Use of Psychedelics for Pain: A Scoping Review.

Akash Goel, Yeshith Rai, Shayan Sivadas, Calvin Diep, Hance Clarke, Harsha Shanthanna, Karim S Ladha

Journal: Anesthesiology 2023;139(4):523-536

PMID: 37698433

Abstract

Chronic pain is a public health concern that affects approximately 1.5 billion people globally. Conventional therapeutic agents including opioid and non-opioid analgesics have been associated with adverse side effects, issues with addiction, and ineffective analgesia. Novel agents repurposed to treat pain via different mechanisms are needed to fill the therapeutic gap in chronic pain management. Psychedelics such as lysergic acid diethylamide and psilocybin (the active ingredient in psychedelic mushrooms) are thought to alter pain perception through direct serotonin receptor agonism, anti-inflammatory effects, and synaptic remodeling. This scoping review was conducted to identify human studies in which psychedelic agents were used for the treatment of pain. Twenty-one articles that assessed the effects of psychedelics in treating various pain states were included. The present scarcity of clinical trials and small sample sizes limit their application for clinical use. Overall, psychedelics appear to show promise for analgesia in patients with certain headache disorders and cancer pain diagnoses. Future studies must aim to examine the combined effects of psychotherapy and psychedelics on chronic pain.

Copyright © 2023 American Society of Anesthesiologists. All Rights Reserved.

Address: Department of Anesthesiology, St. Michael's Hospital, Toronto, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada.; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada.; Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada; Department of Anesthesiology and Pain Medicine, Toronto General Hospital, Toronto, Canada.; Departments of Anesthesia, Surgery and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
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