Do Psychodelics Work in Chronic Pain?

In this episode of the Psychedelic Medicine Podcast, Joel Castellanos joins to discuss the emerging topic of psychedelic therapies for pain-related conditions. Dr. Castellanos is a Board certified physical medicine and rehabilitation and pain management physician and an associate professor in the department of anesthesiology at UC San Diego school of medicine. He earned his medical degree from University of Toledo college of medicine and has since completed a two year program in healthcare administration during his residency at University of Michigan, as well as a fellowship in pain medicine at UC San Diego school of medicine. Most recently he completed the integrative medicine fellowship from the University of Arizona.

In this conversation, Dr. Castellanos introduces the topic of psychedelics as a therapeutic modality for various pain conditions. Dr. Castellanos explains that much of the pain management field focuses on neuromodulation as the basis for particular therapeutic techniques, so psychedelics—which have profound modulating effects within the brain—naturally seem promising.

However, research into this topic is still developing, with studies from the seventies providing some initial data which is now being corroborated and expanded by contemporary research. Dr. Castellanos shares the details of this work, explaining how combined psychedelic treatment and mirror box therapy could prove to be particularly efficacious for individuals suffering from phantom limb pain.

In light of the upcoming trials led by Dr. Castellanos and his colleagues at the Psychedelic Health Research Initiative at UC San Diego, he also discusses certain special considerations for working with amputees as guides or facilitators of psychedelic therapy. The double blind randomized controlled trial investigating the efficacy of psilocybin therapy for phantom limb pain will be conducted first and is currently enrolling. This study seeks to test the efficacy of psilocybin therapy for this condition as well as elucidate its potential mechanism of action through ​​brain imaging. Click here to enroll. 

In this episode:

• An overview of the literature on psychedelics and pain
• Albert Lin’s experience treating his phantom limb pain with combined psychedelic and mirror box therapy
• Why psychedelics may be a great alternative to many current treatment options for chronic pain
• Stories of healing resulting from psychedelic therapy in patients who have suffered with chronic pain
• How to enroll in Dr. Castellanos’ upcoming trial for patients with phantom limb pain

Quotes:

“It’s really interesting to me that neuromodulation - modulating the nervous system - is such a big part of pain medicine—and no one had really looked at psychedelics as an option when they are something that really modulates the nervous system in a profound way.” [4:24]

“I don’t want people to think that this is going to be a panacea, that this is going to be the cure for everything and everyone’s pain because we need to do the research, we need to do the work and really answer the clinical question on who this is going to be most efficacious for.” [7:50]

“Where there has been the most evidence so far and the most work done is in the headache patient population, which is definitely needed. There are so many people who suffer from migraines, from cluster headaches, and it can be really debilitating.” [17:45]

“In the same way that patients who have had PTSD or have severe anxiety or depression it helps to do some talk therapy with those [psychedelic therapy] sessions, maybe some movement therapy during the psychedelic sessions may be beneficial [for treating pain].” [23:26]

Links:

Enroll in Dr. Castellanos’ upcoming study through PHRI at UCSD

Dr. Castellanos on Twitter

Psychedelic Health Research Initiative at UC San Diego

Psychedelic Medicine Association

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