LSD and Psilocybin may have therapeutic potential to treat chronic pain on a “mechanistic and experiential” level, according to a recently published literature review. The review highlights the scientific findings that are happening as part the “psychedelic Renaissance,” a recent thawing out of stigma and opposition towards psychedelics after decades of prohibition.
The authors also note that the effects of LSD, psilocybin, and other drugs on pain seem to improve with repeated treatments, as opposed to opioids which show a “decreased effect” over time.
The South African Medical Journal published a narrative review last month that traces the history of these two substances and the new understanding scientists have of their mechanisms of action. The review notes that these drugs do not only reduce pain, but also help to better manage pain.
The authors stated that “recent neuroimaging combined with small-scale interventions using classic psychedelics” may point towards a way to improve the treatment of chronic back pain from a mechanistic as well as experiential perspective.
The literature review explains that classic psychedelics are those which bind to 5-HT2A central nervous system receptors. These include LSD and Psilocybin.
According to the literature review, the way psilocybin interacts with receptors on the central nervous systems “has similar effects as LSD in cognition, emotion processing, self awareness and pain perception,” which underpins the potential therapeutic benefit of treating people who suffer from pain. Many small studies of LSD and Psilocybin in the treatment of chronic pain have shown that they are safe, with little physical dependence, withdrawal symptoms, or compulsive drugs seeking.
The two drugs share the same alkaloid family, but their histories are very different. LSD was synthesized for the first time in 1938. Humans have only been using it since then. Psilocybin has been used for thousands of years. Psilocybin was first popularized in America in the 1950s. LSD became more common in the 1960s and 1970s.
The study states that “there have been no reports on direct death from either substance or withdrawal after chronic use.” Psilocybin research in clinical settings ended around the same time LSD research was banned by the Controlled Substances Act.
Authors wrote that LSD and Psilocybin were abandoned because of their associations with the counterculture and antigovernment sentiment. From 1977 to the early 2000s no LSD research publications were published despite overwhelming evidence that LSD has therapeutic benefits.
LSD was found to be effective in treating depression, physical pain and suffering among cancer patients. Participants treated with LSD for phantom-limb pain reduced their need for analgesics, and the pain of two patients was eliminated.
In what is referred to in the review as “the modern psychedelic Renaissance” or “the New Wave of Psychedelic Research,” studies have shown that LSD or psilocybin may reduce chronic pain, cluster headaches and end-of life depression among cancer patients.
A small sample of self-medicating patients with psychedelics showed a reduction in pain for 5 days following the treatment.
The review states that “the most exciting revelations from these interviews relate to the lasting emotional and psychological effect the psychedelics have on those interviewed.” They describe increased resilience, self-awareness, psychological flexibility and psychological adaptability, which led them to feel acceptance, agency, and hope.
The article continues, “Most recent, the journal pain published case studies of three people who had chronic neuropathic symptoms and took low-doses of psilocybin to manage their symptoms, referred to as’microdosing.'” The authors commented on microdosing’s positive effects, including minimal side-effects as well as a reduced need for analgesics.
The article repeatedly notes that part of what’s appealing about LSD and psilocybin in the treatment of pain is that the experience of pain is multidimensional–something psychedelics seem to effectively address.
It says that “people with pain may have many psychological, social, and spiritual needs and desire to reclaim a locus of internal control in order to resolve unresolved relationship and family issues.” Recent developments in the management of chronic pain have increased treatment options beyond oral analgesics or interventional pain procedures. We now include patient education, psychological support and physical therapy in the management of people with chronic pain.
The review touches on the possible mechanisms of action behind the therapeutic effects of pain.
The analgesic effect of LSD and Psilocybin, via the descending noxious inhibition control system as well as cortical processes, provides a convincing argument for using these classic psychedelics in chronic pain. The analgesic effects of 5-HT1A/2A agonists increase with repeated treatments, unlike opioid receptor stimulation which shows receptor upregulation, and a decreased therapeutic effect.
The conclusion of the article highlights the negative effects of U.S. Prohibition, which have rippled across the globe.
The Controlled Substances Act, which was passed in 1970, had a significant impact on the knowledge of psychedelics and their possible role in the mental illness and chronic pain epidemics of the 21st Century,” they wrote. The psychedelic Renaissance, led by researchers and clinicians around the globe, has taken its time to reintroduce this research. Researchers are advancing research on the role that serotonin receptors play in the treatment of chronic nociplastic and physical pain.
Another study, published last month, found that marijuana could also be a multidimensional way to treat pain. It was concluded that it is “equally effective” in treating pain as opioids but that it also has “holistic” effects, such as improving sleep, focus, and emotional wellbeing.
Another study, published in November, found that CBD was effective at treating dental pain. It could be a good alternative to opioids.
The Drug Enforcement Administration (DEA), in October, proposed a dramatic rise in the production quotas of marijuana and psychedelics such as psilocybin or ibogaine in 2023 to “support the research and clinical trials” into these substances.
Experts are awaiting a possible federal approval of certain psychedelics, like psilocybin or MDMA for therapeutics in the treatment serious mental conditions.
DEA’s Schedule I drug production quotas are cited as proof that it supports rigorous research on the substances. However, advocates and scientists have criticized its actions as being antithetical to promoting study.
After a backlash, DEA has recently retracted its proposed ban on psychedelic substances which scientists claim have research value.
This was a major victory for the scientific community. It comes just one month after DEA dropped separate plans to include five psychedelics containing tryptamine in Schedule I.
A federal appeals court ruled recently against DEA over a suit filed by a Washington State physician to reschedule psilocybin. The court ruled that DEA did not explain why it denied the petition and ordered it to provide a fuller justification.
Psilocybin Study Demonstrates ‘Efficacy and Safety’ of Psilocybin for Bipolar II Depression
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