How Psychedelic Therapy Can Help Treat Chronic Pain

As the medical utility of psychedelics continues to reveal itself to a refreshing generation of open-minded thinkers, many prospective journeyers have started to approach us inquiring about the effects that psychedelics may have on chronic pain and its often co-occurring disorders. 

Chronic pain takes an obvious, strenuous toll on the lives of those affected by its uncompromising wrath. Picture putting yourself to bed every night in the same gnawing pain that jerked you out of bed that morning. It’s demoralizing, it’s debilitating, and it may very well be a personal truth for many that come across this article.

If you or someone you know is affected by chronic pain, we extend our complete empathy for you and your current situation. Your pain is an undeniable part of your story, but we shouldn’t allow it to narrate the spirit of our whole being. As best we can, we should use the pain to feel and embrace the unconditional humanness of our flesh-boned terrestrial vehicles.

Today, we’ll analyze the mechanisms by which psychedelics may help alleviate both the physical and mental torment that accompanies chronic pain. We’ve collected anecdotal reports from chronic pain sufferers who’ve opted to share their psychedelic-assisted pain reduction stories. 

How can psychedelics help change our pain perception? Can we use the emotional dimension of pain to change its sensory dimension? What conclusions have research studies on psychedelics and chronic pain arrived at? Let’s jump right in and find out. 

What is Chronic Pain?

By definition, chronic pain is a physical pain that lasts longer than 12 weeks, with medication and medical interventions having little effect on the intensity level of pain. Chronic pain can stem from several underlying conditions. Physical injuries and surgical operations are usually the first to come to mind.

However, pain can mean many different things. Individuals facing its chronic presence come to define the word through their own experiences. Some specific forms of chronic pain include pain in the back and neck often from trauma or injury, nerve-induced pain (e.g. diabetes), cluster headaches and migraines, muscle pain (e.g. fibromyalgia), or swollen joints (e.g. arthritis). 

Prolonged physical discomfort can cause several well known mental health disorders, such as depression, anxiety, and chronic fatigue. Thus, treatment of chronic pain should involve mind-body therapies that address all areas of life pervaded by the condition. Luckily, psychedelics have already been proven to be highly effective for the co-occurring disorders with chronic pain, but more on that later.

The Current Treatments For Chronic Pain

Advancements in medicine have made way for a large body of treatments that target chronic pain. From over-the-counter and prescription drugs to acupuncture and surgical implants, the options are more open than ever.

Trigger point injection is a popular procedure that aims to relax muscle pain via injection of local anesthetic and/or steroid into a trigger point. It’s been a useful approach for many suffering from fibromyalgia, myofascial pain syndrome, and tension headaches. 

Botox is often used to block nerve-muscle signals associated with chronic headaches and migraines. Though effective for some, relief may be short-lived, at which point sufferers begin turning their sights onto less conventional treatment options. 

When physical therapy and standard medicines fail to ameliorate pain, a surgical procedure may be the next best option. Infusion pain pumps can be used to deliver drugs like morphine or muscle relaxants via the spinal theca. 

These medications can be incredibly potent pain-numbing agents, but it’s common for people to fear the dependency associated with narcotic use. Bioelectric therapy, chiropractic treatment, and reiki healing are a few alternative pain management routes.

But what happens when chronic pain sufferers find no relief from any of these treatments? Where do they turn to next? While mindfulness practices like meditation and breathwork have proven to be excellent relaxation techniques, the persistence of chronic pain can make it quite challenging to recognize their benefits. 

It’s here, at this common mind-body gap, that psychedelics can teach us to manage pain by helping us reestablish ‘mind over matter’. They can reduce pain by changing our cognitive relationship to sensory events.

Chronic Pain: Where the Body Meets the Brain

In a 2015 review titled “Chronic Pain: Where the Body Meets the Brain”, Leslie Crofford analyzes psychological factors associated with the amplification of central pain. This amplification cannot be understood by traditional somatic or neuropathic studies.

Instead, it calls for the evaluation of stress response systems affected by chronic pain, and their contributions to clinical presentations. How does the sensory dimension of pain affect its emotional dimension, and vice versa?

A number of studies have investigated the influence of cognitive and emotional factors on the perception of pain. They’ve confirmed that positive and negative emotions associated with the expectation and subjective contextualization of pain can have both reducing and amplifying effects on the sensory dimension of pain.  

In fact, a 2019 study by deCharms RC and colleagues, used real-time functional MRI (rtfMRI) to successfully train healthy subjects and chronic pain patients to regulate the activation of their own anterior cingulate cortex (ACC). The ACC is a core component of the pain network. 

This brain region is responsible for encoding the unpleasantness of pain, thus, modulation of its activity can alter an individual’s subjective experience of pain. In the study, participants were taught cognitive strategies for manipulating ACC activity.

They were later instructed to apply these strategies while receiving pain caused by noxious thermal stimuli. In the meantime, rtfMRI provided direct feedback on the ACC’s activation, and findings were then correlated to the subjects’ reported changes in pain perception.

Eventually, participants learned how to control ACC activity. The further this skill was developed, the lower their perception of the pain stimulus became. Importantly, chronic pain patients were able to effectively and significantly reduce their level of pain by modulating ACC activation.

This study reveals a potential target for chronic pain treatment with psychedelic therapy. As research has shown, psychedelic drugs significantly modulate activity in not only the ACC, but also in core self-referential brain regions. 

Psychedelics can facilitate the cognitive acquisition of pain-neutralizing skills by rapidly reorganizing the associated signaling pathways. We’ll explain more on this in the following section, but first, let’s review the specific techniques that these study participants used to manipulate pain perception.

Researchers in this study instructed participants to change their behaviors related to attention, stimulus quality, stimulus severity, and control. Study subjects were to either direct attention toward the pain or away from it (toward the other side of the body).

Changes in stimulus quality involved perceiving the stimulus as a neutral sensory experience versus a “tissue-damaging, frightening, or overwhelming experience” (deCharms RC et al., 2019). Stimulus severity required changes in perceiving the pain stimulus as either low or high intensity. 

Lastly, instructions on control concerned attempts to either control the painful experience or to allow the stimulus to control the perception. As expected, when participants diverted attention away from the pain, interpreted the pain as a neutral experience of low intensity, and when they didn’t allow the stimulus to control the pain, the subjective level of pain was greatly reduced.

As you may have already noticed, the instructions provided in this study heavily employ techniques from visualization meditation exercises. Today, the Western world has begun to adopt centuries of Eastern meditation and yogic practices that harness the mind’s power to control one’s physical state. 

In a 2013 study by Lutz et al., researchers sought to explore the link between mindfulness-based therapies and the experience of pain. The study compared perceived pain between meditators with over 10,000 hours of practice and novice meditators who matched the experimental group in age and sex. 

They found that in contrast to novices, expert meditators reported equal pain, but significantly less unpleasantness. Expert meditators demonstrated reduced baseline activity in the amygdala (the brain region that processes fearful stimuli), which is associated with enhanced neural habituation in pain-related regions before and during presentation of painful stimuli. 

As the researchers note, these findings suggest that cultivation of experiential openness via mindfulness practices reduces negative anticipations of adverse events, while increasing the use of attentional resources during pain. 

These factors all contribute to faster neural habituation of pain. Neural habituation describes a type of non-associative plasticity in which progressive decreases of neural responses occur as a result of repeated exposure to stimuli.

Just as multiple training sessions were necessary for deCharms’ study participants to begin successfully modulating ACC activity, the effectiveness of mindfulness exercises in promoting neural habituation to pain are heavily contingent on their regular practice. Next, we’ll explain how psychedelics may offer a quicker route for acquiring and implementing affect regulation techniques.  

The Link Between Openness and Benefit-Finding

The studies presented above share two primary findings. One– the context/tone of our mental narratives can reduce or amplify pain by either increasing or decreasing activity in stress response systems, which can either slow or speed up the process of neural habituation to pain. Two– the context/tone of our mental narratives correlate to the direction of our attentional resources, which may be dependent on our level of experiential Openness. 

Thus, at the core of one’s ability to modulate pain perception is their ability to be Open, to experience without making negative associations or attaching negative expectations to adverse events. In fact, making positive associations to painful experiences can enhance one’s ability to modulate pain perception.

This information isn’t new though. In a 1992 study by Larsen and Diener, researchers found that when chronic pain sufferers made greater daily efforts to remind themselves of the benefits that came from their illness, they were significantly more likely to experience a pleasurable mood, despite the intensity of their pain.  

Studies have also proven that Openness to Experience and Extraversion are the primary dimensions of personality that predict overall benefit-finding (Tedeschi & Calhoun, 2009). 

Other personality trait predictors of benefit-finding that tend to result from openness and extraversion are an internal locus of control– the belief that our actions can impact our wellbeing (Wollman & Felton, 1983); and dispositional optimism– the tendency to expect good outcomes (Tennen et al., 1992).

So we know that the unpleasantness of chronic pain can be greatly reduced by benefit-finding and openness. This information is interesting, but how can it be applied to those seeking psychedelic therapy for the purpose of reducing chronic pain and the symptoms of its often co-occurring disorders?

How Psychedelics Can Help Us Manipulate Pain Perception

As we can recall from the 2019 deCharms et al. study, chronic pain sufferers learned how to modulate pain perception by changing the direction of their attention and by qualifying their pain as a neutral sensory experience. 

Successful completion of these cognitive tasks are predicted by two primary dimensions of personality: Openness and Extraversion, thus dispositional optimism and an internal locus of control.

In a 2011 study by MacLean and colleagues, researchers analyzed changes in openness following high-dose psilocybin experiences. Using ANOVA to analyze variances between two groups of participants from two separate psychedelic studies, researchers found that Openness increased significantly following high-dose psilocybin sessions.

Using the Mysticism Scale, researchers found that the level of mystical experience significantly correlated with the degree of change in Openness (p=.002). The higher the ratings were on level of mystical experience, the greater the increase in Openness. 

It’s useful to note that Openness encompasses aesthetic appreciation and sensitivity, imagination and fantasy, and broad-minded tolerance of others’ viewpoints. Not only do psychedelic-induced mystical experiences produce large-scale increases in Openness, but they also increase other specific personality traits that promote positive attention and positive regard for typically neutral or negative events. 

After a high-dose psilocybin session, increases in Openness were larger in magnitude than the changes traditionally observed over decades of life experiences (Terracciano et al., 2005). Similar levels of Openness are observed in expert meditators with over 10,000 hours of practice (Lutz et al., 2013).

This confirms that psychedelics catalyze large-scale increases in experiential Openness quicker than any day-to-day life experience would, and in less time than it would take to be qualified as an expert meditator.

As expected, Extraversion levels also see drastic, clinically significant and sustainable increases following psilocybin therapy. In a 2018 study by Erritzoe and colleagues, they found that in the three months following psilocybin therapy, participants experienced an average 6.5-point increase in Extraversion. 

Again, these findings implicate psilocybin mushroom therapy in seismic increases of Openness and Extraversion– the two key personality domains that aid in qualifying pain as a neutral sensory experience.

It’s useful to note that this study also found significant decreases in Neuroticism (disposition to experience negative affects), depression, vulnerability, and self-consciousness. They also found clinically significant increases in positive emotion and self-discipline. 

These changes in and of themselves, specifically in measures of self-discipline, illustrate psychedelics’ ability to help us cultivate routine– a necessary component of any mindfulness practice used to further reduce pain perception.

A Review of Studies on Psychedelic-Reduced Chronic Pain

In a 2021 study by Bornemann et al., researchers recruited 11 individuals who reported self-medicating with serotonergic “classic” psychedelics to manage their chronic pain. Participants engaged in a 1-hour-long semi-structured discussion about their therapeutic protocols and changes in pain levels. 

These discussions were then transcribed, analyzed, and thematically organized to identify the processes that play a role in pain reduction and mental wellbeing. All participants had been experiencing chronic pain for anywhere between two to 25 years, and all participants reported comorbid depression associated with the severity of their pain.

In the study, researchers found that the period of direct pain relief ranged from 0 to 6 months or more, with an average of 36 days of pain relief, and a median of 7 days following high-dose psychedelic use. Complete or “analgesia-like” pain relief ranged from 3 to 7 days, with 5.4 days being the mean. 

Psychological effects demonstrated much longer durability, with six participants stating that positive psychological changes endured indefinitely after self-medication began, and four participants reporting several months of psychological changes. 

Upon further analysis, Positive Reframing and Somatic Presence were identified as the primary cause for improvements in sensory and emotional pain. Positive Reframing, akin to benefit-finding, describes the psychological transition from depression and pain catastrophizing toward subjective experiences of acceptance, optimism, and self-compassion.  

Researchers identified that the participants’ quality of life were critically compromised by pain-related pessimism, which stunted their perceived potential to recover health. The following quotes are directly sourced from Bornemann and colleagues’ 2021 study, and suggest that the psychological effects of chronic pain were “at least as impactful as the pain itself” (Bornemann et al., 2021).

When I’ve had breakthroughs in my therapy, the pain has gone down. That’s probably the biggest correlation between my trauma and my painC1.

There was, and still is, a very clear correlation between my stress and emotional state and my level of painC11.

I notice (the pain) more in the times when I’m really stressed outC4.

In line with previous studies, participants highly reported on the antidepressant and anxiolytic effects of psychedelics

I legitimately considered killing myself a few weeks ago. I feel like my life has been saved… I have more of a will to exist nowC7.

Every time I’ve done (mushrooms), it’s always reminded me that there’s a light at the end of the tunnel, that (the pain) might suck, but it’s not that bad. It’s totally manageable, I can be happy while all of this is going onC3.

Trying to focus on the positive and being grateful and being aware of all the wonderful things that are going on in their life. That really does make a huge difference for meC2.

In terms of Somatic Presence, study participants reported feeling physical release through crying, tingling, vocalization, change in temperature, and release of muscular tension. These are common themes that Psychedelic Passage facilitators observe in our clients. 

They are forms of catharsis which gives way for both physical and emotional wellbeing. At the beginning of this article, we noted that psychedelics help integrate mindfulness practices by bridging the often-present mind-body gap. Some study participants actually made a note on this. 

I noticed that while on mushrooms, I could actively feel where there’s tension in the body. In yoga, or any practice for healing, they talk about breathing into that space, relaxing that space. I felt I was actually able to do that on mushrooms” C9.

“I was laying on the floor and just breathing in different spots and feeling the energy in my body. I had more access to breath and (was) able to breathe into the spot and to actively feel the muscle, almost visualizing the muscle, and watching it release”—C9

When I’m breathing, I can feel my whole body is vibrating everywhere except for that one spot… when it lets go, it releases any kind of pain that I have”—C2.

In a 1973 study by Grof S. and colleagues on LSD-assisted therapy, 60 terminal cancer patients were administered LSD. They found that 29% of participants experienced dramatic improvement in emotional and physical distress, with 41.9% seeing moderate improvement. 

In a 2006 study led by Sewell and colleagues, 56 cluster headache patients who self-medicated with psychedelic drugs like LSD and psilocybin, were interviewed by researchers. 

85.62% of psilocybin users indicated that psilocybin completely aborted migraine attacks. About 52% of LSD users reported that LSD completely terminated the cluster period. More than 94% of psilocybin users and 80% of LSD users reported an extension of their remission period. 

According to pharmacological studies, potential applications of psychedelics in chronic pain are plausible, given that classic psychedelics act via the 5-HT2A serotonin receptor, which play a vital role in inflammatory pain (Nau Jr et al., 2013). 

Current research indicates that psychedelics’ anti-inflammatory properties are associated with tumor necrosis factor (TNF) regulation (Szabo, 2015). TNF is a cytokine with a major effect on inflammatory responses, thus its regulation may result in desensitized central pain response. 

Discussion

From what we’ve learned today, psychedelics do demonstrate pain-reducing properties in populations that suffer from chronic pain. Whether this pain relief is predominantly caused by some inherent analgesic property of psychedelic drugs or to changes in the emotional dimension of pain, remains unclear.

Our findings suggest that psychedelics’ ability to cultivate experiential Openness is at the core of their diminishing effects on pain. We hypothesize that psychedelics’ rapid upending of mental paradigms are positively reinforced by the therapeutic effects that follow it, which as a result, condition more Openness to experience.  

Since a significant correlation was found between level of mysticism and intensity of pain, it seems that the degree to which psychedelics upend our mental paradigms correlates to the degree of change in Openness that’s experienced. 

This makes sense. Someone who is already very Open, is likely to experience less upending, because there is less to upend. Their beliefs are already malleable and open to change. However, someone who goes into the experience with low Openness, is likely to endure more upending, since their beliefs are more rigid, and thus more susceptible to disillusion.

With enhanced openness to experience, we stop frequently identifying with flat-out or one-faced beliefs. This broad-mindedness breeds less polarity and more neutrality in our thinking patterns. Adopting more Open perspectives is a practice of non-attachment, which makes us more able to narrate physical pain as a neutral sensory experience. 

In this process, we learn to create distance between our thoughts and our identity. Our pain ceases to define our identity, thus our thoughts surrounding pain become less personal and pessimistic.

We stop perceiving others’ beliefs as an attack on our intelligence. We have more mental real estate and attentional resources available to focus on things other than pain. Our aesthetic appreciation and sensitivity grows, along with our imagination– a key component in actualizing a neutral perception of sensory experience. 

Anecdotal Reports

As mentioned earlier, we reached out to communities of people that self-medicate with psychedelics to manage the effects of their chronic pain. These are sufferers of chronic headaches and migraines, multiple sclerosis, fibromyalgia, arthritis, and pain from traumatic injury. Here’s what some of them had to say:

I first ate mushrooms about 6 years ago. I ate about 3 grams. It was a life-changing experience. I felt 0 anxiety for the first time in my life ever. While I was going through the ” trip” the mauhrooms told me I needed to get healthier and drop some weight. I can’t explain it.

I started growing my own psilocybin mushrooms back in February. I grew them for a friend who had cluster headaches. I later learned about the benefits of microdosing. It helps me with anxiety and depression and undiagnosed PTSD.

I was in a car accident in my teens. Broken bones and infection. resulted in 2 years of being bedridden. I put in 100 lbs and ballooned up to 350 lbs. I used food as a method of coping with the depression. It’s a nasty trap to fall into. 

You eat because your depressed, you then get depressed because you binged and ate 8,000 calories. After the years passed I put on another 100 lbs. I got up to 451 and probably more. Idk my scale just said error. I was in such bad shape I could barely move.

I lost my job due to the constant pain from bone deformity and my massive size. I had a lot of free time so I decided to grow mushrooms for a friend. I was so successful at it I had an ample supply. 

I live in Oregon and the laws passed and so much research came about on the benefits of microdosing and the use of psilocybin for mental health conditions. As well as addiction and compulsive behavior like binge eating.

I started microdosing (about .10 grams a day) and within a month I felt no desire to over eat to cope with my anxiety. In less than a year I have dropped 180 lbs. Even after loosing all that weight I still have a lot of pain all over my body. Probably more now than ever because I am moving around more. It’s worth it.

Lately I have been transitioning into macrodosing once or 2 times a month. Unfortunately mushrooms are not something you can take in big doses very often. You develop a tolerance rather quickly and the magic disappears. You have to respect the mushroom.

For someone who is affected by anxiety everyday as well as pain. It’s nice to get about 4 hours of blessful pain free worry free time. I usually listen to some music or stare at the wall and watch it wave mildly. 

I don’t hallucination that much, nothing like the movies. It’s much more of a body buz. Comparable to taking a pain pill. Eating a 8th of mushrooms is the human equivalent of unplugging the router for 10 seconds when the internet stops working or restarting your phone when it gets glitchy It just seems to 

help repair some of the mental connections. I believe mushrooms have saved my life. I could talk about this stuff for hours.” -Anonymous Respondent

“For background, My persisting pain is (I think) overall just joint inflammation- One of the first things I notice when microdosing regularly is the inflammation goes down/I have less pain & better sleep because of it.” -Anonymous Respondent

Early in Jan 2016, I started to experience clicking/crunching and stiffness in the left side of my neck despite being very physically active and almost non-sedentary lifestyle. Over the next 2 months things started to get ugly the pain becoming severe, and out of no where when day I woke up and went into severe derealization and depersonalization.

Over the next couple of months my body lost all vitality and vigor it had, hair started to become thin and I started to experience pain in different joints of my body; end of 2017 I started to get these pus filled boils on my face abruptly (folliculitis) and would wear a face mask to hide them and avoid

grossing out people, high pitch tinnitus and ringing in my ears every second; things kept worsening over the years and months in all aspects. I spent an arm and a leg in medical treatments and no one was able to find the root cause of any of my issues and just kept treating my symptoms without any

betterment either; all the MRIs and CT scans and X-rays and infinite blood tests came out normal but my issues kept getting worse, even tried alternative treatments and even religious/spiritual ones under the impression that I may have been jinxed or cursed/hexed somehow but all to no avail!

To cut a extremely long and painful story short; early 2021 I took LSD and the trip turned out to be a therapeutic one, did shrooms later on and felt a decrease in my symptoms and issues; I was told that all the health issues I was experiencing were due to trauma and emotional scars my body was storing

inside all my life that was getting overboard and the symptoms I was experiencing was my body’s way of telling me that it needs help (I come from a severely dysfunctional family, turbulent childhood and teenage years progressing well into my adulthood)

My biggest breakthrough came thru MDMA/Ecstasy therapy where I experienced being loved and warmth for the first time of my entire existence of 33 years and after that trip the pain in my neck and 

the stiffness for the first time went down drastically and I was able to rotate my neck without much stiffness! I am still on the way to recovery (fingers crossed) and far from it but for the first time in 7 years” -Anonymous Respondent

“Psilocybin has changed my life. I microdose 0.3gr 3x daily. It helps with pain and the depression that comes with chronic pain. I don’t get high, never any magical effects or distorted reality. It feels like a warm hug and relaxing like cannabis without the psychoactive effects.” -Anonymous Respondent

“I did this [microdose 3x daily] for 6 months. It totally worked! Especially for anxiety which seems to make me notice my pain more.” -Anonymous Respondent

Explore How it Feels to Be Open

 

If today’s article propelled an interest to incorporate psychedelics into your healing journey, we empower you to connect with our pre-vetted network of psychedelic facilitators by booking a consultation with us. 

This fresh space of psychedelic medicine can be tricky to navigate, but it shouldn’t have to be. Our program is specifically designed for personal transformation. Every stage of the process can and will be tailored to your specific intentions and circumstances. 

If you want to learn more about all-things-psychedelic, check out our resources page for more informative articles like this one. That’s all for now, fellow psychonauts. As always, safe and mindful journeying! 

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