Semi‑structured interviews with 11 people who self‑medicated chronic pain with classic psychedelics revealed substantial subjective reductions in pain and identified two recurrent processes—Positive Reframing and Somatic Presence—alongside adjunct practices (mindfulness, breathwork, movement) that participants credited with improving wellbeing and pain experience. Although qualitative and not causal, these patient‑involvement findings were used to inform the design of a forthcoming controlled trial of psychedelic therapy for chronic pain.
Background
Chronic Pain is among the leading causes of disability worldwide with up to 60% of patients suffering from comorbid depression. Psychedelic-assisted therapy has recently been found effective in treating a host of mental health issues including depression and has historically been found to be useful in treating pain. Reports of self-medication for chronic pain using psychedelic drugs have been widely documented, with anecdotal evidence indicating widespread success in a range of pathologies.
Aims
In preparation for an upcoming trial, to better understand how those with lived experience of chronic pain self-medicate with psychedelic drugs, and to establish, in detail, their therapeutic protocols and practices for success.
Methods
As part of patient-involvement (PI) for an upcoming trial in this population, 11 individuals who reported self-medicating with psychedelic drugs took part in a 1-h semi-structured discussion, which was then transcribed and thematically analyzed.
Results
Across a range of psychedelic substances and doses, reported pain scores improved substantially during and after psychedelic experiences. Two processes, Positive Reframing and Somatic Presence, were reliably identified as playing a role in improvements in mental wellbeing, relationship with pain, and physical (dis)comfort. Inclusion of other strategies such as mindfulness, breathwork, and movement were also widely reported. Due to the data's subjective nature, this paper is vulnerable to bias and makes no claims on causality or generalisability. Together, these results have been used to inform study design for a forthcoming trial.
Conclusion
This pre-trial PI work gives us confidence to test psychedelic therapy for chronic pain in a forthcoming controlled trial. The results presented here will be instrumental in improving our ability to meet the needs of future study participants.
Papers in Blossom that reference this study
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Syed, O. A., Petranker, R., Fewster, E. C. et al. · Journal of Psychoactive Drugs (2024)
Kettner, H., Roseman, L., Gazzaley, A. et al. · The American Journal of Geriatric Psychiatry (2024)
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Di Virgilio, A., Di Virgilio, V., Minerbi, A. et al. · MedRvix (2023)
Timmermann, C., Vollenweider, F. X. · Trends in Cognitive Sciences (2023)
Butler, M., Seynaeve, M., Bao, J. et al. · Journal of Clinical Psychiatry and Clinical Neuroscience (2023)
Lyes, M., Yang, K. H., Castellanos, J. P. et al. · PAIN (2022)
Henningfield, J. E., Coe, M. A., Griffiths, R. R. et al. · Neuropharmacology (2022)
Dursun, S. M., Kelly, J. R., Gillan, C. M. et al. · Frontiers in Psychiatry (2021)