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Psychedelic Drug Research Continues for Treating Pain

Psilocybin, MDMA, and LSD are on the research roster as possible treatments for a variety of disorders – from PTSD to neuropathic pain.

with Timothy Furnish, PhD

Mind Medicine, a leading psychedelic research company already focusing on treatments for anxiety and addiction, including one aimed primarily at opioid use disorder, has launched Project Angie, a program that will advance the study of psychedelic medicine to treat pain conditions.

Due to more recent advances in neuroscience and brain imaging technology, the possibilities for psychedelics for treating medical and psychiatric disorders have contributed to a resurgence of scientific interest in the therapeutic use of these substances (Image: iStock).

 

The Ups and Downs of Psychedelic Research

Psychedelic, or consciousness-altering, substances have been used by indigenous communities for thousands of years, both for medicinal and spiritual purposes. In 1938, Swiss chemist Albert Hofmann synthesized lysergic acid diethylamide (LSD-25), marking the beginning of modern research on this class of drugs. The discovery of LSD led to, among other things, the discovery of serotonin.1

Research during the 1950s and 1960s examined the role of psychedelics in time perception, metabolism, and combatting addiction, among other things. However, in the 1970s and 1980s, the backlash against recreational drug use and the culture that accompanied it led to government restrictions that all but halted research into psychedelics. In 1970, President Richard Nixon signed into law the Controlled Substances Act (CSA), making most drugs in this class not only illegal but also falling under Schedule I, the class of drugs for which possession and/or use carries the harshest penalties. Although a few intrepid researchers continued their work, most did not, and decades of progress in this area were lost.

However, due to more recent advances in neuroscience and brain imaging technology, the possibilities for psychedelics in both better understanding the brain and treating medical and psychiatric disorders have contributed to a resurgence of scientific interest in the therapeutic use of these substances. In the past decade, major research universities have begun investigating the use of psychedelics for treating a variety of psychiatric conditions, including post-traumatic stress disorder (PTSD), depression and anxiety, as well as for assisting patients near the end of life. Project Angie will be one of the first major initiatives to study the role of psychedelics in treating pain.

"Evidence dating back to the 1950s suggests that LSD and other psychedelics may have analgesic effects, but this treatment area remains largely untapped by companies studying psychedelics, with the majority of research focusing solely on psychiatric indications,” Mind Medicine’s Chief Development Officer, Rob Barrow, said in a press release announcing the program. 

Psychedelics for Pain: Proof of Concept

While it is still unclear how this class of drugs may help with pain, the possibilities are intriguing. “What is potentially exciting [about research into psychedelics] is that they hold the promise of being neuro-modulating, meaning that if we can reverse some of the neurologic changes that happen with certain chronic pain conditions, especially with large dose psychedelics, we might be able to effect something that looks more like a cure, or at the very least, a sustained, longer-term effect than simply taking a pill every day,” Timothy Furnish, PhD, a pain medicine specialist and researcher at UC San Diego’s Psychedelics and Health Research Initiative, told PPM.

Project Angie is starting with a study of LSD as an indication for severe pain and plans to submit a pre-investigational NDA to the FDA later this year. The company is also currently evaluating a second indication for chronic pain. Although at this point, they have not yet announced any specific indications, Mind Medicine's Chief Medical Officer, Dan Karlin, MD, MA, says they are “casting a pretty wide net across the different sorts of pain syndromes.”

If psychedelics do work for pain, they probably won’t work for every kind of pain. “Nothing in the world of pain medicine works for everything,” notes Furnish, “not even opioids. I suspect if it is going to work, it's going to work better for nerve pain, and especially nerve pain that has a central component, meaning that there are alterations at the level of the spinal cord and the brain, as opposed to pain that's entirely peripheral, like surgical pain or knee arthritis, for instance.”

See more research on psychedelics for chronic pain conditions.

Hurdles to Psychedelic Research

Despite increasing interest and promising initial results (particularly for psychiatric and behavioral disorders),2 researchers with Project Angie face many hurdles ahead. “These drugs have been considered a taboo, Schedule I, for over a generation,” Furnish points out. “So there’s probably going to be some public perceptual issues.” However, the biggest challenge, he says, is on the regulatory side. “There are hurdles with the FDA, with the DEA. In various states, you may need special state permission to do clinical research with these drugs.”

Nonetheless, Karlin is optimistic about the prospects of these new, potentially game-changing therapies for treating one of the most challenging conditions physicians face: chronic pain. "We're very hopeful that we can develop a body of evidence that allows us to bring these medicines to folks for whom other things haven't worked," he says.

Last updated on: July 8, 2021
Continue Reading:
Psychedelics for Chronic Pain: Is It Time?
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