Psychedelics for Chronic Pain Management May Improve Outcomes, Reduce Substance Use

Naturalistic psychedelic use among individuals with chronic pain is associated with significant reductions in nonpsychedelic substance use and perceived improvements in both physical and mental health outcomes, according to study findings published in the British Journal of Pain.

Psychedelics have demonstrated promising therapeutic potential for neuropsychiatric disorders, and growing research indicates they may also benefit individuals living with chronic pain. Chronic pain, which affects up to 30% of the global population, often coexists with substance use disorders, complicating treatment options. While previous studies have suggested that psychedelics could help alleviate pain symptoms, little is known about their impact on substance use patterns in patients with chronic pain.

To bridge this knowledge gap, researchers conducted a cross-sectional survey using data from the Global Psychedelic Survey, distributed online between May and June of 2023. They analyzed responses from 466 adults (age, ≥21 years) who reported using psychedelics to self-manage chronic pain conditions. Participants provided information on their psychedelic use, changes in nonpsychedelic substance use, and perceived health outcomes. Statistical analyses, including chi-squared testing and logistic regression models, were used to identify factors associated with changes in substance use.

A total of 466 participants were included in the survey, of whom the mean (SD) age was 42.6 (12.1) years, and 46.1% were women.

Among 453 participants who had previously used nonpsychedelic substances, 391 (86.3%) reported reducing or stopping at least 1 substance following psychedelic use. Available data indicated that the most commonly reported substances that were stopped or reduced were alcohol (71.1%) and prescription opioids (64.1%), followed by antidepressants (63.1%) and illicit opioids (60.7%). However, 39.1% of participants reported an increase or initiation of substance use after psychedelic experiences, with the highest increases observed for illicit opioids (27.8%) and cannabis (21.5%).

The most frequently identified psychedelic contributing to reduced substance use was psilocybin (29.9%), followed by ketamine (12.5%), and ayahuasca (11.8%). Notably, 21.2% of participants who decreased their substance use reported sustained reductions lasting more than 26 weeks.

In regard to health outcomes, 78.8% of participants reported that psychedelics were effective in managing physical health conditions, with chronic pain, migraines, and sleep disorders being the most frequently targeted. Additionally, 99.3% of participants found psychedelics beneficial for mental health conditions, particularly depression, anxiety, and post-traumatic stress disorder. Participants attributed reduced substance use and health improvements to increased feelings of connection to self (62.7%), others (52.2%), and nature (50.4%). Dissatisfaction with conventional treatments was the primary reason cited for turning to psychedelics (41.2%).

Limitations of the study include its reliance on self-reported data, the cross-sectional design, potential recall bias, and the inability to confirm substance identity or dosage. Additionally, the survey sample was predominantly North American and recruited from psychedelic interest groups, which may introduce bias toward positive outcomes.

The researchers concluded, “Perceived effectiveness of psychedelics for physical and mental health were positive and long lasting, and significant reductions in conventional treatments following psychedelic use were observed in retrospective reports.” They added, “These findings provide important contributions to the study of psychedelics for chronic pain conditions and should motivate future investigation in this area.”

This article originally appeared on Clinical Pain Advisor