Can psychedelics treat chronic pain?

Court Wing experienced relief from persistent, long-term chronic pain with just one administration of psilocybin. Now, Court, alongside a team of experts, has developed a groundbreaking, free course on psychedelics and pain. This is his story.

With a five-year bout of increasingly treatment-resistant depression, Court Wing jumped at the opportunity to participate in NYU’s Psilocybin for Major Depressive Disorder (MDD) trial in 2021. His depression was instantly relieved after a single dose, which he likened to psilocybin “surgically removing” his symptoms. Astonishingly, Court’s long-standing moderate chronic pain also disappeared. 

Prior to the trial, Court’s incredibly active life as a CrossFit and kettlebell instructor and a former Aikido competitor had gotten the better of him. Years of physical impact and neglect for his own recovery accumulated into widespread musculoskeletal pain.

“My range of motion decreased, and motor output dropped. Anytime I banged into anything, it would ache for the rest of the day. When I had back pain, if I coughed, my hips would buckle,” he described.

During his psilocybin experience, one of Court’s affected legs began intensely trembling. Court was familiar with the evidence about psychedelics to enhance neuroplasticity–the capacity for nerve cells to form new connection patterns–and suspected the trembling was caused by the nerves responsible for his leg pain reconfiguring. 

“Animal and human studies have shown that psychedelics enhance neuroplasticity in the prefrontal cortex and amygdala, thereby altering emotional pain processing and patients' experience of pain” the authors of a  Psychedelics & Pain review published in Anesthesia explained.

Court’s guessing was seemingly correct, with a marked decrease in pain during the trial. He also recognized psilocybin had opened a “massive neuroplastic window” and began re-engaging physical rehabilitation practices he knew from his expertise as a recovery coach.

“Before psilocybin, it was like all these rehabilitation practices worked, but nothing lasted. And now it took zero effort to regain traction, and the benefits of these drills have stuck.”

Court shared his story on the Psychedelics Today podcast with Joe Moore - who also experienced chronic pain relief through psychedelics. The episode gained huge traction, and Joe introduced Court to Jim Harris, a former paraplegic who regained motor control in some of his previously unresponsive leg muscles after eating magic mushroom chocolate at a festival. Court interviewed Jim online, who has received hundreds of comments and messages from other chronic pain sufferers interested in or with experience with psychedelics.  

The sharing and support motivated Court to establish the Psychedelics & Pain Association (PPA) along with Joe and the founder of the cluster headache charity Clusterbusters, Bob Wold. The PPA is a platform for patients and researchers to share knowledge, with a mission to “advance research, understanding, awareness, and access to psychedelic medicines for the treatment of chronic pain.”

The PPA launched an in-depth psychedelics and pain course last month, combining the expertise of several top researchers in the psychedelic research field. It addresses the many ways psychedelics are already being used for and could be useful for chronic pain, given the various models of pain and their therapeutic mechanisms of psychedelics.

With generous funding from the Riverstyx Foundation, the course is free to access online. It is primarily intended for healthcare providers, psychedelic facilitators, and those with chronic pain conditions – but is open to anyone with an interest in learning how psychedelic medicines can be used to reduce pain and suffering.

Physiotherapist and researcher Dr James Close is a key course contributor. He is currently leading an Imperial College London trial, looking at psilocybin therapy to treat fibromyalgia.   

“You have all the biomedical and physiological reasons for fibromyalgia, but there’s also lots of psychological and social factors as well, and our current treatments aren’t really set up to deal with those things,” explained James. He hopes psilocybin therapy could be an innovative new treatment for the condition that addresses not just the physical but all the psychological and social factors of the disease.

Fibromyalgia is one of the many conditions that could be addressed through psychedelics. A wealth of anecdotes and increasing studies show psychedelics can benefit those with cluster headaches, recognized medically as the most painful condition. Cases of psychedelics to treat phantom limb and cancer pain have also been documented since the 1960s. 

Like Court, increasing instances of participants experiencing pain relief on other psychedelic trials are also being reported. Course contributor Dr. Devon Christie published that participants had reduced chronic pain following MDMA therapy in the MAPS phase two MDMA for PTSD trial. The PPA team expects more of these reports as the medical use of psychedelics becomes increasingly legitimized. “I hope we see more cases of chronic pain relief now that Australia has legalized medical psychedelics,” said PPA advisor Magalia Brecke.

Magali described the psychedelic industry as a “speed train,” given its rapid evolution, but explained pain is lagging behind in terms of public knowledge. “PPA is so important, creating communities for chronic pain patients and bringing voices when it comes to advocacy, inclusion and legislation because that's not really happening yet. Psychedelics are taking off, but pain is so far not included in the wider conversation. But it needs to be, and it needs to be now,” she said. 

By bringing personal stories and up-to-date research into the public knowledge, the PPA’s new course could be hugely useful in pushing forward the development of innovative, effective treatments for those suffering from chronic pain. The course can be accessed for free on the PPA website.