I was worried the first time I tried psilocybin for my headache. It was my first experience with psychedelics, and I had no idea what to expect. I had heard various reports, ranging from glowing reports calling it a miracle cure all the way to scary accounts of panic and elevated pain. Now, about 2 years into using psilocybin regularly for my head pain, I think I have a good understanding of why the reports were so mixed.
Psilocybin does not numb you. In fact, it can make you feel more. It can make us more sensitive and flexible, and with that flexibility we can find new ways to flourish and grow in less-than-ideal circumstances.
Not A Painkiller
While I was completely pain free during sessions with large doses, psilocybin does not exactly work like a traditional painkiller. In fact, smaller doses seemed to exacerbate pain for me. With traditional pain medication, large doses just offer “more” of whatever smaller doses do. Bit with psilocybin, it seemed like I needed to pass a certain threshold to be comfortable during the session.
I imagine this is stressful for anyone looking to start small and scale up. If 2 gram causes more pain and anxiety, it would be just logical to assume that 4 grams would cause twice the pain and anxiety. With psilocybin, this logic not only fails, but it may also keep you from enjoying the benefits.
So How Does It Work?
This is a million-dollar question. Neurologists were constantly writing me scripts for medications with mechanisms they couldn’t fully explain. They could assure me that they were safe, which I guess speaks for something, but they couldn’t tell me how they worked exactly. No one can explain without a doubt exactly how psilocybin works for pain or mental health treatment. There are theories, some better than others, but we have nothing solid and irrefutably tested.
Psilocybin is a powerful and unique anti-inflammatory agent. It is unique because it can cross the blood/brain barrier, while other TNF blockers can’t. Neuroinflammation is an underlying factor with many autoimmune conditions, and psilocybin and similar substances seem to be uniquely adept at addressing it. It is possible that neuroinflammation plays a role in my condition, hemicrania continua.
Psilocybin’s effect on pain is a bit less clear, and this is where I have to incorporate some guessing and conjecture. To be fair, medical science does not have a great understanding of pain. Doctors are not fully sure why ketamine infusions work on chronic pain, and there is even less data available on other psychedelics like psilocybin. One thing that ketamine providers seem to agree on is that the frequency and duration of treatment along with the level of dissociation seem to be important for success.
Strength In Flexibility
I often hear people refer to psychedelics as a “hard reset” for your brain. I think this is a good term, but it is not the full story. I felt like my psilocybin sessions put me in a more flexible, “softer” state of mind with each session. Unpleasant sensations became tolerable, and even music I detested started to grow on me.
In that state, my psyche was pliable like clay. With each session, the effect would go deeper and the changes more likely to stick. Gradually everything would start to solidify fully again over the following days. Many psychedelic users call the time immediately following a session the “afterglow”. For me, this effect lasted several days. I think this is why one session is not enough to provide lasting pain relief. Sometimes it takes multiple sessions to achieve the flexibility required to fully reset, and if you put too much time between sessions, it is like starting from zero.
What my Progress Looked Like
It took several sessions for my headache to fade away, and for me to completely habituate my tinnitus. While the head pain did not increase between sessions, the tinnitus definitely did. Even today, when I’ve had my headache under control for a couple of years already, the tinnitus returns with each session and takes a few days to fade out. I have heard that many people experience tinnitus symptoms while tripping, even those that don’t normally have it. In my case, it increases temporarily in the week following the trip, then went down to nothing. I think the amount of time I spent in this “flexible” state of mind allowed me to rapidly habituate.
My head pain began to break up after the third session, so around week 3. It didn’t just disappear all at once, but little windows of pain free time started appearing in the days following the psilocybin session. These “windows” just expanded more and more after the subsequent sessions until I was pain free.
So, in conclusion, using psychedelics for managing pain is a tricky, counterintuitive process. I can see how some get lucky and get favorable results from a recreational dose, but I can also see how many others would need a much more precise approach. It amazes me when I read case reports of people discovering long term relief from conditions like Guillain-Barré or rheumatoid arthritis with just one recreational dose. A single dose didn’t have a lasting effect for me, it took persistence.