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Research

PT369 – Chronic Pain and Phantom Limb Pain: Could Psilocybin Be the Answer?

November 1, 2022
Featuring: Timothy Furnish, MD & Joel Castellanos, MD

In this episode, Joe invites Court Wing to co-host, interviewing two members of UC San Diego’s Psychedelics and Health Research Initiative (PHRI): Joel Castellanos, MD (Associate Medical Director of PHRI and board-certified physical medicine and rehabilitation and pain medicine physician), and Timothy Furnish, MD (Medical Director of PHRI and Associate Clinical Professor of Anesthesiology and Pain Medicine). 

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In this episode, Joe invites Court Wing to co-host, interviewing two members of UC San Diego’s Psychedelics and Health Research Initiative (PHRI): Joel Castellanos, MD (Associate Medical Director of PHRI and board-certified physical medicine and rehabilitation and pain medicine physician), and Timothy Furnish, MD (Medical Director of PHRI and Associate Clinical Professor of Anesthesiology and Pain Medicine). 

As one of the early participants of a psilocybin-for-depression trial in NYC, Court Wing (of REMAP Therapeutics) discovered that immediately after the session, his chronic pain had miraculously gone away. He began researching how psychedelics could be used (with or without other therapies) to continue the alleviation of pain psychedelics had brought him. Through the Psychedelics and Health Research Initiative, Drs. Castellanos and Furnish are following that that same road, and are currently recruiting for a randomized controlled trial on psilocybin for phantom limb pain. 

They talk about the relationship between the mind and chronic pain: how people confuse pain with the simple act of nerves firing, but how it’s so much more. And they discuss how pain can become part of one’s identity (and how the Default Mode Network could be contributing); how physical therapy is related to neuroplasticity; mirror box therapy; microdosing for chronic pain; the unusual nature of phantom limb pain; and where the mystical psychedelic experience may come into play. If this topic is as fascinating to you as it is to us, stay tuned – we will be featuring much more on chronic pain and psychedelics, including a blog series from Court Wing coming soon.

Notable Quotes

“One of the things that may be unique about or interesting about chronic pain is that the longer it goes on, the more people start seeing pain as a part of their identity and that Default Mode Network is probably playing a role in that. And it’s possible that something like psychedelics could open up the possibility of changing that internal story so that pain is no longer so much a part of one’s identity.” -Tim

“I think that people oftentimes confuse pain with simply nerves firing. …[But] there is this rich interplay between the way we think about pain, the way we perceive pain, and how we feel about it.” -Tim

“When you’re not really dealing with chronic or severe pain on a daily basis, it’s really hard to think about how life-changing that is or can be.” -Joel

“When we hear things like ‘It’s only just in your head,’ I don’t think people quite get [that] the head can be a scary place to be trapped sometimes.” -Court

Links

PHRI.ucsd.edu: Psychedelics and Health Research Initiative at UC San Diego

REMAPtherapeutics.com

Psychedelics Today: Court Wing – Pain and Its Relationship to the Mind

Pubmed: Chronic pain and psychedelics: a review and proposed mechanism of action

Sciencedirect.com: Mirror Visual Feedback Therapy. A Practical Approach

Psychologytoday.com: Catastrophizing

Physio-pedia.com: Kinesiophobia

Sinobiological.com: What is tumor necrosis factor (TNF)

Neuropathycure.org: Cryoneurolysis: A Freezing Cold Way To Treat Chronic Nerve Pain

Journals.lww.com: Microdosing psilocybin for chronic pain: a case series

Clusterbusters.org

Clinicaltrials.gov

Healthgrades.com: Diagnosing and Treating Anhedonia: Loss of Pleasure Explained

Furnish, Timothy, MD, Pain Med

In this Episode

Timothy Furnish, MD

Dr. Furnish is Clinical Professor of Anesthesiology and Pain Medicine at UC San Diego where he is associate chief of the pain division, associate program director of the pain fellowship, and director of the inpatient pain service. His practice includes high-risk peri-operative pain, cancer-related pain, and chronic pain management. Dr. Furnish has a master’s degree in social work from the University of Kansas and graduated from Jefferson Medical College in Philadelphia. He completed both his anesthesia residency and pain medicine fellowship at UC San Diego. He has studied, published, and lectured on post-operative pain management, gabapentin and opioid-related risks in inpatients, intrathecal drug delivery, the use of cannabinoids for the treatment of pain, and classical psychedelics and analgesia.

Joel Castellanos

Joel Castellanos, MD

Joel Castellanos MD, is a board-certified Physical Medicine and Rehabilitation (PM&R), Brain Injury Medicine, and Pain Medicine physician. As a Physical Medicine and Rehabilitation (PM&R) physician and the Medical Director of Inpatient Rehabilitation, Dr. Castellanos’ prime focus is improving function through an individualized approach. This background, along with his expertise in interventional pain techniques, allows for a truly integrative approach to not acute and chronic pain but preserving and restoring function.  While Dr. Castellanos welcomes and treats all patients with different types of functional impairments and pain, he has specific clinical interests in pelvic pain, complex regional pain syndrome, phantom limb pain, and post-spinal cord injury pain syndromes. His research interests include altering nutrition as a means of treating chronic pain, neuromodulation for chronic painful conditions, as well as the potential use of psychedelics for these conditions. He is the Co-Founder and assistant medical director of the Psychedelics and Health Research Initiative at UC San Diego. An associate professor in the Department of Anesthesiology at UC San Diego School of Medicine, Dr. Castellanos instructs pain medicine fellows, as well as medical students, residents in their pain rotations. He is board certified in physical medicine and rehabilitation, brain injury medicine, and pain medicine. He also completed the University of Arizona Integrative Medicine Fellowship to further his ability to provide a holistic, individualized, and comprehensive approach to his care.

Socials: Twitter / Instagram

Court Wing

Court Wing

As a former chronic pain sufferer, Court Wing is the founder and CEO of REMAP Therapeutics. Under his leadership, REMAP Therapeutics is dedicated to exploring, innovating, and developing the intersection between psychedelics and chronic pain. Under Court, REMAP organized and hosted the first-of-its-kind “Psychedelics and Pain Symposium” with some of the most prominent researchers in the field. In March of 2020, Court was a study participant in NYU’s clinical trial of Psilocybin for Major Depressive Disorder, sponsored by the Usona Institute. By the end of his “dosing” day in the trial, he was astounded to realize he was in full remission; no longer qualifying for the diagnosis of depression. But almost more astounding were the lateral benefits; he was also no longer suffering from low-to-moderate chronic pain and related neurological issues. Court is an accomplished performance and pain professional with over 30 years of experience in not only maximizing the athletic performance of his clients, but also in helping countless clients overcome injury and return to competition or daily life. REMAP Therapeutics offers the first online course in educating the medical community, practitioners, and pain sufferers at large about current and past research on psychedelics to aid in resolving numerous pain conditions.

REMAP Therapeutics socials: Twitter / Instagram / Facebook / Linkedin

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