4.1.1 Palliative care and cancer-related pain
Early reports of the use of LSD to mitigate cancer-related pain include examinations of a single dose of LSD in patients with various forms of metastatic cancers.13 Among the 128 participants included in this study, a fraction had various forms of metastatic cancer (i.e., breast, cervical, lung, larynx, and pancreatic cancer). A single 100μg dosage of LSD, administered orally, improved pain for up to two weeks, as measured by the numerical rating scale. No sensitivity analyses were reported for the participants with cancer pain.
Suggested mechanisms included “LSD produces an inability to maintain selective attention “, hinting at what is also called attentional bias. This effect was proposed as a psychological mechanism to explain the reduction of participants’ concerns for pain, suffering, and death. They noted that “participants displayed a particular disregard for the gravity of their situation and talked freely about their impending death”. Later studies published throughout this early period mostly replicated these early findings and emphasized the importance of “distracting patients from their pain” and reaching the “psychedelic experience” to achieve the best results.70,71 Modern trials of LSD in those with palliative cancer states have continued, with a focus on mood, anxiety, and quality of life (QoL) outcomes. While few details have been specifically reported on the measurement of pain or the use pain as a primary outcomes measure, these studies provide the foundation on which to further study the unique biological, analgesic, and psychological effects, in the setting of cancer-related pain.