Could Psychedelics Transform How Doctors Treat Chronic Pain?

Doctors across the country are beginning to look beyond their prescription pads to explore new treatments for chronic pain management: psychedelics. 

As clinical research mounts, patient stories become more frequent, and a desperate call for new solutions to help people find relief for chronic pain becomes louder, substances like psilocybin and MDMA are entering medical education as promising new treatments.

Healthcare professionals are listening and learning how psychedelics could become part of their practices, offering new hope to patients for whom traditional methods – like opioids and nerve blocks – often fall short. 

Recently at the annual PAINWeek conference, more than 1,400 pain management professionals gathered to learn about advances in the field. Psychedelics took center stage: the 2024 event marked the first time psychedelic medicines had a dedicated track on the agenda.

Retired FDNY firefighter Joe McKay and advocate Court Wing shared their experiences with using psychedelics to combat their chronic pain conditions.

Presentations in the psychedelic track were delivered by patients, healthcare professionals, including Dr. Eugene Vortsman, licensed clinical social worker Erica Siegal, and attorney Deborah Linden Saly, who are each engaged in research, advocacy, or clinical practice with substances like psilocybin, MDMA, LSD, and DMT.

A growing body of evidence shows people living with conditions including chronic low back pain, migraine, cluster headaches, fibromyalgia, traumatic brain injuries, and phantom limb pain often find that existing treatments are either ineffective or come with troubling or dangerous side effects.

The presence and fervor around psychedelics at the conference is the latest example of a growing focus by the medical community on psychedelics as a new and promising treatment for a wide range of chronic pain and physical conditions.

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Dem House candidate pushes tough on fentanyl stance after dismissing it as border issue

Democratic congressional candidate Monica Tranel appears to be changing her tune on the fentanyl crisis this cycle after previously suggesting that the deadly drug was not coming from the southern border.

Tranel, the Democratic candidate running in Montana’s First Congressional District against Republican incumbent Rep. Ryan Zinke, recently released a campaign ad appearing tough on the border.

However, during her first congressional bid in 2022, Tranel claimed that the border crisis is unrelated to fentanyl trafficking while debating Zinke at the City Club Missoula.

“It is a significant issue where we are, but where it is coming from is not the southern border,” Tranel said of fentanyl during the debate. “It’s being made in China, and how it’s getting here is a complex series of things that are happening, and shutting down the border is not going to reduce the fentanyl crisis.”

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Medical Marijuana Helps People With Arthritis And Other Rheumatic Conditions Reduce Use Of Opioids And Other Medications, Study Shows

New research on the use of medical marijuana among people with rheumatic conditions such as arthritis finds that more than 6 in 10 patients who used medical cannabis reported substituting it for other medications, including NSAIDs, opioids, sleep aids and muscle relaxants. Most patients further said that the use of marijuana allowed them to reduce or stop using those medications entirely.

“The primary reasons for substitution were fewer adverse effects, better symptom management, and concerns about withdrawal symptoms,” says the study, published this month by the American College of Rheumatology. “Substitution was associated with THC use and significantly higher symptom improvements (including pain, sleep, anxiety, and joint stiffness) than nonsubstitution.”

The findings, say authors at the University of Michigan Medical School, McGill University and the University of Buffalo, “suggest that an appreciable number of people with rheumatic diseases substitute medications with [medical cannabis] for symptom management.”

Data for the study came from an online, anonymous survey of adult residents of the United States and Canada, which was advertised on social media and through email contact lists of the Arthritis Foundation and Arthritis Society Canada. Of 1,727 completed surveys, 763 respondents said they currently used cannabis, while 655 said they’d never used marijuana and 268 said they’d used but since discontinued. Researchers analyzed responses of only those who said they were current cannabis users.

“Among 763 participants, 62.5% reported substituting MC products for medications, including nonsteroidal anti-inflammatory drugs (54.7%), opioids (48.6%), sleep aids (29.6%), and muscle relaxants (25.2%),” the report says.

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How the Opiate Conspiracy Widened

Many businesses will gleefully sell you a harmful addiction.

The tobacco industry was supposedly subdued decades ago by a historic legal beat-down, yet somehow spends $22 million every day promoting its wares. That’s nearly a million dollars an hour. Websites for kids sport vaping ads. “Cigfluencers” work the podcasts. And movies are smoke-choked like never before.

There was a time when a cigarette company could pay a mere $43,000 for Superman to be thrown into a Marlboro truck by the evil General Zod in front of Marlboro-smoker Lois Lane. (She had never smoked in the comic books, by the way.)

These days, modern Hollywood supposedly disdains tobacco cash. Yet somehow the movies remain one long, glamorous advertisement for cigarettes. Of this year’s ten Oscar Best Picture nominees, nine featured seductive and edgy smoking. (Only “Barbie” did not.)

The marketeers assure us we’ll be inhaling happiness and hipness. Maybe so, but there are also those hot, lung-damaging fumes — a reality that eventually catches up and kills about half a million of us every year.

(Brief digression: COVID-19 had a U.S. death toll of about 1.2 million over three tough years. Many COVID-19 victims were also smokers, so it’s hard to compare the pandemic and smoking death tolls. That said, we can certainly compare the public health responses. When COVID-19 arrived, we shut down the entire planet, and the virus would go on to kill an average of 400,000 Americans a year for three years. Smoking has been here all along — glamorized, marketed to kids — cheerfully killing 500,000 Americans a year, every year, forever.)

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Psychedelics Have ‘Demonstrated Potential For Treating Drug Addiction’ And Alcoholism, New Research Shows

Two new studies on psychedelics and alcoholism—including one with contributions from a top federal drug official—offer hope for new ways to treat alcohol use disorder (AUD).

One says a single dose of psilocybin “was safe and effective in reducing alcohol consumption in AUD patients,” while the other concludes that classic psychedelics like psilocybin and LSD “have demonstrated potential for treating drug addiction, especially AUD.”

The first study looked at 10 treatment-seeking adults “with severe AUD,” according to a preprint version of the research published online at Research Square. After a single 25 milligram dose of psilocybin, “alcohol consumption significantly decreased” during a 12-week period, the team found.

Coauthored by National Institute on Drug Abuse (NIDA) Director Nora Volkow—in her role at the National Institute on Alcohol Abuse and Alcoholism’s neuroimaging laboratory—along with 10 researchers at the University of Copenhagen, in Denmark, the open-label study found that most participants craved alcohol less and consumed fewer drinks following treatment with psilocybin.

“Participants reported a decrease from baseline to week 1 in alcohol craving,” the paper says—a decrease that was sustained four weeks and 12 weeks after the psychedelic was administered. “Further, participants reported an immediate change from baseline to week 1 in self-efficacy, i.e. confidence in the ability to abstain from alcohol.”

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Cannabis Is More Effective In Treating Musculoskeletal Pain Than Traditional Medications Are, Patients Say In New Study

More than 1 in 5 patients who go to orthopedic surgeons with chronic musculoskeletal pain are using or have used some form of cannabis to manage their pain, according to a new study published this month. Of those, almost two thirds said they felt cannabis was very or somewhat effective, while more than 9 in 10 said it was at least slightly effective.

“More than half (57%) claimed cannabis to be more effective than other analgesic medications, and 40% reported decreasing their use of other analgesic medications since starting cannabis use,” the research found, adding that only 26 percent reported a doctor recommended cannabinoids to them to treat their musculoskeletal (MSK) pain.

Notably, among those who said they used cannabis to manage pain, the most commonly used cannabinoid was CBD (39 percent), followed by a hybrid of multiple cannabinoids (20 percent). Almost a quarter (23 percent) said they were unaware of their cannabis’s composition.

Further, among patients who were not cannabis users, roughly two thirds (65 percent) said they were interested in using marijuana to manage their pain but reported barriers to use such as “lack of knowledge regarding access, use and evidence, and stigma,” although stigma was, contrary to previous research, not a primary concern.

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Kentucky Governor Pushes DEA To Reschedule Marijuana, Saying It’s An “Alternative To Deadly Opioids’

The governor of Kentucky has added his voice to the chorus of people urging the Drug Enforcement Administration (DEA) to follow through on the Biden administration’s plan to reschedule marijuana.

Gov. Andy Beshear (D) on Wednesday submitted a public comment on the proposed rule, which would move cannabis from Schedule I to Schedule III of the Controlled Substances Act (CSA). There are currently more than 31,000 comments submitted on the proposal, with the deadline to weigh in coming up on Monday.

“As Governor, my job is to move our state forward,” Beshear said, referencing his state’s medical cannabis legalization policy that he signed into law. “Rescheduling marijuana to Schedule III is a significant, common-sense step forward for all Kentuckians, especially those with significant medical conditions.”

He added that the reclassification will have “substantial and meaningful impacts” on patients, communities, businesses and research.

While he argued that the reform would provide an “alternative to deadly opioids,” that’s not necessarily the case. As a Schedule III drug, marijuana would still be federally illegal unless the Food and Drug Administration (FDA) approved it as a medicine, which is unlikely for a botanical substance.

Beshear added that rescheduling will promote “fair markets” for cannabis, as it will allow state-licensed marijuana businesses to take federal tax deductions that they’ve been barred from under an Internal Revenue Service code known as 280E. The policy change would also mean “real opportunities for research on marijuana” since certain barriers imposed on studying Schedule I drugs would be lifted.

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Legalizing And Regulating Drugs Is The Only Way Out Of The Overdose Crisis

Should heroin and cocaine be legally available to people who need and want them? If we are serious about stopping the crisis of drug overdose deaths, that is exactly the kind of profound change we need. Yes, extensive regulations would be necessary. In fact, the whole point of regulating drug production and sales is that we can better control what is being sold and to whom.

After British Columbia’s Provincial Health Officer Dr. Bonnie Henry testified to the all-party health committee in Ottawa in May that regulating these controlled drugs would minimize harms, B.C. Premier David Eby said he disagreed. He is quoted saying that “in a reality-based, real-world level, (it) doesn’t make any sense.” But does our current approach of drug prohibition “make sense?”

Since the overdose crisis was declared in 2016, illicit drug toxicity deaths have become the leading cause of unnatural death in B.C. and the leading cause of death from all causes for those aged 10 to 59. More than 44,000 people have died from drug poisoning in Canada since 2016, and more than one-third of those were in B.C. An average of 22 people are dying every day in Canada because the illicit supply of drugs is toxic.

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Clarence Thomas appears open to making drug addiction illegal

U.S. Supreme Court justice Clarence Thomas identified a previous ruling that he would like to upend.

The conservative majority sided with an Oregon city that prohibited unhoused people from sleeping on public land, and Thomas said in his opinion in the case that he would like to “dispose” of a 1962 ruling that struck down a California law that criminalized being addicted to narcotics, reported Newsweek.

“In an appropriate case, the Court should certainly correct this error,” Thomas wrote.

The court relied on that decades-old ruling in Robinson v. California to decide that penalizing homeless people for sleeping on the streets when no other shelter was available did not violate the Eighth Amendment prohibition on cruel and unusual punishment.

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Afghan heroin shortage could lead to more overdose deaths – UN

The Taliban’s crackdown on poppy cultivation in Afghanistan  could trigger a spike in overdose deaths if the global heroin lack is filled by more potent synthetic compounds, the UN has warned.

A report released on Wednesday by the UN Office on Drugs and Crime (UNODC) assessed the impact of a ban on opium cultivation, production, processing and trade which the Taliban reintroduced in April 2022. It came too late to affect the harvest that year, but the crackdown caused output to shrink 95% in 2023, it said.

The loss of this supply from Afghanistan, previously the world’s dominant producer of opium and heroin, was partially compensated by Myanmar, where there was a 36% increase in output. Nevertheless, global opium production fell by 74% last year, according to UN research.

Prices of opiates in Afghanistan skyrocketed last year, but the availability of old stockpiles meant that no real shortage was reported in destination markets until early 2024, the report said.

Preliminary field observations indicate that this year the supply may slightly increase, but Afghanistan is unlikely to “reach the very high production observed in the years before 2023.” If the crunch continues, the purity of heroin on the global market may decline, and the demand for substitute opiates will surge, UNODC has predicted.

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