When Kevin was only 11 months old, he was diagnosed with type 1 diabetes. As he grew up, this led to other health problems: vision loss in the left eye and peripheral neuropathy, which is caused by nerve damage Painful condition. Then, in 2019, a colonoscopy revealed that he had colon cancer.
Feeling anxious and depressed, Kevin (pseudonym) decided to try self-treatment with psychedelic drugs, including the “magic mushroom” containing psilocybin. Twice a week, the 28-year-old delivery driver will take away about half a gram of this prohibited fungus. This is equivalent to too little siloxibin to trigger a full-scale trip. Kevin said he quickly noticed that his mental health has improved-a result that is consistent with the few recent studies on the drug’s clinical potential. And he was pleasantly surprised to find that even on the days when he did not take anything, his body pain seemed to be relieved.
“A lot of the anxiety and depression I faced began to subside—then the pain in my leg began to disappear,” Kevin said. “I can almost always feel the lasting effect of psilocybin on my stomach and colon.”
Bright colors, distorted textures and sounds, and intense introspection are all related to psychedelic experiences—and now, mental health conditions such as anxiety and post-traumatic stress disorder are improving. But how to relieve the pain? This is a question raised by more and more researchers. According to rumors, drugs such as LSD or psilocybin can help solve this problem. Under federal law, both drugs are currently illegal, although medical research on them is now officially approved more and more frequently.
From psychedelic drug startups to university laboratories, scientists are beginning to test such drugs in various types of pain: cluster headaches, chronic pain, fibromyalgia and even phantom limb pain. In May of this year, Mind Medicine (MindMed), a multimillion-dollar psychedelic startup based in New York, announced Project Angie, a series of studies using LSD and an undisclosed drug to treat chronic pain.
“We really don’t know how psychedelics regulate people’s long-term symptoms in any disease, let alone pain disorders, which are less studied than others,” said Dr. Dan Carlin, Chief Medical Officer of MindMed . “But there is convincing preclinical evidence that they are effective…through psychological mechanisms…but they may also have some direct effects on the descending pain pathway.”
Tryp Therapeutics is a psychedelic start-up company based in California that is exploring the use of psilocybin and another psilocybin-based drug to relieve chronic pain. The formulation of the drug is not disclosed and is called TRP-8803. The company is also working with the University of Michigan to study how these drugs can treat fibromyalgia, a complex and little-known disease that is blamed on body pain. Tryp has added Robin Carhart-Harris, a leading psychedelic researcher, to its scientific advisory board, and the company said he will play a “key role” in the design of clinical trials.
Earlier this year, Yale University announced a trial using psilocybin to treat cluster headaches. In August, Beckley Psytech, a pharmaceutical startup based in Oxford, UK, raised $80 million for psychedelic research. Part of this will fund a phase 1b safety trial to study low-dose psilocybin in the treatment of a rare type of headache called a transient unilateral neuralgia-like headache.
These efforts are still at a very early stage, and so far, any results are far from clear. Some experts argue that the evidence for psychedelic drugs to relieve pain is weak and that these drugs are so effective that they can only be used in psychotherapy, if any.Even psychedelics were able To relieve body pain, they may not be better tools than those that are already widely used.
Vivianne Tawfik, assistant professor of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine, said: “Pain is a four-letter word that can mean many different meanings.” In outpatient clinics, Tawfik treatment is usually related to surgery or injury. Of rare and intractable pain, such as chronic neuropathic pain and complex local pain syndrome. “Opioids have an effect,” she said. “Ultimately, psychedelics may play an established role. The jury is still out.”
Tawfik warned that any off-target effects of psychedelics require careful monitoring. “I think it is necessary to seriously consider the abuse of responsibility to ensure that there is no accidental mental impact, especially in people at risk,” she said.
The history of pain and psychedelics
One of the earliest recorded pain relief studies of psychedelics was conducted by Eric Kast, a doctor born in Austria, who fled the Nazis with his family in 1938 and resettled in the United States, and later became Chicago Cook An anesthesiologist at the county hospital. Kast has long been interested in how to measure pain responses: in 1962, he designed a well-designed device-a pneumatically operated “mechanical pain-generating device”-which uses air pressure to allow subjects to apply “pain-generating elements” “(Possibly a needle) to his leg.
Two years later, his attention was drawn to the powerful psychedelic hallucinogen LSD. He tried to use this drug on 50 “seriously ill” patients who suffered from cancer and gangrene. They first received the synthetic opioids hydromorphone (Dilaudid) and meperidine (Demerol)-later they also received 100 micrograms of LSD. For most people, this will be a strong psychoactive dose.
“Compared with LSD-25, both [other] The analgesic effect of the drug is insufficient,” Castell wrote in 1964. This is a great anecdote, but there has been little further research. For decades, apart from some case studies, this is still some of the best in the field. Good research.
“I think most of the research that has been done is not doing well,” said Fadel Zeidan, a neuroscientist at the University of California, San Diego, who studies the underlying mechanisms of pain and mindfulness. Zeidan co-led a study on the treatment of phantom limb pain with psilocybin, and he hopes to see “higher standards and more rigorous” in this research field. In 2020, he co-authored a review that weighed the evidence that psychedelics relieve chronic pain and proposed a mechanism of action. The review pointed out that psychedelic drugs act on the body’s serotonin receptors—especially the type called 5-HT2A—in some studies that have been linked to the development of chronic pain.
“Serotonin is also involved in the downward regulation of pain [from the brain] All the way down to the spinal cord,” Tawfik said. But she and others pointed out that there is very little data to support the hypothesis that psychedelic analgesia works through this mechanism. “Although we know that some of the receptor systems that make up pain may be similar, but There may be many nuances that we don’t really understand or don’t understand. “
One of the few double-blind, randomized, placebo-controlled studies on this topic was published last year. Researchers from Maastricht University in the Netherlands and their colleagues conducted a trial on 24 people who took an oral solution of ethanol containing low-dose LSD (too low to cause strong effects such as visual disturbances) or a placebo. The subjects then placed their hands in the almost freezing water. The longer they immersed their hands in the water, the better their tolerance for pain was determined.
The pain tolerance ratings of subjects who received LSD were comparable to those in studies using opioids oxycodone and morphine, so the authors concluded Journal of Psychopharmacology “Low-dose LSD may constitute a new pharmacological therapy.”
The researchers again hypothesized that the serotonin receptor plays a role in this effect. The two scientists conducting this research, Matthias Liechti of the University of Basel and Kim Kuypers of Maastricht University, are currently collaborating with MindMed on LSD and pain research. The lead author of the paper, Johannes Ramaekers of Maastricht University, said he is conducting another pain study to study hallucinogens and fibromyalgia.
But Boris Heifets, a Stanford medical anesthesiologist who studies pain and “rapid-acting psychotherapies” (including psychedelics), said that focusing on pain-relieving serotonin may be a “diversion.” . Heifets (who is starting a trial on psilocybin and chronic low back pain) believes that given the neurological link between pain and depression, the fact that psychedelics can also improve mood should not be ignored.
“If these drugs help, it will be much like the way we think they help depression -[that is], Change your relationship with pain,” Heifets said, emphasizing that psychotherapy is at the core of the apparent effectiveness of psychedelics in mental health. “The revolution of this type of drug is that it is really not just the drug itself… The entire study emphasizes the importance of treatment, psychological support, and connection. “
Zeidan of the University of California, San Diego agrees. He said that drugs like psilocybin can help “cure the whole person”-adding that he believes this should be a greater focus of modern medicine.
“Chronic pain is really just a snowball of this comorbidity,” Zeidan said. “Not only paresthesias, but depression, anxiety, sedentary lifestyle, self-doubt, learned helplessness-that’s all.”
If psychedelic drugs are used to treat pain, this will not be the first time that drugs developed for another treatment have been selected in this way. Gabapentin and pregabalin (Lyrica) are currently two antiepileptic drugs commonly used to treat nerve pain, while duloxetine (Cymbalta) is an antidepressant commonly used to treat chronic musculoskeletal pain.
Although there is a lack of conclusive evidence that psychedelics can solve physical pain, some people like Kevin did not wait. Three other people interviewed for this article claimed to use LSD to treat different types of pain, from cluster headaches to degenerative disc disease in the neck and waist.
All said that they are willing to take the risk of breaking the law because they have tried all other methods with little success. An ever-increasing amount of research can reveal whether these long-term demonized drugs can alleviate physical pain — or whether they are just placebos — while also checking for long-term side effects.
“Everyone’s chronic pain experience is unique,” Taufik said. “Many of my patients are still looking for better treatment options… We always need to have these risk-benefit dialogues with any of these drugs.”