Psilocybin Is Proving to Be Beneficial for Chronic Pain

Source: Peggy und Marco Lachmann-Anke from Pixabay

There is a renewed and increasing interest in psychedelic drugs as potential therapeutic resources for the treatment of psychiatric disorders. In particular, psilocybin—the psychoactive psychedelic ingredient in “magic mushrooms”—has shown promise for the treatment of depression, and I’ve written previously about it as a treatment adjunct for alcohol abuse.

The rising awareness around psychedelics as potential treatments for mental health has significantly raised their profile, helping to generate interest in exploring their use related to other conditions, including chronic pain. According to the CDC, an estimated 51 million Americans suffer from chronic pain—defined as pain lasting longer than 3 months.[1]

Notably, the National Institutes of Health recently announced funding of $8.4M to support trials examining the efficacy and safety of psychedelic treatments for chronic pain. Per NIH, "A potential novel approach to treatment of chronic pain in adults involves psychedelic-assisted therapy (PAT). Evidence for the efficacy of PAT has been particularly notable in depression, anxiety (especially existential distress), post-traumatic stress disorder (PTSD), and substance use disorders, among other indications." The NIH-funded research can include psilocybin, LSD, mescaline, and MDMA, a.k.a. ecstasy.[2]

Despite growing evidence of therapeutic potential, there had been no systematic studies to investigate the effectiveness of psilocybin to help treat chronic pain. However, researchers from the University of Michigan recently demonstrated that psilocybin can significantly reduce chronic pain in rats. Published in the December 18, 2023 issue of Current Biology, this study examined chronic pain in rats induced using intravenous formalin injections, a compound known to cause long-lasting pain sensitivity.[3]

Two types of pain responses were analyzed. Mechanical hypersensitivity—increased sensitivity to pain from physical touch that wouldn’t normally be painful, and thermal hyperalgesia which occurs when intense pain is experienced from warm temperatures that would not usually be painful.

The researchers then administered different doses of psilocybin to the rats and observed the effects on pain sensitivity. The rats were provided either: saline solution, a low dose of psilocybin, or a high dose psilocybin. Pain responses to touch and heat stimuli were then measured a few hours after initial dosing, every second day during the first week, and then weekly over the next three weeks.

The results indicated that both the low and high doses of psilocybin significantly reduced mechanical hypersensitivity for up to 28 days. In comparison, there was a more limited effect on thermal hyperalgesia. Importantly, the pain relief provided lasted considerably longer than the time psilocybin stays in the body. This long-lasting effect suggests that psilocybin is working through a central mechanism in the brain, not just at the local site of pain.

This holds particular significance because many chronic pain conditions are thought to be due to neuroplastic changes in the brain and spinal cord, in that chronic pain often lasts long after the underlying tissue damage has healed. At that point, the pain no longer appears to be a signal of actual tissue damage, but rather a complex mind-body phenomenon based on embedded experience. In this view, chronic pain is analogous to a traumatic memory the mind brings into the present. This is what makes psychotherapy an important and effective part of treating chronic pain, and an essential component of any psychedelic-assisted treatment.[4]

A January 2023 literature review surveyed potential mechanisms of action of psychedelics on chronic pain. They ranged from activating the brain’s serotonin receptors (known to be involved in pain processing), altering how brain regions communicate with each other and process pain perception, to the anti-inflammatory properties of psychedelics.[5]

The new research suggests that psilocybin may well act via neuroplastic effects produced by psychedelics, helping to effectively rewire certain brain circuits involved in pain and providing relief that goes beyond the temporary effects of traditional pain medication.

The timeline from funding more trials that include human subjects to the medically-sanctioned use of psychedelics—including psilocybin—for chronic pain is likely to be measured in years rather than months. That said, each step toward the availability of an additional potentially beneficial treatment for a chronic condition that causes intense suffering and adversely affects the quality of life of many millions of people is a step in the right direction.

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Copyright 2024 Dan Mager, MSW