Psychedelic Medicine: Exploring Their Pain Management Potential with Maya Armstrong, MD
Jul 1, 2024
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Dr. Maya Armstrong, a board-certified physician in addiction and family medicine, explores psychedelic medicine for pain management. She discusses pain as an emergent property, the role of psychedelics in chronic pain and addiction, epigenetics, therapeutic potential of psychedelics like psilocybin and MDMA, legal complexities, medication considerations, and new approaches for chronic pain management.
Psychedelics may disrupt maladaptive brain networks to enhance neuroplasticity post-experience.
Understanding pain as an emergent property of a complex system is crucial for effective treatment.
Psychedelic therapy requires specialized training and has contraindications for certain individuals.
Deep dives
Psychedelic-Assisted Therapy for Chronic Pain Management
Psychedelic-assisted therapy is gaining interest for treating chronic pain and mental health conditions. Dr. Maya Armstrong, a certified addiction and family medicine physician, discusses the neuroscience and theory behind psychedelic therapy. The podcast explores different psychedelic substances, their indications, precautions, and the potential role of cognitive, mindful, behavioral, and movement therapies alongside psychedelic therapy. Current legal limitations in the US are noted, requiring specialized training for clinicians in the event these therapies become accessible.
Understanding Pain as an Emergent Experience
The podcast delves into the concept of pain as an emergent property of a complex system, highlighting the importance of biopsychosocial elements in pain perception. Dr. Armstrong's paper on the emergent nature of pain emphasizes the role of interoception and how individuals sense internal bodily signals. The discussion extends to the implications of interoception and its relevance in medical contexts, particularly in how past experiences influence pain perception.
The Intersection of Neuroplasticity, Epigenetics, and Psychedelic Therapy
The conversation delves into the potential impact of psychedelics on neuroplasticity, gene expression, and reversibility of epigenetic changes associated with chronic pain. Dr. Armstrong details the neuroscientific underpinnings of psychedelic substances, highlighting their effect on receptors and how they stimulate neuroplasticity. The discussion touches on the challenges of studying psychedelics due to legal restrictions and the need to integrate specialized therapy with psychedelic treatments for optimal outcomes.
Neuroplasticity and Disruptive Effects of Psychedelics
Psychedelics, when used in a supportive environment, can positively impact neuroplasticity by disrupting maladaptive brain networks such as the default mode network. This disruption leads to a period of neuroplasticity post-experience, with different substances affecting the duration of this window. Short-acting agents like DMT result in shorter windows, compared to longer-acting substances like LSD. This highlights the importance of additional therapies to optimize the effects of neuroplasticity.
Safety and Contraindications in Psychedelic Therapy
Psychedelic therapy poses contraindications for individuals with a history of psychosis, schizophrenia, Alzheimer's, uncontrolled hypertension, or weak hearts. Safety considerations extend to acute suicidal ideation and specific medications that may interfere with the psychedelic experience. Furthermore, the age of participants, substance use issues, and preparation involving mindset and psychological flexibility are crucial factors that influence the efficacy and safety of psychedelic therapy.
In this week's episode of the Pain Science Education Podcast, we delve into the intriguing and emerging field of psychedelic medicine for pain management. Our guest, Dr. Maya Armstrong, a board-certified physician in addiction and family medicine, shares her insights and research on this topic. Dr. Armstrong discusses her background and how her personal experience with chronic pain and her professional journey in addiction medicine led her to explore the potential of psychedelics in treating chronic pain. We explore the concept of pain as an emergent property of a complex system, emphasizing the importance of understanding pain beyond the traditional biopsychosocial model.