It’s 2022 and psychedelic drugs are garnering the attention of world ranking medicine scientists and high government officials. No longer are these substances confined to the catacombs of niche scientific communities or deemed as weapons of an insubordinate counterculture.
The resurfacing of psychedelic interest has sparked a global ascent of psychedelic-positive research, with more and more studies continuing to prove their efficacy in treating disorders like depression, PTSD, and anxiety.
As psychedelic studies begin to narrow their investigations into less common, but equally pervasive medical conditions, people are beginning to grow curious about their efficacy in treating the chronic pain associated with fibromyalgia.
In this article, we’ll analyze the mechanisms by which psychedelics may help reduce the emotional and physical pain associated with fibromyalgia and its co-occurring disorders. We’ll examine the findings of research studies to determine potential treatment efficacy.
We’ll also present anecdotal reports of Psychedelic Passage survey respondents who use psychedelics to treat their fibromyalgia-induced chronic pain. Where do the sensory dimensions of pain meet the emotional dimension? How can we manipulate the emotional dimension of pain to reduce its sensory intensity?
What is Fibromyalgia?
Fibromyalgia is a disorder marked by full-body musculoskeletal pain which pervades sleep and memory, causing fatigue and difficulties regulating mood. Cognitive difficulties with focus and task-oriented attention associated with fibromyalgia have been dubbed “fibro fog”.
It’s hypothesized that fibromyalgia amplifies sensory pain by causing dysfunction between the brain and spinal cord’s ability to process sensory signals. The onset of fibromyalgia symptoms are often triggered by traumatic injury, infection, or psychological stress. However, this varies from person to person. In some cases, symptoms slowly develop over time, with no specific trigger source.
Co-occurring disorders often include migraines, arthritis, anxiety, and depression. Luckily, psychedelic therapy has already been proven to effectively treat depression and anxiety. Research has also supported psychedelics’ efficacy in treating cluster headaches and migraines.
However, no cure has been identified for specific treatment of fibromyalgia. Women appear to be more predisposed to the condition than men, and family history can play a significant role in genetic predisposition to the disorder.
The Current Treatments For Fibromyalgia
Due to a lack of scientific knowledge on the disorder, fibromyalgia treatment is focused on symptom-mitigation medications and therapies. Over-the-counter pain relievers are the most common pain-reducing agents.
Antidepressants are often prescribed to treat anxiety and depression caused by fibromyalgia pain. Muscle relaxants are used to promote sleep, along with specific sleep medications. Anti-seizure drugs are also commonly employed to reduce certain types of pain.
Physical therapy, occupational therapy, and counseling are vital for improving physical strength and flexibility, and overall mental wellbeing. Sufferers of chronic pain often turn to alternative therapies that help develop affect regulation skills, such as meditation, yoga, and breathwork.
Psychedelic therapy has been proven to aid in the development of these skills. Our focus today will be on identifying psychedelics’ potential for reducing pain perception by promoting the cultivation of pain-neutralizing mental narratives.
Exploring Chronic Pain at The Mind-Body Axis
Many studies have concluded that chronic pain is a significant predictor of negative affective states. Persistent pain is very often associated with anxiety, depression, and anger disorders (Yang & Chang, 2019). The development of these comorbidities has been shown to amplify the sensory intensity of pain.
The negative feedback loop associated with emotion-amplified pain is often referred to as pain catastrophizing or pain pessimism. As the stress response system becomes accustomed to the physical experience of pain, sufferer’s begin to expect this routine.
The expectation of the pain enhances the physical sensation of it, in a sort of confirmation bias fashion. Confirmation bias is the tendency to search for information that confirms or strengthens our beliefs. This search for confirmation is illustrated as sufferers of chronic pain begin to expend more attentional resources onto their pain. As attention to pain grows, so does the pain itself.
In a 2019 study by deCharms RC and colleagues, real-time functional MRI (rtfMRI) was used to train healthy subjects and chronic pain patients to regulate the activation of their own anterior cingulate cortex (ACC). The ACC is responsible for encoding the unpleasantness of pain.
Researchers 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”. 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. Later, participants were instructed to apply these strategies while receiving pain caused by noxious thermal stimuli. RtfMRI provided direct feedback on the ACC’s activation, and findings were then correlated to the subjects’ reported changes in pain perception.
They found that the further this ACC-modulating skill was developed, the lower participants’ perception of the pain stimulus became. This study tells us two things. One– focusing attention onto our pain enhances the sensory intensity of it. Diverting attention away from pain, decreases the sensory intensity of it.
The study also reveals a very important constituent to pain, which is our mental contextualization of it. If we catastrophize pain by attaching negative labels to it, the pain becomes pronounced. If we contextualize pain as a neutral sensory experience, the pain begins to diminish.
The results of a 2013 study by Lutz et al., confirm these findings. Researchers recruited meditators with over 10,000 hours of practice and novice meditators who matched the experimental group in age and sex.
In contrast to novices, expert meditators reported equal pain, but significantly less unpleasantness. They showed reduced baseline activity in the amygdala (the brain region that processes fearful stimuli), while novice meditators did not.
Upon further investigation, researchers concluded that the expert mediators were less prone to experiencing unpleasantness from pain because their consistent mindfulness practices cultivated increased experiential Openness, which reduced negative anticipations of adverse events, and allowed the expert meditators to more easily direct attention away from the pain.
This study not only confirms the role of attention in pain amplification and reduction, but introduces a personality dimension that underscores one’s ability to manipulate pain perception: Openness.
This makes sense, someone who is very Open is less likely to experience less pain because their beliefs are more neutral and malleable. Their attention isn’t motivated by one-faced beliefs, thus, they’re less likely to fall victim to confirmation bias strategies.
They’re more likely to adopt the belief that their actions and thoughts have an effect on an experience (often referred to as an internal locus of control), including painful ones. Conversely, someone who is less Open is more likely to allow a specific stimulus, including pain, to control their perception of it.
People with a low level of Openness are much more susceptible to negative affectivity, the stable tendency to experience negative emotions. People with a high level of Openness are more prone to positive affectivity, the stable tendency to attaching positive emotions to experiences, including adverse ones.
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.
How Psychedelics Can Promote Positive Affectivity
Knowing that pain can be greatly reduced by experiential openness, and significantly amplified by negative affectivity, it’s vital that we analyze psychedelic-induced changes in these dimensions of personality.
In a 2011 study by MacLean and colleagues, researchers found that Openness increased significantly following high-dose psilocybin sessions. In fact, psychedelic-induced changes in openness are greater than changes in openness typically only observed in healthy adults over decades of life experience (Terracciano et al., 2005).
In a 2018 study by Erritzoe and colleagues, the most significant changes were seen in Neuroticism reductions (P=0.002), Extraversion increases (P=0.000), and Openness to Experience increases (P=0.012). Neuroticism is a trait disposition to experience negative affects, including anger, anxiety, and depression.
Already, we can deduce that psychedelics can be powerful tools for dismantling pain pessimism by significantly reducing neuroticism. Their ability to increase Openness can directly increase chronic pain sufferers’ ability to perceive their pain as a neutral experience.
Since studies have shown that Openness to Experience and Extraversion are the primary dimensions of personality that predict overall benefit-finding, psychedelics’ ability to rapidly increase Extraversion and Openness levels make them promising therapeutic tools for enhancement of dispositional optimism in fibromyalgia sufferers.
Consistent with previous research, the study also found significant decreases in depression (P=0.006), and significant increases in positive emotions (P=0.000), openness to values (P=0.001), and in self-discipline (P=0.010).
As mentioned earlier, chronic sufferer’s daily efforts to remind themselves of the benefits that come from their illness significantly increase the likelihood of experiencing a pleasurable mood, despite the intensity of pain.
Psychedelic-induced increases in self-discipline can aid in the integration of benefit-finding routines. Their ability to increase positive emotions would evidently contribute to the development of positive affectivity. The enhancements observed in Openness to values would undoubtedly aid in the mental paradigm shifts necessary for qualifying pain as a positive or neutral experience.
The Current Research on Psychedelics For Fibromyalgia
In a 2021 study by Bornemann and colleagues, researchers conducted a semi-structured discussion with 11 individuals who self-medicated with psychedelic drugs to treat their chronic pain. Of the overall study population, 18% of participants had fibromyalgia.
Average baseline pain severity amongst the participants was 7.25/10. The study found that participants experienced an average of 36 days of direct pain relief following psychedelic use. Complete or analgesic-like pain relief persisted for an average of 5.4 days following psychedelic use.
Researchers thematically organized the conversation transcripts to understand major categories of change. The most prominent effect on pain reduction was caused by Positive Reframing. That is– the shift from pain catastrophizing toward optimism and compassion.
Again, we find evidence that psychedelics can reduce chronic pain by enhancing openness and promoting benefit-finding. Five of the study’s participants reported difficulties sleeping, two reported not sleeping for days, and ten reported feeling fatigued from the pain.
However, after psychedelic use, all participants reported improvement to quality of life through increased function, energy, and ability to move. The following participant report was sourced directly from Bornemann and colleagues’ 2021 study.
“I am able to sleep, move, cook, use the bathroom, etc. I have regained mobility I have not had for years and am still in complete disbelief… I’ve had full mobility… I have felt unusually fine ever since…
It feels like my body time-machine-reverted all the way back to (when I was healthy) … I thought, maybe I can have a life again, and I laid there for maybe an hour just thinking about all the stuff I could potentially be able to do again” -C7.
To finalize our discussion, we evaluate a 2022 study by Glynos and colleagues which collected survey responses from 354 North American participants with fibromyalgia. LSD and psilocybin mushrooms were the most commonly used serotonergic psychedelics amongst this population.
12 of the participants expressed using psychedelics with the specific intention to treat their chronic pain. 11 of those participants reported improved chronic pain symptoms following psychedelic use. 36.8% of the overall study subjects indicated a positive perceived benefit from psychedelic use. 59.4% reported a generally neutral perception on psychedelic benefits.
However, seeing as 91.6% of people who intentionally used psychedelics to treat their chronic pain, saw a positive improvement, it’s very likely that those who reported a generally neutral perception of benefits, would have a more positive perception if their use was intentional.
Anecdotal Reports of Psychedelic-Medicating Fibromyalgia Sufferers
As mentioned earlier, we reached out to communities of people that self-medicate with psychedelics to manage the effects of their fibromyalgia pain. Here’s what three of them had to say:
“LSD helps my pain levels for a couple weeks after a normal dose. The hardest part of having fibro is mourning the life and abilities I used to have. Also, remembering to pace myself when I’m feeling good is difficult.” -Anonymous Respondent
“I did ketamine infusions.and it helped tremendously. Had some wild trips that helped to resolve some long standing psychological issues.” -Anonymous Respondent
“I’ve tried a few times and each time it has made my body feel light and significantly easier to carry around with me. I felt less impeded by brain fog or the general aches and pains I’m used to.
It also helped me to feel cooler (I have temperature regulation issues) for the next several days after, when when at work! I’ve found that shrooms work best for me specifically, LSD is a little more recreational than medical in my mind, but everyone is different!” -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 our fellow psychonauts. As always, safe and mindful journeying!