Agony and Ecstasy: Psychedelics for Chronic Pain with Dr Akash Goel

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Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 

Welcome back to "Ditch the Lab Coat," the podcast where we dive into complex healthcare topics with a scientific and skeptical lens. In this episode, our host Dr. Mark Bonta sits down with Dr. Akash Goel, an esteemed anesthesiologist and pain specialist, to explore the intricate world of chronic pain management.

We'll delve into the prevalence of chronic conditions like stenosis, myofascial pain dysfunction, and sacroiliac joint dysfunction, particularly in older adults and women. Dr. Goel sheds light on the challenges of pain assessment and the often-overlooked patient experience of feeling disbelieved by family and caregivers.

We'll discuss the limitations of traditional pain scales and the innovative tools reshaping pain treatment, such as quantitative sensory testing and real-time data from wearables. Dr. Goel's pioneering research, including a clinical trial with MDMA and ketamine for chronic pain management, will provide a glimpse into the future of pain therapy.

Join us for an engaging conversation that highlights the evolving interface of AI, psychedelics, and psychotherapy in tackling chronic pain. Dr. Bonta and Dr. Goel also touch upon the broader challenges within the healthcare system and the exciting potential of new research and technological advancements. Stay tuned for insights that could change how we understand and treat chronic pain.

06:40 - Doctors frequently encounter medically unexplained symptoms.

08:57 - Chronic pain is diverse, commonly affecting older women.

11:45 - Many patients feel disbelieved when reporting chronic pain.

16:45 - Pain-related disability and interference assessed using specific scales.

17:42 - Leveraging data to predict and manage chronic pain effectively.

23:45 - Psychedelic compounds shown to aid in chronic pain psychotherapy.

26:17 - Understanding chronic pain requires grouping patients into subcategories.

28:48 - Chronic pain alters the brain and spinal cord's response mechanisms.

33:58 - Emphasis on the need for quality placebo-controlled clinical trials to refine approaches.

37:49 - Research into safe MDMA dosing and administration frequency.

38:41 - 120mg of MDMA produces effects similar to 60mg of Ritalin.

43:03 - Psychotherapy improves connection, access, and creates lasting therapeutic impacts.

49:12 - Chronic pain’s complexities inspire exploration of new treatments.

50:16 - Psychedelics enhance psychotherapy, with Dr. Goel’s research showing optimism.