Are psychedelics the answer to chronic pain: A review of current literature

Psychedelics like LSD and psilocybin may help manage chronic pain by activating the serotonin-2A receptor, disrupting maladaptive brain connections and enabling healthy reconnections via neuroplastic effects, though the process is not fully understood and evidence is limited and low quality. In cancer-related pain, decades-old findings and recent studies show promising analgesic and safety benefits for psychological distress. People with migraine or cluster headache who self-medicate report acute and preventive relief, and randomized trials for cluster headache are underway. Psychedelics have a favorable safety profile and lack the addictive potential of opioids, making further research important given the opioid epidemic.

Study at a glance

Abstract

Abstract Aims We aim to provide an evidence‐based overview of the use of psychedelics in chronic pain, specifically LSD and psilocybin. Content Chronic pain is a common and complex problem, with an unknown etiology. Psychedelics like lysergic acid diethylamide (LSD) and psilocybin, may play a role in the management of chronic pain. Through activation of the serotonin‐2A (5‐HT2A) receptor, several neurophysiological responses result in the disruption of functional connections in brain regions associated with chronic pain. Healthy reconnections can be made through neuroplastic effects, resulting in sustained pain relief. However, this process is not fully understood, and evidence of efficacy is limited and of low quality. In cancer and palliative related pain, the analgesic potential of psychedelics was established decades ago, and the current literature shows promising results on efficacy and safety in patients with cancer‐related psychological distress. In other areas, patients suffering from severe headache disorders like migraine and cluster headache who have self‐medicated with psychedelics report both acute and prophylactic efficacy of LSD and psilocybin. Randomized control trials are now being conducted to study the effects in cluster headache Furthermore, psychedelics have a generally favorable safety profile especially when compared to other analgesics like opioids. In addition, psychedelics do not have the addictive potential of opioids. Implications Given the current epidemic use of opioids, and that patients are in desperate need of an alternative treatment, it is important that further research is conducted on the efficacy of psychedelics in chronic pain conditions.