Can Psychedelics Replace Opioids As Addiction-Free Painkillers?

Our brains are funny old things. Their specific kind of magic still unknowable in many ways, even to the most advanced neuroscientists. But it is our brains that process and communicate the pain we feel — both emotionally and physically. And due to these interconnected processing mechanisms, the line between these different types of pain become blurred. 

A Pain with No Cause

This is most evident in those who suffer from nociplastic pain. Nociplastic pain is a type of pain that does not have a clear or obvious trigger, making it different from nociceptive or neuropathic pain. It is an umbrella term that covers conditions that range from dysfunctional pain to unexplained bodily syndromes. These include fibromyalgia, musculoskeletal pain such as chronic low back pain, bladder pain syndrome, and irritable bowel syndrome. It can be extra traumatic for those who suffer from these conditions because a traceable cause, such as injury or nerve damage, is not apparent. This can lead to them not being believed, or perhaps even questioning their own grip on reality.

The Trouble with Opioids

For many of these people there is no other option other than to turn to painkillers, such as opioids. And, you doubtless have read, the opioid epidemic is the current scourge of the medical system. Opioids are at once dangerously addictive, as well as ineffective for actually treating the root causes of pain. The initial feelings of elation and numbed pain are replaced by growing tolerance and no back-up plan other than continuing to take the drug. 

So when we look at it this way, it starts to become clear as to why exploring the potential of psychedelics to treat physical pain, as well as psychological, is so crucial. It makes sense right? Both depression and chronic pain hurt. They can ruin our quality of life. And, our current methods of treatment are causing, if anything, more hurt in the long run. 

Psychedelics Become More Effective Over Time

So, once again studies have delivered promising results indicating that psychedelics can be effective in the treatment of physical pain. But here’s the kicker — the cherry on top. It seems that, in direct opposition to opioids, psychedelics actually become more effective over time. Nerve pain research has shown that drugs, like psilocybin and LSD, that target serotonin receptors, actually increasingly relieve pain and discomfort with repeated use. 

In a recent literature review researchers explored and compared the different studies covering this area of psychedelic research. And, they found that the history of psychedelic treatment for physical pain is not as new as you might think. In fact, between 1964 and 1977 various small-scale clinical trials were taking place that showed that LSD could work as an effective painkiller. These studies even found the psychedelics outperformed opioids in the treatment of cancer and gangrene. Scroll up to today, and more people than ever before are self-medicating conditions such as cluster headaches using psilocybin or LSD, finding them to be far more effective. 

Working on Both Physical and Emotional Pain at Once

So how do these trippy substances manage to tackle pain? Well psilocybin and LSD, unlike opioids, don’t immediately and directly start to manipulate pain receptors. However, due to their serotonergic action they may be ideal for treating nociplastic conditions such as IBS, fibromyalgia, and complex regional pain syndrome (CRPS). The same literature review suggested that these drugs work on both physical pain and the origins of emotional distress at the same time. 

Psychedelics may be on their way to becoming the new painkillers for this very reason. Psilocybin and LSD seem to be able to rewire the brain in ways that alter its relationship to emotional distress and make it less receptive to physical pain signals. This complicated neural reshuffle is critical for treating patients with nociplastic pain, as their pain-detecting neurons are very easily triggered, causing them pain other people may not feel. This kind of sensitivity often starts with general discomfort, but over time it becomes more intense. Eventually it becomes unbearable for the sufferer.

Chronic Pain Can Change Our Brain

The condition can transform from acute to chronic rapidly, because cells shift rolls, cellular proteins are rearranged and genes begin to function differently. Ultimately, the brain, already mismanaging physical pain, goes on to do the same with our emotional processes too. This may explain why those who suffer from chronic pain also develop anxiety and/or depression. 

Chronic pain even changes the Default Mode Network (DMN), the part of our brain network associated with thoughts about our ‘self’. Both people suffering from depression and chronic nociplatic pain show unusually high levels of activity in the DMN, and it seems cut off from other parts of the brain that process emotions and pain. This is linked to self-obsession and negative thought loops. 

Brain Diversity is Key

When psychedelics interact with the serotonin receptors in our brains, such as the 5-HT2A, they increase the ‘entropy’ of our brain. This is like our brain’s richness and diversity— it increases connection to other parts of the brain, helping us break free from the self-obsessed control of the DMN. This process is thought to reset our brains, offering up a novel way to treat both chronic pain and emotional anguish. 

Inflammation is another key factor in chronic pain and depressive conditions. Psychedelics have been shown to reduce inflammation, as well as promoting the growth and connection of brain cells.

A Holistic Treatment for a Healing World

As medical science becomes more and more sophisticated, the more it becomes clear that our ‘self’ is a complex combination, that’s equal parts our physical body and our emotional and spiritual being. The mind cannot be separated from the body, and the body cannot be separated from the mind when it comes to full healing. Psychedelics are one of the only substances able to treat us holistically, working on our mind, body, and spirit. The more research we do into their mysterious effects, the better.