Psychedelics are showing real promise for pain! In a 60-person randomized trial, ketamine infusions gave significantly lower pain scores than placebo (P<0.001), 2.68 versus 5.45 at the end of week one. In an MDMA-therapy trial, pain scores were significantly lower afterward in people with medium or high baseline pain. And among 250 people with chronic pain who had tried psychedelics, hallucinogenic doses were rated as giving a higher level of pain relief than conventional pain medications, opioids and cannabis included! A controlled trial of psychedelic therapy for chronic pain is now planned. Encouraging to see this research moving forward for people living with pain!

Key studies

Study 1. Ketamine infusion in 60 people with complex regional pain syndrome (Sigtermans, 2009)

Pain scores of 2.68 versus 5.45 at week one: ketamine infusion beat placebo in 60 people with severe CRPS!

In a double-blind, randomized, placebo-controlled trial, researchers gave 60 people with severe complex regional pain syndrome type 1 (a long-lasting pain condition, usually in an arm or leg) an infusion of low-dose S-ketamine (esketamine) or placebo into a vein over about four days. They reported that pain scores over the 12-week study were significantly lower with ketamine than with placebo (P<0.001), and lowest at the end of the first week: 2.68 with ketamine versus 5.45 with placebo. Amazing to see substantial pain relief in a condition that responds poorly to standard pain treatment!

“Pain scores over the 12-week study period in patients receiving ketamine were significantly lower than those in patients receiving placebo”

Abstract of the published study (text from Europe PMC), key sentence highlighted in yellow. Source: Sigtermans MJ, van Hilten JJ, Bauer MCR, et al. Ketamine produces effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1. Pain. 2009;145(3):304-311. https://doi.org/10.1016/j.pain.2009.06.023

Study 2. MDMA-assisted therapy in 32 people with PTSD, most of whom reported pain (Christie, 2022)

84% of 32 people with severe PTSD in an MDMA-therapy trial reported pain, and pain scores were significantly lower afterward in the medium and high pain groups!

Researchers analyzed pain questionnaires from 32 people with severe post-traumatic stress disorder (PTSD) taking part in an open-label phase 2 trial of MDMA-assisted therapy (MDMA-AT); 27 of them (84%) reported having pain. They reported significantly lower pain intensity after treatment in people who started with medium or high pain, plus significantly lower pain-related disability and overall pain severity grade in the high-pain group.

“Chronic pain scores among medium and high pain subgroups were significantly lower following MDMA-AT”

Abstract of the published study (text from Europe PMC), key sentence highlighted in yellow. Source: Christie D, Yazar-Klosinski B, Nosova E, et al. MDMA-assisted therapy is associated with a reduction in chronic pain among people with post-traumatic stress disorder. Front Psychiatry. 2022;13:939302. https://doi.org/10.3389/fpsyt.2022.939302

Study 3. Psychedelic use in 250 people with chronic pain (Bonnelle, 2022)

250 people with chronic pain rated hallucinogenic doses as giving more pain relief than conventional pain medications, opioids and cannabis included!

In an online survey run between August 2020 and July 2021, researchers asked 250 people with chronic pain who had used psychedelics, in very small doses (microdoses), in hallucinogenic doses, or both, about the pain relief they experienced. They reported that hallucinogenic doses were rated as inducing a higher level of pain relief than both microdoses and conventional pain medications, including opioids and cannabis, and that microdoses also suggested some benefits.

“Macrodoses, while less often used for analgesic purposes than microdoses, were reported to induce a higher level of pain relief than both microdoses and conventional pain medications”

Abstract of the published study (text from Europe PMC), key sentence highlighted in yellow. Source: Bonnelle V, Smith WJ, Mason NL, et al. Analgesic potential of macrodoses and microdoses of classical psychedelics in chronic pain sufferers: a population survey. Br J Pain. 2022;16(6):619-631. https://doi.org/10.1177/20494637221114962

Study 4. Self-treatment with psychedelics in 11 people with chronic pain (Bornemann, 2021)

Pain scores improved substantially during and after psychedelic experiences, reported 11 people with chronic pain!

To help design a future trial, researchers held one-hour interviews with 11 people with chronic pain who reported treating themselves with psychedelic drugs, and analyzed the transcripts for common themes. Participants reported that pain scores improved substantially during and after psychedelic experiences, often alongside practices such as mindfulness, breathwork and movement, and the researchers identified two recurring processes they called Positive Reframing and Somatic Presence. The team said the results give them confidence to test psychedelic therapy for chronic pain in a forthcoming controlled trial!

“Across a range of psychedelic substances and doses, reported pain scores improved substantially during and after psychedelic experiences”

Abstract of the published study (text from Europe PMC), key sentence highlighted in yellow. Source: Bornemann J, Close JB, Spriggs MJ, et al. Self-Medication for Chronic Pain Using Classic Psychedelics: A Qualitative Investigation to Inform Future Research. Front Psychiatry. 2021;12:735427. https://doi.org/10.3389/fpsyt.2021.735427

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This page summarizes published research for education only. It is not medical advice. Any change to a medication remains the decision of that person’s own prescriber.

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