Can psychedelics heal chronic pain?
Psychedelic medicine is booming
Perhaps you’ve heard the news that our moral (and politically motivated) panic surrounding psychedelics is starting to fade. In 2020, Oregon became the first state in the U.S. to (re)legalize psilocybin for therapeutic use. Communities in several states, such as Massachusetts, California, Michigan, and Washington, have decriminalized psilocybin. Rates of use of psychedelic drugs are increasing among young adults. Microdosing is all the rage for whatever ails you.
Research on psychedelic medicine is booming. Psychedelic-assisted psychotherapy (PAP) has shown promising results for treating things like end-of-life anxiety, PTSD, treatment-resistant depression, and substance use disorders, using MDMA (ecstasy), psilocybin (mushrooms), LSD, ketamine, ibogaine, and more.
But what about pain? Is there reason to think that psychedelics could heal our chronic pain?
While there have not yet been any clinical trials testing PAP for chronic pain, there are many reasons to be hopeful.
Clearly researchers agree: There are several dozen clinical trials on PAP for chronic pain that are planned or starting to recruit participants--including nine trials on psilocybin alone!
How psychedelics could help people with chronic pain
What is behind this high level of enthusiasm? Here are some reasons why psychedelic-assisted psychotherapy holds great promise in relieving chronic pain:
Breaking through fear and avoidance. People often describe confronting their deepest fears during a psychedelic experience and finding that they’re not so terrifying after all. The theory behind neuroplastic pain (pain generated by neural pathways in the brain) is heavily fear- and avoidance-based: Our fear of acute pain is adaptive because it helps us to modify our behavior to avoid things that hurt us. However, this process can go awry when we interpret normative body sensations as dangerous and start to shape our lives around avoiding something that cannot, in fact, be avoided. More holistically, being in pain chronically is a scary experience filled with possible threats. Chronic pain inevitably leads to a shrinking away from many aspects of life, out of fear of what they will do to your pain level. Being able to confront the pain and see it for what it really is (which might be nothing at all!) can be a powerful paradigm shift for people who have been chronically struggling with and suffering from pain.
Having out-of-body experiences. It is not uncommon for a psychedelic drug to facilitate a disembodied experience, where the person experiences a sense of being out of their body or of not having a body (Listen to Ram Dass’s experience here). It’s not hard to see how a temporary reprieve from embodiment would be welcome for someone with chronic pain. A qualitative study of 11 people who used psychedelics to treat their chronic pain found that 9 of them experienced “pronounced reductions” in pain during the experience. The real value in these acute effects is that, because they are so divergent from everyday life, they can fundamentally change your relationship to your body and thus to your pain. If your body isn’t real, how could your pain be? While of course you will come back into your body when the drug wears off, the experience of being out of body can serve as a touchstone to come back to in the future.
Connecting to something greater. Psychedelics can help us to experience a profound feeling of interconnectedness or unity with the world around us, along with a recognition of the sacredness of it all. So-called mystical experiences have been highlighted as a primary way that psychedelics exert their therapeutic effects. Those of us in chronic pain know all too well that our day-to-day lives are often the polar opposite of mystical: we feel isolated and alone, hyper-focused (out of necessity) on our own suffering. Having a substance temporarily wash away our separateness and lonely misery is a balm on our souls. It can help us to feel deeply cared for in a way that we may not have felt for years. It can provide a deep reassurance that everything will, in fact, be OK, in a way parallel to psilocybin’s effects in people facing terminal illness.
It’s not all about the drugs
A few caveats here:
It is important not to separate the drug effects from the therapy that surrounds them. We are talking about psychedelic-assisted psychotherapy, not necessarily about the drugs used in isolation. It’s likely that each one potentiates the other, making the effects of both more powerful.
Are there other ways to get these effects if you don’t want to use a powerful mind-altering substance? Of course! Meditation, hypnosis, psychological approaches, holotropic breathwork, and other spiritual practices are all ways of accessing these same benefits without ingesting a substance. Psychedelics help us tap into parts of ourselves and ways of looking at things that are already there; we have plenty of other ways to access them.
So what now? Don’t feel like waiting years for the FDA to approve psychedelic medicine for your chronic pain? Don’t have access to a clinical trial or ketamine clinic? There is plenty that you can do now to prepare yourself to take full advantage of these medicines when they become available. Start by reviewing this article on cultivating a pain-reducing mindset and actually putting these strategies into practice in your life. Strategies like these will help you to make the most of psychedelic-assisted psychotherapy when it becomes available.
I’ll be writing more about some specific practices that you can start integrating into your life now to support your future psychedelic explorations. You may even find that the work you do to prepare results in major reductions in pain all on its own.
Need more help releasing your mind and reducing your pain? Check out my group coaching program for chronic pain and request to join today.
The content shared here is for informational purposes only and is not intended as a substitute for professional medical advice, diagnoses, or treatment. Always seek advice from your physician or other qualified healthcare provider before making changes to your health regimen.
