Episode 291: Psychedelics for Chronic Pain and Depression with Patrick Finan and Rebecca Ehrenkranz
Sep 22, 2024
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Join Patrick Finan, an expert in pain psychology and psychedelics research, and Rebecca Ehrenkranz, a postdoctoral researcher at Johns Hopkins, as they explore groundbreaking uses of psychedelics for chronic pain and depression. They discuss the transition from research to clinical trials involving substances like psilocybin and LSD. Hear about the complexities of managing expectations in trials, the role of active placebos, and the emotional breakthroughs psychedelics can provide. Plus, get insights on participant recruitment and some fun book and music recommendations!
Psychedelics like psilocybin interact primarily with serotonin receptors, potentially leading to significant and lasting improvements in mood and emotional states.
Expectancy plays a crucial role in the therapeutic effects of psychedelics, influencing patient perceptions and experiences during clinical trials.
Ongoing research aims to understand the intricate relationship between chronic pain and emotional processing, exploring psychedelics as alternative pain management strategies.
Deep dives
Psychedelics and Their Mechanisms
Classic psychedelics, such as psilocybin, LSD, and mescaline, exert their effects primarily through the serotonin 5-HT2A receptors, influencing mood and cognitive functions. These substances can produce significant perceptual alterations and emotional states, often allowing individuals to experience increased feelings of connectedness and joy. Research suggests that the effects of these psychedelics can have long-lasting positive outcomes on mental well-being, potentially persisting even a year post-experience. However, it is essential to recognize that adverse experiences, such as challenging emotions and ego dissolution, may also occur during psychedelic use.
The Role of Expectancy in Psychedelic Trials
Expectancy plays a significant role in clinical trials involving psychedelics, often influencing participants' perceptions and experiences during treatment. Many patients enter trials with low expectations due to previous treatment failures, but the prospect of psychedelics can rekindle hope. Understanding how both expectancy and actual drug effects contribute to therapeutic outcomes remains an active area of research. Researchers are eager to determine the balance between these factors and how they might interact with the unique properties of psychedelics.
Current Research on Chronic Pain
Ongoing studies are exploring the use of psychedelics for chronic pain management, particularly focusing on conditions like chronic low back pain and comorbid depression. One notable trial aims to assess psilocybin's effects on patients with chronic pain alongside mental health conditions, investigating both pain intensity and emotional processing. By analyzing interplays between pain perception and emotional states, researchers hope to elucidate how psychedelics might provide alternative approaches to pain management. This research is vital as chronic pain often encompasses a complex interplay of physical and psychological factors.
Therapeutic Approaches and Integration
The integration of therapeutic practices alongside psychedelic treatments is critical for optimizing patient outcomes. Supportive preparation and integration sessions, conducted by trained professionals, help participants process their experiences and apply insights gained during dosing. This non-directive approach has shown promise, although more structured therapeutic modalities may enhance results. Future research aims to explore various therapeutic frameworks and their effectiveness in prolonging positive outcomes from psychedelic-assisted treatments.
Future Directions in Psychedelic Research
The future of psychedelic research involves expanding clinical trials to include diverse populations while addressing challenges related to adverse event reporting and categorization. As the field grows, standardization in defining and measuring adverse events will enhance the understanding of psychedelics' safety profiles. Researchers are also eager to explore how combining established therapeutic modalities with psychedelic therapy might amplify and sustain positive effects. This interdisciplinary approach aims to further bridge the gap between psychedelics and traditional mental health treatments, offering new avenues for patient care.
In this 290th episode I welcome Drs. Finan and Ehrenkranz to the show to discuss the data on using psilocybin and other psychedelics for treating chronic pain and depression as well as their ongoing study on the topic.
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