clinical researcher has returned to Kast’s ideas, however, anecdotal cases have begun to emerge highlighting some people self-medicating with LSD microdoses to treat chronic pain.

This new study, led by researchers from Maastricht University with assistance from the Beckley Foundation, is the first clinical trial to revisit this topic in more than 50 years. Unlike Kast’s prior work, this new research focused on microdoses of LSD rather than larger, actively psychedelic doses.

“From a medical point of view, controlled research on the efficacy of LSD in pain management should focus on non-hallucinogenic, low doses of LSD, which are more manageable and thus preferable over treatment with high doses of LSD that produce full-blown psychedelic effects,” the researchers explain in their paper.

The double-blind, placebo-controlled trial recruited 24 healthy subjects, each of whom took part in four separate experimental sessions, separated by at least five days. Three different LSD microdoses were tested (five, 10, and 20 micrograms) alongside a placebo.

During each experimental session, the subjects completed a Cold Pressor Test (CBT) at two time points following dosing: 90 minutes after and five hours after. The test basically involves plunging one’s hand into a tank of water at 3 °C (37.4 °F). Pain tolerance is measured by combining the amount of time one can hold their hand in the cold water, with a series of subjective ratings regarding painfulness.

The researchers described the results of the study as “remarkable”, with the 20-µg-dose group revealing prolonged improvements to pain tolerance compared to both lower doses and placebo. The results were sustained across both time points suggesting the analgesic effect is just as prominent five hours later as it is within the first 90 minutes.

“The current data consistently indicated that LSD 20 µg significantly reduced pain perception as compared with placebo, whereas lower doses of LSD did not,” the researchers write. “LSD 20 µg significantly increased pain tolerance (i.e. immersion time) by about 20%, while decreasing the subjective levels of experienced painfulness and unpleasantness.”

So what exactly is going on here? Is LSD just distracting people from the acute pain, or is it actually inhibiting pain signaling through a more direct pharmacological mechanism?

Kast hypothesized 50 year ago these analgesic effects were the result of LSD reorienting attention away from pain sensations to a more encompassing psychedelic experience. While that hypothesis certainly is reasonable when high LSD doses are administered, it doesn’t really explain the results seen in this new microdose trial.

The researchers do note a small correlation between increasing levels of psychedelic disassociation and greater pain relief in their results, but the association was weak. They estimate it accounting for no more than six percent of the variance in analgesic results.

A variety of possible alternate hypotheses are presented in the new study, from pharmacologically influencing specific brain receptors known to mediate pain sensation, to triggering a condition called hypertension-associated hypoalgesia whereby blood pressure rises can lead to a diminished perception of pain.

“… an extended dose-finding study is needed to determine the dose at which analgesic effects of LSD are optimal, i.e. when efficacy is maximal and mental interference is minimal,” propose the researchers. “Such a study could potentially explore the trade-off between increments in treatment efficacy and psychedelic symptoms in a low to medium dose range (i.e. 20–50 µg LSD).”

Perhaps the most intriguing finding in the study is the observation that the analgesic effect seen in the 20-µg LSD group is comparable to what prior studies have seen with in the same cold water pain test for opioids such as oxycodone and morphine.

Needless to say, a great deal more research is needed before these results can be extrapolated into any real-world clinical treatment. Will these LSD microdose results translate into pain relief for chronic pain sufferers? Or is this kind of analgesic best for certain types of acute pain? What are the safety issues surrounding long-term use?
Does a tolerance eventually build to low-dose LSD?

At the very least these promising results suggest further clinical trials are necessary as modern researchers slowly catch up with where the science was half a century ago.

The new study was published in the Journal of Psychopharmacology.

 

mr peabody

Moderator: Music Discussion, PM
Staff member
Joined
Aug 31, 2016
Messages
5,295
Location
Frostbite Falls, MN



I Can Live Again!

by Tim Riley | LDN Science | 1 Mar 2017

Low Dose Naltrexone dramatically reduced my severe chronic back pain, making opiates obsolete.

Please tell us a little about your health condition.

In 1998 I had 2 back operations that failed and left me in a lot more pain than ever. We're talking constant pain. Every 3-6 months, I'd see yet another doctor and do another procedure (epidurals, burning of the nerves, steroid injections). They did over 30 procedures on my lower back, but nothing seemed to work. I was in an incredible amount of pain.

What was your pain like before LDN?

It was constant and crippling. I'd wake up in the morning and think, Where is my medication? I'd have to pop a pill and wait 20 minutes for it to take effect in order just to get up out of bed. I had to hang onto things, like the countertop, in order to walk. It took me an hour to get going in the morning. I'm only 63 now but I felt like a very old man.

How did your doctors treat your pain?

The doctors put me on high doses of long-acting morphine, and short-acting and extended-release oxycodone. At one point, I would take 60 mg of long-acting morphine in the morning, another 60 mg again at night, and every 4 hours during the day I would take an oxycodone. Here I was taking all those heavy duty drugs, and my body was depending on them. 3 to 4 four hours after taking oxycodone, the pain would flare up again and Id feel like I needed to take it again.

Why did you want to get off opiate-based medications?

I was on those medications for 12 years. I was able to get off of them, but then eventually had to go back on them for another 5 years. A couple times the pain got so bad, I took more than my usual amount. But if you run out of your medication early and you need more (because you cant do without it), you are looked at like a criminal. It was so depressing. If you do one thing wrong, doctors will throw you out of their practice. First they tell you that you need morphine, and then, a year later, they are locking doors behind you. They are treating you like a criminal, requiring urine tests, and scrutinizing your every move. At one point, I couldn't stand it any longer. I was going to commit suicide. I wanted off those other medications.

How did you come to take LDN?

About 16 months ago, after telling my doctor I wanted to get off all opiates, he told me to go to a detoxification center that deals specifically with people with chronic pain. By giving me various other medications for different periods of time, they were able to help me get off all the opiates. As part of their treatment, they gave me shots of Vivitrol, and I started to feel much better. After a year, though, insurance no longer covered those treatments. So, I needed to find something else. I had been reading about low dose naltrexone and decided to pursue it. I found a doctor willing to prescribe 50 mg naltrexone pills to me that I dissolved in water, and I dosed myself with 4.5 mg of LDN each morning. I've been on LDN for about 3 months. I haven't felt this kind of pain relief in over 20 years.

How successful has LDN been in reducing your pain?

I have 75-80% less pain than when I was taking opiates. LDN is affordable and has virtually no side effects. Even with all that, its infuriating that most doctors aren't interested in it. I asked my doctors about LDN every now and then over the years, and they dismissed it, saying that it didn't work. But it does. Yesterday I forgot to take my LDN, and I started to feel the pain return. I took it this morning, and now the pain is gone.

Has LDN affected you in any other way?

I also have COPD, which is a lung disorder. I usually have 2-3 bouts with it during the wintertime, but this winter (since Ive been on LDN) I haven't had any exacerbations. Also, my mood is better. When I was on all those opiates, although I never allowed myself to get really depressed, I had to really fight becoming depressed. Now, because I'm in so much less pain, I don't have to struggle to stay positive.

You mentioned that you take LDN in the morning. Why?

I tried taking it at night, but I couldn't sleep well. So, I started taking it in the morning instead, and it worked just as well without any side effects at all. I could probably try taking it at night again and see if my body has adjusted to it already.

What's been the biggest change for you since starting LDN?

I can walk freely. I just step out of the bed, and I'm walking right away. Like normal. It's incredible. I could walk right across the street. My spine is like a disaster area, so that's really saying something. I'm not 100% pain free, but I can do a lot more than before. LDN has been amazing for me. I am now doing better than I ever was when taking all those heavy duty opiates. There's a radio commercial that says, When you're living on pain meds, you're not really living. I can live again!

What would you like to tell people in the same position as you once were?

If you're in chronic pain and you want to get off opiates, but you're afraid to, I'd recommend finding a detox program that deals with chronic pain patients. After you get off the opiates, I recommend you try LDN. Hopefully you'll get better pain relief than you ever had before. It might set you free.

https://www.ldnscience.org/resources...onic-back-pain
 
Last edited:

mr peabody

Moderator: Music Discussion, PM
Staff member
Joined
Aug 31, 2016
Messages
5,295
Location
Frostbite Falls, MN



Ketamine more effective than opioids for acute pain*

by Brandon May | Clinical Pail Advisor | 18 Dec 2020

Ketamine may be a more effective treatment option than opioids for prehospital acute pain, according to findings from a systematic review study published in the BMJ Open. Ketamine likely decreased pain more than opioids, but had a notable higher risk for agitation.

The review included 8 studies comprising a pooled cohort of 2760 adult patients with prehospital acute pain who were treated with either ketamine, opioids, or nitrous oxide. Studies included in this review were 4 randomized controlled trials, 1 cluster randomized trial, 1 prospective cohort study, and 2 retrospective studies.

Across studies, comparisons were made between intravenous (IV) ketamine and IV opioids, IV ketamine with IV morphine vs IV morphine alone, continuous IV ketamine vs single-dose IV ketamine, intranasal ketamine with nitrous oxide vs nitrous oxide alone.

According to the investigators, there were 5 studies in the review that had high risks of bias. In a cluster randomized controlled trial of 308 patients and a retrospective cohort of 158 patients, treatment with ketamine was associated with probable lower pain scores compared with opioids (change in visual analogue scale, prior to hospitalization}.

The researchers also found that treatment with ketamine probably led to less nausea and vomiting compared with opioids, but greater agitation.

A limitation of the study, according to the researchers, was the potential lack of other studies that may have generated more relevant results, including studies not published in English. Also, none of the studies included in the review were powered to assess the safety of ketamine in this patient population.

Based on this review, the researchers concluded that treatment with IV ketamine in analgesic doses of 0.1 to 0.2mg/kg “appears to be at least as effective as opioids administered alone considering pain reduction.”

*From the article here:
 

Spacecowboys_gurl

Greenlighter
Joined
Sep 21, 2021
Messages
2
I have chronic pain. I was coming home from work waiting to turn, i was behind 3 other cars. Normally I'm looking around but that day I had worked the morning shift, song came on the radio "sugar" my exes and mine song. I sat there just listening waiting when it felt like I had been pushed into a brickwall. I sat stunned, didn't move blink nothing for several moments and snapped out of it and thought OMG someone just hit me. I'd just leased the car, I was making good money at a new job so when I got out I didn't know if the car would lock me out. She sat in the car, not moving nothing...finally she said to pull into the parking lot. After speaking I recognized her from an old boyfriend, she bought ritalin off him and when I said I knew her from Chad she said, "oh,I don't do drugs anymore"! It was 225pm and her short blonde hair was matted and she was high! I was vibrating, still had on my apron, hairnet and name tag and she said you're trembling! No shit, i was just rearended. Next day i went to the er, and with my ex he was an addict and the way people treated him when we went to the hospital it enraged me, i started speaking for him. When the triage nurse saw i was on ritalin the tone changed, there are sick people here! The doctor who id let in the drs lounge when i worked security treated me the same, actually asked if he could get food, i worked in the hospital kitchen. I was amazed, asked why i was on so many pills, how long i was on them? Never did an examination, i asked for a time off slip so i could see my family dr. Turns out the accident triggered fibrodmyalgia (sp). I was had mri,xray and i was told you have chronic pain and will for the rest of your life. I lived for 9 months with no pain relief i contimplated suicide but my ex husband is abusive and i could never leave my kids with him. I was put on percocet 4 a day, tgey dont work if im stressed, upset or if i do too much. I want to go back to work, but im noy ready, if i go back now ill take more pills than i should and ill end up like my ex im up to 5 a day...im miserable im in so much pain. I take ediables to put me to sleep. I dont know what to do, i cant live off insurance disability i need to get back to work. My doctor doesnt listen to me....i need help and i dont know where or who to go. In an instant she ruined my life.
 

mr peabody

Moderator: Music Discussion, PM
Staff member
Joined
Aug 31, 2016
Messages
5,295
Location
Frostbite Falls, MN
I have chronic pain. I was coming home from work waiting to turn, i was behind 3 other cars. Normally I'm looking around but that day I had worked the morning shift, song came on the radio "sugar" my exes and mine song. I sat there just listening waiting when it felt like I had been pushed into a brickwall. I sat stunned, didn't move blink nothing for several moments and snapped out of it and thought OMG someone just hit me. I'd just leased the car, I was making good money at a new job so when I got out I didn't know if the car would lock me out. She sat in the car, not moving nothing...finally she said to pull into the parking lot. After speaking I recognized her from an old boyfriend, she bought ritalin off him and when I said I knew her from Chad she said, "oh,I don't do drugs anymore"! It was 225pm and her short blonde hair was matted and she was high! I was vibrating, still had on my apron, hairnet and name tag and she said you're trembling! No shit, i was just rearended. Next day i went to the er, and with my ex he was an addict and the way people treated him when we went to the hospital it enraged me, i started speaking for him. When the triage nurse saw i was on ritalin the tone changed, there are sick people here! The doctor who id let in the drs lounge when i worked security treated me the same, actually asked if he could get food, i worked in the hospital kitchen. I was amazed, asked why i was on so many pills, how long i was on them? Never did an examination, i asked for a time off slip so i could see my family dr. Turns out the accident triggered fibrodmyalgia (sp). I was had mri,xray and i was told you have chronic pain and will for the rest of your life. I lived for 9 months with no pain relief i contimplated suicide but my ex husband is abusive and i could never leave my kids with him. I was put on percocet 4 a day, tgey dont work if im stressed, upset or if i do too much. I want to go back to work, but im noy ready, if i go back now ill take more pills than i should and ill end up like my ex im up to 5 a day...im miserable im in so much pain. I take ediables to put me to sleep. I dont know what to do, i cant live off insurance disability i need to get back to work. My doctor doesnt listen to me....i need help and i dont know where or who to go. In an instant she ruined my life.
You work in a hospital, is that correct?
 

mr peabody

Moderator: Music Discussion, PM
Staff member
Joined
Aug 31, 2016
Messages
5,295
Location
Frostbite Falls, MN



Hope for chronic pain sufferers with Fibromyalgia*

by dispensaries.com | 23 Sep 2021

When it comes to the health benefits of cannabis, better pain management always ranks high on the list. It’s the reason many people turned to medical cannabis in the first place (often as a replacement for opioids). But it’s of special importance to those with Fibromyalgia.

Chronic pain is one of the unfortunate characteristics of Fibromyalgia, a condition that also causes fatigue, memory problems, and difficulties sleeping. Patients suffer from the condition without any well-defined, underlying organic disease, and the exact cause of fibromyalgia remains unknown.

A new literature review of 22 scientific papers conducted by the California Institute of Behavioral Neurosciences and Psychology investigated the use of cannabis or synthetic cannabinoids with fibromyalgia patients. They report that the studies “suggest that medical cannabis is a safe and effective treatment for Fibromyalgia pain,” although there are some limitations.

Fibromyalgia impacts between 5 and 7 percent of the population.

Millions of people worldwide suffer from Fibromyalgia. In the United States and Europe, about 4 percent of the population has Fibromyalgia syndrome (FMS), according to the study. About twice as many women as men suffer from the syndrome. FMS can develop at any age, and often happens in connection with rheumatic diseases.

Because so many studies have found that cannabis provides effective treatment for pain - and promotes better sleep - it’s often mentioned as a possible medication for FMS patients. A handful of studies have looked at the issue through the years. They include:​
  • A 2008 study involving 40 fibromyalgia patients that found the synthetic cannabinoid nabilone had significant pain-relieving effects​
  • A 2011 study involving 28 patients who used cannabis for Fibromyalgia and found that 43 percent reported strong pain relief and 43 percent reported mild pain relief​
  • In that same 2011 study, 81 percent of participants reported that cannabis provided strong relief from Fibromyalgia-related sleep issues​
The recent review, however, took a comprehensive look at a wide range of studies over the years.

For FMS suffers, cannabis can provide relief with limited side effects.

Essentially, the researchers found that previous studies make a strong case for further research into the treatment of Fibromyalgia pain with weed. The aim of the study was to explore the potential for cannabis use, and the researchers concluded that potential is high.

They wrote, “Ultimately, we believe that the use of cannabis and cannabinoids for pain relief in Fibromyalgia has shown great potential and may be a source of hope for those suffering from chronic pain associated with this condition, and for the physicians treating them.”

However, they also wrote that the benefits must be weighed against any potential harmful effects, calling for more research conducted for longer periods to assess the long-term efficacy of cannabis for chronic pain.

Authors concluded "cannabis carries limited side effects, and can also improve some common and debilitating symptoms associated with FM, thus making them an adequate potential treatment option, when other treatment lines have been exhausted.”

Interest certainly remains high among those with Fibromyalgia. A survey in Canada found that 24 percent of Fibromyalgia patients reported a history of cannabis use. Of those, 61 percent classified themselves as current marijuana users and many reported substantial symptom relief.

*From the article here :
 
Last edited:

mr peabody

Moderator: Music Discussion, PM
Staff member
Joined
Aug 31, 2016
Messages
5,295
Location
Frostbite Falls, MN



Iboga saved me from chronic pain

Most people are not aware that Iboga is profoundly effective for treating severe pain caused by nerve damage. The majority of people I've talked to have only heard of it for treating addiction. The reason I am writing this is because I suffered from debilitating pain that made me feel like my life was over. I lost hope. Before my Iboga experience this summer, I had absolutely no idea it would do anything for my damaged nerve. Little did I know. For three whole months after taking a good dose of Iboga, the noribogaine was still flowing in my body, and I was able to do things that I had not been able to do in a long time.

I had got it into my head that my nerve was damaged, and there was nothing I could do. It is hard not to when everything you try doesn't help or only makes it worse. After 3 months, I began to notice my symptoms were coming back because the noribogaine metabolite was finally being flushed from my body. I made a conscious decision to break away from the beliefs I had about myself and my situation.

So for the past month or so I have been taking ~1g of potent Iboga bark per week. It allows me to function on a level I never thought possible. I feel more like myself now than ever before. I can live and be happy and not even think about my nerve. I am doing more than I ever could before with this disability, and I feel like it's exponential, the more I do, the more I can do. It's an exercise. A constant process.

Iboga allowed me to take a step back into my self unadulterated by the constructs of my mind and start working every day to be the better person that I have always wanted to be. It feels odd saying this, but I feel Iboga saved my life. My work with it keeps evolving, too.

I recently gave up an 11 year cannabis addiction, as well as coffee and nicotine overnight with 1g of potent bark, good food, lot of water, and meditation. I did this because I always told myself I never could, or I never wanted to. I just got fed up. I've been perfectly happy, and sober (except for Iboga effects, which are mild), for the first time in my life. I honestly never ever thought this was possible and I am loving it. I am sure I will use cannabis again, but it feels good to take a break and not be dependent.

So, in conclusion, if you are in a country where Iboga is legal, and you suffer from chronic pain that nothing else seems to help, you may want to consider this medicine.

https://www.dmt-nexus.me/forum/defau...=posts&t=27827
 

mr peabody

Moderator: Music Discussion, PM
Staff member
Joined
Aug 31, 2016
Messages
5,295
Location
Frostbite Falls, MN



Can psychedelics treat pain?*

LSD and psilocybin increasingly show promise as mental health treatments. Now universities and companies are exploring their use in pain management.

by Troy Farah | Scientific American | 30 Sep 2021

When Kevin was just 11 months old, he was diagnosed with type 1 diabetes, which led to other health problems as he grew up: loss of vision in his left eye and peripheral neuropathy, a painful condition caused by nerve damage. Then, in 2019, a colonoscopy revealed he had colon cancer.

Feeling anxious and depressed, Kevin (a pseudonym) decided to try self-medicating with psychedelics, including psilocybin-containing “magic mushrooms.” Twice a week, the now 28-year-old delivery driver takes about half a gram of the outlawed fungi. This amounts to too little psilocybin to induce a full-blown trip, and Kevin says he quickly noticed an improvement in his mental health—a result that is in line with a handful of recent studies about the drug’s clinical potential. And he was pleasantly surprised to find that his physical pain seemed to decrease as well, even on the days he was not taking anything.

“A lot of the anxiety and depression I was dealing with started to fade away—and then the pain in my legs started to go away,” Kevin says. “I’m feeling the lasting effects from the psilocybin on my stomach and colon pretty much all the time.”

Vivid colors, warped textures and sounds, and intense introspection are famously associated with the psychedelic experience—and now, increasingly, so are improvements in mental health conditions such as anxiety and post-traumatic stress disorder. But what about pain relief? That is the question a growing number of researchers are asking, based on anecdotal reports that drugs such as LSD or psilocybin can help with this. Both drugs are currently illegal under federal law, though medical studies on them are now being officially cleared with increasing frequency.

From psychedelic start-ups to university labs, scientists are starting to test such drugs on various types of pain: cluster headaches, chronic pain, fibromyalgia and even phantom limb pain. This May a New York City–based, multimillion-dollar psychedelic start-up called Mind Medicine (MindMed) announced Project Angie—a series of studies using LSD and an undisclosed drug to treat chronic pain.

“We don't really know how psychedelics work to modulate people’s long-term symptoms in any illness, let alone pain disorders, which are less studied than some of the others,” says physician Dan Karlin, MindMed’s chief medical officer. “But there is compelling preclinical evidence that they work ... via psychological mechanisms … but also may have some direct effects on descending pain pathways.”

Tryp Therapeutics, a California-based psychedelic start-up, is exploring chronic pain relief using psilocybin and another, psilocybin-based drug with an undisclosed formulation that is obliquely called TRP-8803. The company has also partnered with the University of Michigan to study how these drugs might treat fibromyalgia, a complex and little understood condition blamed for pain throughout the body. Tryp has added leading psychedelic researcher Robin Carhart-Harris to its scientific advisory board, and the company says he will play a “critical role” in clinical trial design.

Earlier this year Yale University announced a trial using psilocybin for cluster headaches. And in August the Oxford, England–based pharmaceutical start-up Beckley Psytech raised $80 million for psychedelic research. Part of this will fund a phase 1b safety trial investigating low-dose psilocybin to treat a rare kind of headache called a short-lasting unilateral neuralgiform headache attack.

These efforts are in very early stages, and so far any results are far from clear. Some experts argue that the evidence for psychedelics relieving pain is weak and that these drugs are so powerful that they should only be used in psychotherapy—if anywhere. Even if psychedelics can relieve physical pain, they may not be better tools than those that are already widely available.

“Pain is this four-letter word that can mean so many different things,” says Vivianne Tawfik, an assistant professor of anesthesiology, perioperative and pain medicine at the Stanford University School of Medicine. At an outpatient clinic, Tawfik treats rare and refractory types of pain usually associated with surgery or injury, such as chronic neuropathic pain and complex regional pain syndrome. “There’s a role for opioids,” she says. “There might end up being a prescribed role for psychedelics. The jury’s still out.”

Tawfik warns that any off-target effects of psychedelics need to be carefully monitored. “I think abuse liability needs to be really closely considered, making sure that there aren’t unexpected psychiatric effects, certainly in populations at risk,” she says.

History of pain and psychedelics

One of the earliest recorded studies of pain relief from psychedelics was conducted by Eric Kast, an Austrian-born physician who fled the Nazis with his family in 1938 and resettled in the U.S., later becoming an anesthesiologist at Chicago’s Cook County Hospital. Kast had an early interest in how to measure pain responses: in 1962 he designed an elaborate apparatus—a pneumatically operated “mechanical pain-producing device”—that used air pressure to let a subject apply a “pain-producing element” (possibly a needle) to their own leg.

Two years later his attention was drawn to the powerful psychedelic LSD, which he tried giving to 50 “gravely ill” patients afflicted by pain with causes ranging from cancer to gangrene. They first received the synthetic opioids hydromorphone (Dilaudid) and meperidine (Demerol)—and later they were given 100 micrograms of LSD as well. This would be a strongly psychoactive dose for most people.

“When compared with LSD-25, both [other] drugs fell short in their analgesic action,” Kast wrote in 1964. It was a remarkable anecdote but barely investigated further. For decades this remained some of the best research in this area, aside from a few case studies.

“I feel like most of the studies that were done weren’t done well,” says Fadel Zeidan, a neuroscientist who studies the underlying mechanisms of pain and mindfulness at the University of California, San Diego. Zeidan, who is co-leading a study on psilocybin for phantom limb pain, would like to see “higher standards, more rigor” in this area of research. In 2020 he co-authored a review that weighed the evidence of psychedelics relieving chronic pain and proposed a mechanism of action. The review noted that psychedelics act on the body’s serotonin receptors—notably the type known as 5-HT2A—which have been linked in some research to the development of chronic pain.

“Serotonin is also involved in descending modulation of pain, from the brain down to the spinal cord,” Tawfik says. But she and others note there are currently very little data to back up the hypothesis that psychedelic pain relief acts through this mechanism. “Even though we know that some of the receptor systems that underlie pain are probably similar, there’s probably a lot of nuance that we don’t really know yet or appreciate.”

One of the few double-blind, randomized, placebo-controlled studies on this topic was published last year. Researchers at the Netherlands’ Maastricht University and their colleagues trialed 24 people who were given an oral solution of ethanol containing either a low dose of LSD (too low to cause strong effects such as visual disruptions) or a placebo. Then the subjects placed their hands in almost freezing water. The longer they could keep their hands submerged, the better their pain tolerance was determined to be.

Ratings of pain tolerance from subjects who received LSD were comparable to those in studies with the opioids oxycodone and morphine, leading the authors to conclude in the Journal of Psychopharmacology that “low doses of LSD might constitute a novel pharmacological therapy.”

Again, the researchers hypothesized that serotonin receptors had a role in this effect. Two of the scientists who conducted this study, Matthias Liechti of the University of Basel and Kim Kuypers of Maastricht University, are currently working with MindMed on its LSD and pain research. And the paper’s lead author, Johannes Ramaekers of Maastricht University, says he is developing another pain study to look at psychedelics and fibromyalgia.

But Boris Heifets, a Stanford Medicine anesthesiologist who studies pain—as well as “rapid acting psychiatric therapies,” including psychedelics—says the focus on serotonin in pain relief is probably a “red herring.” Heifets (who is beginning a trial looking at psilocybin and chronic lower back pain) argues that the fact that psychedelics can also improve mood should not be overlooked, given neurological connections between pain and depression.

“If these drugs are going to help, it’s going to be much like the way we think they help for depression—[that is], changing your relationship to your pain,” Heifets says, emphasizing that psychotherapy is the core of psychedelics’ apparent effectiveness in mental health. “The revolution with this class of medicines is that it's really not just medication alone.... This whole body of research is emphasizing the importance of therapy, psychological support and connection.”

U.C. San Diego’s Zeidan agrees. What a drug like psilocybin could be doing is helping “treat the whole person,” he says—adding that he believes this should be a greater focus of modern medicine in general.

“Chronic pain is really just this comorbid snowball of shit,” Zeidan says. “It’s not only the sensory abnormalities, but it’s also the depression, the anxiety, the sedentary lifestyle, the self-doubt, learned helplessness—it’s this whole thing.”

If psychedelics are ever prescribed for pain, it would not be the first time a drug developed for another kind of treatment has been co-opted in this way. Gabapentin and pregabalin (Lyrica) are two antiseizure drugs now commonly prescribed for nerve pain, while duloxetine (Cymbalta) is an antidepressant often used to address chronic musculoskeletal pain.

Despite the scarcity of solid evidence that psychedelics can tackle physical pain, some people like Kevin are not waiting. Three others interviewed for this article claim to use LSD to treat different types of pain, from cluster headaches to degenerative disc disease in the neck and lower back.

All say they are willing to risk breaking the law because they have tried everything else, with very little success. The steadily increasing research could shed some light on whether these long-demonized drugs can relieve physical suffering—or if they are simply placebos—while also examining long-term side effects.

“Every individual’s experience of chronic pain is unique,” Tawfik says. “Many of my patients are still looking for better treatment options.... We just always need to have these risk-benefit conversations with any of these medications.”

*From the article here :
 
Top