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Prospective Preference Assessment for the Psilocybin for Enhanced Analgesia in Chronic nEuropathic PAIN (PEACE-PAIN) Trial

Summary

Researchers surveyed chronic pain patients about their willingness to participate in a trial testing psilocybin (a compound from magic mushrooms) as a pain treatment. About 77% of patients were interested in participating. Interestingly, patients who had previously used psychedelics were much more willing to join the trial. Common reasons for wanting to participate included needing new pain treatments, while concerns about side effects and practical difficulties like attending multiple appointments discouraged others.

Background

Chronic neuropathic pain is a debilitating condition with limited effective treatment options. Preliminary evidence suggests psilocybin may alleviate chronic pain, but negative perceptions and enrollment challenges may represent barriers to conducting clinical trials. A prospective preference assessment was conducted prior to initiating the PEACE-PAIN trial to evaluate patient acceptance.

Objective

To determine patients’ willingness to participate in the PEACE-PAIN trial, identify areas for protocol improvement, and explore differences in characteristics between patients willing and unwilling to participate in a psilocybin-based clinical trial for chronic neuropathic pain.

Results

76.9% of participants were willing to participate in the PEACE-PAIN trial. Prior psychedelic use was significantly higher in willing participants (75%) compared to maybe willing and not willing groups (0%). Top motivating factors were need for new treatments (31.7%) and pain management benefits (31.7%), while practical difficulties and adverse event concerns were primary discouraging factors (16.7% each).

Conclusion

The PEACE-PAIN trial design is supported by patient responses, but modifications are recommended including thorough discussions of psilocybin efficacy, safety, and adverse effects. Prior psychedelic use significantly predicts willingness to participate and has important methodological implications for trial inclusion/exclusion criteria.
  • Published in:Canadian Journal of Pain,
  • Study Type:Prospective Preference Assessment Study,
  • Source: PMID: 39529994, DOI: 10.1080/24740527.2024.2406285
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