LSD and psilocybin are becoming increasingly promising methods in the field of mental health. Recently, universities and companies have begun to explore their potential in treating pain syndromes.
George (pseudonym) faced serious health issues from an early age: he was diagnosed with type 1 diabetes at 11 months old, which then led to vision loss in one eye and peripheral neuropathy. In 2019, he was diagnosed with colon cancer. Suffering from depression and anxiety, George decided to try self-medicating with psychedelics, specifically using psilocybin-containing «magic mushrooms».
Now, at the age of 28, he takes about half a gram of these mushrooms twice a week. The dosage is insufficient for a full-blown psychedelic experience, but he has noticed significant improvements in his mental state, which is supported by recent research findings. Plus, he was surprised to find that physical pain was also reduced, even on days when he wasn't taking mushrooms.
George (pseudonym) faced serious health issues from an early age: he was diagnosed with type 1 diabetes at 11 months old, which then led to vision loss in one eye and peripheral neuropathy. In 2019, he was diagnosed with colon cancer. Suffering from depression and anxiety, George decided to try self-medicating with psychedelics, specifically using psilocybin-containing «magic mushrooms».
Now, at the age of 28, he takes about half a gram of these mushrooms twice a week. The dosage is insufficient for a full-blown psychedelic experience, but he has noticed significant improvements in his mental state, which is supported by recent research findings. Plus, he was surprised to find that physical pain was also reduced, even on days when he wasn't taking mushrooms.
«My anxiety and depression began to decrease, and the pain in my legs became less noticeable as well. I feel the lasting effects of psilocybin on my digestive system and colon» — says George.
Psychedelic experiences, such as bright colors and distorted perceptions, are often associated with improved mental health, including a reduction in anxiety and PTSD symptoms. However, a growing number of researchers are questioning whether these substances can be used to relieve pain. Although LSD and psilocybin remain illegal under federal regulations, more and more scientific studies are being officially approved.
Scientists working at universities and psychedelic startups are beginning to test these substances on various pain conditions such as cluster headaches, chronic pain, fibromyalgia, and even phantom pain. In May of this year, Mind Medicine, a New York-based company, announced the launch of Project Angie, which aims to investigate LSD and other substances for the treatment of chronic pain.
Psychedelic experiences, such as bright colors and distorted perceptions, are often associated with improved mental health, including a reduction in anxiety and PTSD symptoms. However, a growing number of researchers are questioning whether these substances can be used to relieve pain. Although LSD and psilocybin remain illegal under federal regulations, more and more scientific studies are being officially approved.
Scientists working at universities and psychedelic startups are beginning to test these substances on various pain conditions such as cluster headaches, chronic pain, fibromyalgia, and even phantom pain. In May of this year, Mind Medicine, a New York-based company, announced the launch of Project Angie, which aims to investigate LSD and other substances for the treatment of chronic pain.
«We don't yet fully understand how psychedelics help modulate long-term symptoms of diseases, including pain disorders, on which not enough research has been done so far. But there is encouraging preliminary evidence that they work through psychological mechanisms and have direct effects on pain pathways» — notes physician Dan Carlin of MindMed.
California-based Tryp Therapeutics is exploring pain relief using psilocybin and another proprietary drug known as TRP-8803. It is collaborating with the University of Michigan to study the effects of these substances on fibromyalgia, a complex and understudied condition often associated with generalized pain.
Leading psychedelics researcher Robin Carhart-Harris has become part of the company's scientific advisory board and will be actively involved in clinical trial design.
California-based Tryp Therapeutics is exploring pain relief using psilocybin and another proprietary drug known as TRP-8803. It is collaborating with the University of Michigan to study the effects of these substances on fibromyalgia, a complex and understudied condition often associated with generalized pain.
Leading psychedelics researcher Robin Carhart-Harris has become part of the company's scientific advisory board and will be actively involved in clinical trial design.
Yale University this year also announced a trial of psilocybin against cluster headaches. In August, Oxford-based startup Beckley Psytech raised $80 million for psychedelics research, some of which will go toward a phase 1b clinical trial on the safety of low-dose psilocybin in treating a rare type of headache.
However, these studies are in the early stages and the results remain uncertain. Some experts note that the existing evidence for the efficacy of psychedelics in relieving pain is insufficient and point to the need for caution. Even if psychedelics can relieve physical pain, they may not be the best choice over already available remedies.
«Pain is an overly broad term that encompasses many different conditions» — explains Vivianna Tofik, assistant professor of anesthesiology at Stanford University. She treats rare types of pain associated with surgery or trauma, such as chronic neuropathic pain.
«Opioids have their niche, but there may be a place for psychedelics in the future. However, a final decision on their use has not yet been made» — she adds.
However, these studies are in the early stages and the results remain uncertain. Some experts note that the existing evidence for the efficacy of psychedelics in relieving pain is insufficient and point to the need for caution. Even if psychedelics can relieve physical pain, they may not be the best choice over already available remedies.
«Pain is an overly broad term that encompasses many different conditions» — explains Vivianna Tofik, assistant professor of anesthesiology at Stanford University. She treats rare types of pain associated with surgery or trauma, such as chronic neuropathic pain.
«Opioids have their niche, but there may be a place for psychedelics in the future. However, a final decision on their use has not yet been made» — she adds.
Tofik also emphasizes the importance of monitoring the side effects of psychedelics. «The possibility of their abuse and potential psychiatric consequences need to be carefully assessed, especially in vulnerable groups» — she says.
One of the first documented studies of the use of psychedelics for pain management is the work of Eric Kast, an Austrian-born physician who fled the Nazi regime in 1938 and moved to the United States, where he later became an anesthesiologist at Cook County Hospital in Chicago. Kast became interested in methods of assessing pain responses and in 1962 created a sophisticated device, a pneumatic «mechanical pain inducing device» that used air pressure to allow a subject to apply a «pain-promoting element» (possibly a needle) to his leg.
One of the first documented studies of the use of psychedelics for pain management is the work of Eric Kast, an Austrian-born physician who fled the Nazi regime in 1938 and moved to the United States, where he later became an anesthesiologist at Cook County Hospital in Chicago. Kast became interested in methods of assessing pain responses and in 1962 created a sophisticated device, a pneumatic «mechanical pain inducing device» that used air pressure to allow a subject to apply a «pain-promoting element» (possibly a needle) to his leg.
In 1964, he began experimenting with LSD, examining its effects on groups of 50 patients with severe chronic pain caused by diseases such as cancer and gangrene. They were first given synthetic opioids such as hydromorphone (Dilaudid) and meperidine (Demerol) and then 100 micrograms of LSD, a high dose for most people. Kast concluded that «compared to LSD-25, these two drugs were less effective in terms of pain relief», but there was little further research on this topic.
Fadel Zeidan, a neuroscientist at the University of California, San Diego, believes that much research in this area has not been done properly. Zeidan, who is studying psilocybin for phantom limb pain, advocates for higher standards and rigor in scientific research.
In 2020, he participated in a review that evaluated the evidence for the effectiveness of psychedelics in reducing chronic pain and suggested a possible mechanism of action. The review shows that psychedelics affect serotonin receptors, especially the 5-HT2A type, which is associated with the development of chronic pain.
«Serotonin is also involved in the downward modulation of pain from the brain to the spinal cord. However, very little data are currently available to support the assumption that psychedelic pain relief works through this mechanism» — notes Tofik.
One of the few randomized double-blind studies on this topic was conducted last year. Researchers from Maastricht University in the Netherlands studied 24 people who were given an ethanol solution with a low dose of LSD or a placebo. Participants placed their hands in ice water, and those who took LSD showed similar results in pain tolerance to participants who took opiates, leading the study authors to suggest that «low-dose LSD may be a new option for pharmacologic therapy».
The researchers again suggested that serotonin receptors play a key role in this effect. The team that conducted this study continues to work towards investigating the effects of LSD on pain with MindMed. The study's original author, Johannes Ramaekers, is developing a new study on psychedelics and fibromyalgia.
One of the few randomized double-blind studies on this topic was conducted last year. Researchers from Maastricht University in the Netherlands studied 24 people who were given an ethanol solution with a low dose of LSD or a placebo. Participants placed their hands in ice water, and those who took LSD showed similar results in pain tolerance to participants who took opiates, leading the study authors to suggest that «low-dose LSD may be a new option for pharmacologic therapy».
The researchers again suggested that serotonin receptors play a key role in this effect. The team that conducted this study continues to work towards investigating the effects of LSD on pain with MindMed. The study's original author, Johannes Ramaekers, is developing a new study on psychedelics and fibromyalgia.
However, Boris Heifitz, an anesthesiologist at Stanford University, says the focus on serotonin may distract from an important aspect: «psychedelics can also improve mood, which cannot be ignored given the link between pain and depression». He emphasizes that medical research must take into account the psychotherapeutic context, which plays a key role in the efficacy of psychedelics in mental health.
Zeidan shares this view, stating that drugs such as psilocybin can help «treat the whole person». He emphasizes that chronic pain is often conflated with other conditions such as depression and anxiety, creating a complex «set of problems».
If psychedelics are ever used to treat pain, it will not be unusual for medicine, where drugs originally developed for one purpose are used for other prescriptions, as has already happened with gabapentin and pregabalin, which are prescribed for neuralgia.
Zeidan shares this view, stating that drugs such as psilocybin can help «treat the whole person». He emphasizes that chronic pain is often conflated with other conditions such as depression and anxiety, creating a complex «set of problems».
If psychedelics are ever used to treat pain, it will not be unusual for medicine, where drugs originally developed for one purpose are used for other prescriptions, as has already happened with gabapentin and pregabalin, which are prescribed for neuralgia.
Despite the lack of convincing evidence for the efficacy of psychedelics in treating physical pain, some patients like George are actively using LSD to treat their ailments. They are willing to take the risk of breaking the law because no other method has brought them significant relief.
With more research, it may become clearer whether these long-taboo substances can relieve physical suffering or are merely placebos, and potential long-term side effects will be investigated.
«Every experience of chronic pain is unique. Many of my patients are still searching for optimal treatments, so it is important for us to discuss the risk-benefit ratio when using these substances» — notes Tofik.
With more research, it may become clearer whether these long-taboo substances can relieve physical suffering or are merely placebos, and potential long-term side effects will be investigated.
«Every experience of chronic pain is unique. Many of my patients are still searching for optimal treatments, so it is important for us to discuss the risk-benefit ratio when using these substances» — notes Tofik.