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Scoping Review: The Role of Psychedelics in the Management of Chronic Pain

Summary

This review examines how psychedelic drugs like LSD and psilocybin might help treat chronic pain conditions such as cluster headaches and phantom limb pain. The researchers found nine studies suggesting these substances could reduce pain by affecting serotonin receptors in the brain. While early results are promising, more rigorous clinical trials are needed before these drugs can become standard pain treatments. The authors note that strict legal restrictions on psychedelics currently limit research opportunities.

Background

Chronic pain affects 50-100 million Americans and costs nearly $600 billion annually. The opioid epidemic has limited pain treatment options, creating a need for novel therapeutic approaches. Psychedelics, including LSD and psilocybin, have emerged as potential alternatives for chronic pain management through serotonin receptor modulation.

Objective

To systematically evaluate the role of psychedelics in managing chronic pain conditions including cluster headache, phantom limb pain, and fibromyalgia through a comprehensive scoping review following PRISMA guidelines.

Results

Nine studies were identified including case reports, open-label studies, surveys, and one randomized controlled trial. For phantom limb pain, 7 of 8 patients showed pain resolution with LSD. Cluster headache studies demonstrated significant relief with sub-hallucinogenic doses. Fibromyalgia surveys showed 11 of 12 intentional users reported pain improvement. One RCT showed a trend toward significance but lacked statistical power.

Conclusion

Psychedelics demonstrate potential in alleviating pain across multiple chronic pain conditions through 5-HT2A receptor activation. However, Schedule I classification and limited randomized controlled trials restrict clinical research. Further well-powered, double-blind, placebo-controlled trials are essential to establish efficacy and safety for chronic pain management.
  • Published in:Journal of Pain Research,
  • Study Type:Scoping Review,
  • Source: PMID: 38496341, DOI: 10.2147/JPR.S439348
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