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- Worldwide interest in the potential therapeutic value of psychedelics is increasing in many areas of science and healthcare.
- Evidence tentatively suggests benefits in addiction, treatment-resistant depression, terminal-illness-related anxiety, obsessive-compulsive disorder, cluster headaches and pain.
- Psychedelics may alleviate pain indirectly through the action a psychedelic experience has on an individual's metacognitive interpretation of their pain.
- Psychedelics may act in the brain tomodulate pain using mechanismssimilar to mindfulness.
- Psychedelics may alleviate pain directly through 5-HT2A receptor binding at the rostral ventromedial medulla with enhancement of descending pain inhibitory pathways.
- There have been very few trials assessing the effectiveness of psychedelics in the management of acute or chronic pain since 1977.
- There are reports that self-medication with psychedelics is superior to current medications in the treatment of cluster headaches and a small-case series demonstrated 2-bromo-lysergic acid diethylamide improved cluster headache symptoms and frequency of attacks.
- Small studies without controls suggest potential benefit for malignant and neuropathic pain.
There is an age-old tradition of using fungi and plants to produce psychedelic effects in religious ceremonies and ritual healing. Isolation of substances from fungi and plants led to the development of a range of psychedelic drugs including lysergic acid diethylamide (LSD, made from ergotamine, found in the fungus ergot), psilocybin (found in Psilocybe mushrooms), dimethyltryptamine (found in various trees and shrubs including Acacia species, Mimosa tenuiflora and Psychotria viridis) and mescaline (found in the peyote cactus Lophophora williamsii). Psychedelic drugs (classical hallucinogens) cause visual, auditory, tactile and olfactory hallucinations and/or an altered sense of reality through perceptual anomalies of sensation, cognition and affect. Drugs that produce a sense of detachment from the surrounding environment and/or a state of delirium (e.g.,ketamine, dextromethorphan, phencyclidine, nitrous oxide, belladonna) may also produce hallucinations and/or perceptual anomalies. However, these drugs are not considered psychedelic hallucinogens in the ‘classical’ sense.
Originally, psychedelic drugs were used to assist explorations of ‘inner experience’ during psychotherapy. Clinical research in the 1950s and 1960s suggested that psychedelic drugs were of therapeutic promise for distress secondary to terminal cancer and for addiction (1). However, medical use declined due to prohibition resulting from their use as recreational drugs as part of the counter culture (2). Recently, there has been a resurgence of interest in the therapeutic use of...