How Psychedelics Could Transform Chronic Pain Management?

Opioid medications such as oxycodone, morphine, and codeine are commonly prescribed for chronic pain management. However, more than 81,000 U.S. deaths have been linked to opioid use, whether legal or illegal, in 2022. Their addictive potential, tolerance development over time, and increased risk of substance use disorder raise serious concerns about long-term use.

In recent years, another class of drugs, psychedelics, has been explored for chronic pain management and as a potential aid in reducing substance use disorder (SUD) as well. However, these hallucinogenic drugs come with other risk factors, including altered thinking patterns and changes in consciousness. What is the current state of research and legal landscape on these drugs, and how are they reshaping chronic pain management? Gain insight into the available evidence while looking at both sides of the coin.

What is Chronic Pain and Its Potential Treatment?

Chronic pain refers to pain that lasts for more than three months, usually persisting even after an injury or illness has healed. Migraine, fibromyalgia, arthritis, neuropathic pain, and complex regional pain syndrome are some of the most common chronic pain conditions. These disorders adversely affect quality of life.

Management often relies on a combination of complementary and conventional strategies aimed at improving quality of life. Chronic pain disorders heavily strain healthcare systems and resources, as there is currently no permanent cure, so scientists are striving to identify further therapies.

Prevalence of Chronic Pain Conditions

In the United States, around 50 million adults suffered from chronic pain in 2016. According to a survey conducted in 2023, the prevalence of such health issues is common across all age groups in the United States. In 2023, it was estimated that:

• Around 36% of adults aged 65 years and older suffered from chronic pain
  
  

• 29% of adults aged 45 to 64 years experienced chronic pain
  
  

• About 18% of individuals aged 30 to 44 years reported chronic pain
  
  

• Around 12% of adults aged 18 to 29 years experienced chronic pain

Potential Role of Psychedelics for Pain and Mental Health

How psychedelic substances such as psilocybin are gaining a beneficial role toward mental health and chronic conditions despite their potential to cause “bad trips.” Here is the science-backed evidence behind the use of psychedelics:

Pain Management

According to research, psychedelic substances such as psilocybin, LSD, and ketamine are emerging as therapeutic agents for chronic conditions. They have shown effectiveness in alleviating pain in conditions such as migraine, cancer, and neuropathic pain. Other studies support the potential role of psychedelics in managing headache disorders and cancer pain, although many of these studies lack controlled clinical trials.

A psychedelic substance called methylenedioxymethamphetamine (MDMA), in small doses, was found to be effective for neuropathic pain, and the analgesic effects persisted even after stopping MDMA treatment. However, the majority of such studies involve small sample sizes, so predicting the potential effects of these drugs as a whole is still uncertain.

Mental Well-Being

According to research, 40 percent of adults suffering from chronic pain also experience mental health issues such as depression and anxiety. This highlights the need for adopting a holistic treatment approach that addresses both pain and mental health. Here again, psychedelic substances are gaining recognition for their potential role in supporting mental and emotional well-being.

Research supports the role of MDMA and psilocybin in treating psychiatric disorders such as post-traumatic stress disorder (PTSD) and treatment-resistant depression. Another study supports the potential of psychedelic substances such as psilocybin, ayahuasca (active component DMT), LSD, and MDMA in managing various conditions, including:

• Tobacco addiction

• Eating disorders

• Sleep issues

• Obsessive-compulsive disorder (OCD)

Risks and After Effects of Psychedelics 

How psychedelics affect a person varies depending on their weight, dosage, timing, and any other medications taken alongside them. However, some of the common risk factors associated with their use include:

• Hallucinations

• Bad trips

• Difficulty concentrating

• Vision issues

• Irregular heart rate

• Irregular breathing

• Numbness

• Dizziness

How do psychedelics interact with other medications, and what potential risk factors may arise? This still requires further study before making claims or advocating for their medicinal use. However, compared to opioids and non-steroidal anti-inflammatory drugs, which carry risks of dependence and other side effects, psychedelic substances generally do not lead to dependence or addiction. 

Moreover, psychedelics do not generate withdrawal symptoms, and their usage can typically be controlled based on the body’s response. However, some users may experience flashbacks days, months, or even years after using the drug.

Legal Landscape of Psychedelic Drugs

Currently, the majority of psychedelic substances are illegal in the U.S. and many other global regions due to their psychoactive effects and cognitive alteration. According to federal law, they are classified as Schedule I substances, which means they have no accepted medical use.

Yet, the legal landscape is gradually reforming with recent research and emerging studies. Some of these substances are gaining therapeutic status, particularly for their potential benefits in treating mental illnesses. In certain regions, specific psychedelics are being allowed for supervised or medical use.

Epic Healing Eugene became the first licensed psilocybin service center established in 2023 in Oregon. Outside of Oregon, several regions worldwide where psychedelics such as psilocybin and ayahuasca are gaining legal support include Canada, South Africa, Australia, Brazil, Costa Rica, the Netherlands, Portugal, Switzerland, and parts of the United States.

The Future Outlook for Psychedelics

Psychedelic substances, extracted from magic mushrooms or other sources, are redefining the treatment landscape for chronic conditions. Due to their potent psychoactive effects and significant influence on cognition, these substances are still largely illegal for the general public, with only a few exceptions where limited legalization has occurred.

However, their therapeutic effects remain under investigation. Researchers are focusing on identifying the potential benefits and safe usage patterns of these substances. In short, psychedelic drugs are undergoing legislative reforms as more scientific evidence emerges regarding their therapeutic role.

More studies are required to understand the harmless status of psychedelic-assisted therapy for chronic pain, as well as its potential in managing conditions such as anxiety, depression, and stress.