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Background and Aims Chronic pain presents a significant healthcare burden and can become quite debilitating. The current standards of care for chronic pain include lifestyle management, procedures, and analgesics for acute exacerbations. However, using analgesic approaches has led to significant adverse effects and healthcare burdens. This review aims to investigate the current literature regarding emerging pharmacological approaches to chronic pain.

Methods This investigation eliminated non-pharmacologic therapies and established chronic pain regimens, focusing on three primary drug classes: cannabis, psychedelics, and dissociative hypnotics. Emphasis was placed on ketamine (hypnotic) and psilocybin (psychedelic), with other drugs also considered. Cannabis was treated as a unique drug class due to its distinct mechanism of action and abundant literature.

Results The review revealed promise in all three drug classes, with marijuana being the most researched yet needing further study on adverse effects. Ketamine showed potential but had abuse concerns; other hypnotics require more evidence of efficacy. Finally, psychedelics, the least understood treatment for chronic pain, demonstrated promise in small studies but need further research on dose-dependent adverse effects, mainly acute psychosis.

Conclusions Despite limited literature and class-specific concerns, emerging pharmacological pain management approaches can improve patients‘ quality of life. Issues include abuse potential, acute adverse effects, and legality. Significant progress is needed before these drug classes become standard in chronic pain treatment, but they can potentially reduce the overuse of highly addictive analgesics.