I use psilocybin for pain management. It isn’t a very common practice (yet), but I expect it to become much more common as psilocybin becomes more common and accepted. The most common application for psilocybin is for mental health, so there are very few resources available on how to implement a psilocybin dosing schedule for managing pain. This is a list of useful points I wish I had before starting.
#1. Microdosing May Not Be a Great Idea
Microdosing may not be the best choice for severe pain conditions. Microdosing may reduce pain and inflammation over time, but it can also temporarily exacerbate pain for many people. When I am in pain, even a minidose will feel like it is increasing my pain sensitivity.
Starting out with series of larger “loading” doses is a great way to get results quicker and with less initial pain. “Trip” level doses are generally pain free for me, even if I am in pain at the start of the session. Smaller doses were unbearable if I was coming from a point of high pain. Pain clinics employ similar tactics when using other psychedelic-like medications like ketamine for chronic pain management.
#2 The Goal Is To Be Pain Free, Without Being Under The Influence
When using psilocybin for pain, you cannot treat it like a “pain killer”. It is not something you take daily to subdue pain. A psilocybin session is more like a very intense meditation session, except it works SIGNIFICANTLY better than meditation alone. You are putting yourself into a very flexible, fluid mental state in which you can begin to reinterpret pain signals. Think of it as like a physical therapy session, with lasting results long after the session has ended. Some people get more pain free time from each dose than others, so mileage may vary.
#3 Tripping Is Challenging
I had to really work hard to learn how to control and direct my psilocybin sessions. The ability to benefit from the psilocybin is directly linked to your ability to tolerate the sessions. If the experience is unpleasant, you are unlikely to stick with a dosing program long enough to see results. Therefore, I recommend taking an extremely cautious approach to dosing. Traumatizing yourself right out the gate is not a good idea. Find a good, experienced sitter. A pain patient has more to lose than the average person seeking a recreational experience. A recreational user can have an unpleasant experience and decide to avoid the substance in the future with no downside while a traumatized pain patient would miss out on the chance to benefit from it later on.
#4 Control Your Supply
I grow my own psilocybin mushrooms. Early on in my journey, I would purchase them from an outside source. After achieving pain free status, I had an interruption in my supply. This set me back to square one. My pain came back, and I had to start a grueling loading dose schedule again to get back to where I was. It is better to be in complete control of your access.
#5 Support Matters
Being in touch with other people who use psilocybin for pain management has been extremely important. Using a substance that has such a profound effect on your psyche can be a bit isolating, so having support groups or counseling is important.