Test Bulletin 3

16 March 2023

Higher Education

Higher Education

Psychedelic Research
Finds a Home in Academia

By Ali McGhee

Introduction

In a previous issue (32.1), we profiled universities across the United States and Canada that have embraced the promise and potential of psychedelic research.

         Now, we’re profiling six more institutions that have stepped into psychedelic studies by launching centers or programs dedicated to psychedelic research. While their missions overlap, they all bring unique expertise and focus to the field. Yale University and the University of Michigan broke ground decades ago with their work on LSD and ketamine. The Ohio State University and the University of Madison-Wisconsin are forging some of the first paths in the Midwest. They are also centering voices that have historically been overlooked in psychedelic circles, including those of people of color and Indigenous tribal communities. New York University and Columbia University are prioritizing research while developing rigorous training programs.

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         Each institution brings a critical perspective to ongoing national and international conversations surrounding psychedelics, as well as to conversations happening locally in their cities and on their campuses. As psychedelic medicines like MDMA and psilocybin near full FDA approval, programs like these will train the next generation of doctors, therapists, researchers, and cross-disciplinary thinkers.

Rich Histories, Bright Futures

Researchers and students at Yale University’s Program for Psychedelic Science, housed in the Department of Psychiatry, are embracing a decades-old legacy. In 1968, Dr. George Aghajanian and colleagues at the university found that LSD acted on serotonin receptors. Now, program Co-Directors Dr. Christopher Pittenger and Dr. Benjamin Kelmendi credit a grassroots movement already happening across the university and medical school for the program’s momentum.

We haven’t had to convince anyone that this is clinically and scientifically important.
Dr. Christopher Pittenger

         “The resurgence of interest in MDMA, psilocybin, and other psychedelic drugs fits with a pattern we were already seeing here,” Pittenger says. He adds that the program netted broad support from university leadership within and outside of their department. “We haven’t had to convince anyone that this is clinically and scientifically important.”

         Current program focuses include both human and animal studies on OCD, depression, PTSD, and alcohol use. Pittenger is exploring the MDMA analogue methylone and its effects on preclinical models of depression and PTSD, and is hoping to test his findings in human studies. Kelmendi has also researched methylone, publishing some of the first papers showing that it was safe to use in patients being treated with SSRIs. Researchers also recently completed the Usona Institute-sponsored Phase 2 study in psilocybin and major depressive disorder.

         Both Kelmendi and Pittenger have worked for over a decade in Yale’s OCD Research Clinic, which Pittenger currently directs, and they have long focused on psilocybin’s effect in patients with OCD. The team currently uses fMRI imaging to measure treatment efficacy for in-patient study participants with treatment-refractory OCD. Another study funded by the Steven and Alexandra Cohen Foundation will investigate the optimal psilocybin dose for patients with OCD.

Dr. Christopher Pittenger and Dr. Benjamin Kelmendi, Co-Directors of Yale University’s Program for Psychedelic Studies photo credit: Robert A Lisak

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         Pittenger and Kelmendi are most excited about the way the program has brought together strands of research across the campus community. “We are joining around this as a community and approaching this work from a very broad perspective, doing cellular work all the way up to linguistics and philosophy,” Kelmendi notes.

         Interest from prospective students “has also been enormous,” he shares. Currently, medical students get foundational knowledge about psychedelic medicine via a “multilevel multiyear model, just like they learn about cancer,” Pittenger explains. He and Kelmendi envision a more expansive set of materials for psychiatry residents who will develop core expertise through the Center. “They will need this, just like training in ECT, dynamic psychiatry, and pharmacology,” he says. “We want knowledge of psychedelic medicine and therapy to become part of the definition of what it means to become an adequately trained psychiatrist.”

         They are working to develop an accredited specialty fellowship where people pursuing other tracks of medicine can get training in psychedelic medicine. “It’s not a solution to the 20,000 therapist problem,” says Kelmendi, speaking to the need for many trained therapists once psychedelic-assisted therapy is widely legalized. “But it is about how we integrate psychedelic medicine with allopathic medicine and train the next generation of leaders.”

         Many researchers now affiliated with the program have been working with psychedelics since long before its existence, and their groundbreaking studies are now furthering its reputation. Dr. Deepak Cyril D’Souza, director of Yale School of Medicine’s Neurobiological Studies Unit, came to Yale in 1992, when he joined a lab doing work with ketamine. While there, he conducted one of the first double-blind, placebo-controlled human studies of Salvinorin A, the main active psychotropic molecule in Salvia divinorum.

         He credits Dr. R. Andrew Sewell, an assistant professor, psychiatrist, and neurologist who passed away in 2013, with providing much of the lab’s early enthusiasm and momentum for psychedelic research. “It’s important to think about how we may come to study these drugs from different perspectives, with different objectives,” he says, “but the most vital first step is establishing structures and going through the regulatory frameworks that allow you to do this kind of work. Without that, things stay abstract and nothing happens. Andrew was quite persuasive and infectious in his enthusiasm to get started.”

         Dr. Emmanuelle Schindler, a neurologist, joined the lab to research psilocybin’s effect on headache disorders, work Sewell was beginning when he passed away. She first focused on the effects of psilocybin on cluster headaches, a severe headache disorder that is relatively uncommon and does not have many treatment options. She and Dr. D’Souza began a study of the effects of psilocybin on cluster headaches in 2015, then expanded their research to migraines and post-traumatic headaches.

         The lab’s investigation of Salvinorin A and DMT is a departure from much of the research being done with longer-acting psychedelic compounds. “The traditional way MAPS and other groups have done studies, drugs are administered in a very specific context and a spa-like setting, with the presence of two therapists and a great emphasis on psychotherapy,” D’Souza notes. “We did the first DMT study [on its effects for major depressive disorder] without those elements, not because they are not important, but because we wanted to establish the psychopharmacological effects over others.”

         D’Souza stresses that establishing these effects first is a necessary step in investigating the many elements to this line of research. “From there, we can ask how psychotherapy contributes to this, and what the impact is when they come together.”

         The shorter duration of the psychedelic experience was another factor in his decision to work with DMT. “It’s hard to see how the current model within which psychedelics are implemented would reach the common man and would be covered by insurance companies,” he explains. “DMT shares properties with other psychedelics and produces deep effects,but the whole experience is over in about an hour or so. It’s an injection, as well. The model is much more similar to the model for ketamine.”

         “I think of this field as in its infancy,” he adds. “My concern is that the hype has far outpaced the science. We want to make sure we try to catch up with that hype and get the science done.”

         Schindler agrees. “This is unlike any other drug discovery, where normally a company is secretive about its drug until it’s ready to be released,” she explains. “Here we have compounds people can grow and obtain themselves, and we have pop culture latching on and adding to the hype. It’s challenging to do research with those factors in play. Alongside the usual challenges of funding and staffing, we also have to fight hype and the availability of these drugs in order to fully understand them.”

         D’Souza and Schindler flag funding as a continued challenge, but see the founding of the Program for Psychedelic Studies as a promising strategy. “Headache is never well funded no matter what drug you’re looking at,” says Schindler.

         “Throughout the studies we’ve done, we kept in touch with Dr. Kelmendi,” she continues. “We talked about formalizing some kind of program so people who knew what they were doing could share data that could be helpful. It was also a potential way to help boost funding.”

         She and D’Souza explain that the Program for Psychedelic Studies has, first and foremost, given them a way to connect with other people doing work on psychedelics at Yale. “The most concrete expression of the program is a monthly seminar where people present some topic related to psychedelics,” says D’Souza. “Yale is a big place. It has helped to put me in touch with some other people in Yale, but our research is the same as it’s always been.”

Dr. George Mashour, founder of M-PsyC (Michigan Psychedelic Center)

         Dr. George Mashour founded the Michigan Psychedelic Center at the University of Michigan (M-PsyC) in 2022. An anesthesiologist and neurologist, Mashour’s passion for consciousness studies began during his undergraduate study of philosophy. He founded the university’s Center for Consciousness Studies in 2014.

         Researchers at the Center started by studying anesthetics and sleep, but “we became increasingly interested in non-ordinary states, which evolved to an interest in psychedelics,” he says. Momentum grew at the university, culminating in M-PsyC’s creation. Its official approval “galvanized the community,” he shares. It is the first psychedelic center founded by a Department of Anesthesiology.

         Mashour points out that ketamine was first tested on humans in the university’s Department of Anesthesiology and Department of Pharmacology in the 1960s. “We have carried that research forward with recent studies investigating complexity, connectivity, and brain state transitions under ketamine,” he says. Center-affiliated researchers have also recently published data on “common neural correlates of ketamine, nitrous oxide, and LSD in humans, with mechanistic implications,” he explains. “Beyond this, there are also ongoing studies on DMT, psilocybin, salvinorin A, and DOI, which cross species and neural scales.

         “We have [also] had an interest in—and made contributions to—understanding non-pharmacologic states with psychedelic phenomenology, such as near-death experiences and shamanic trance,” he adds. “We hope to continue those themes.”

         Potential collaborators have reached out from departments including anesthesiology, chemistry, music, neurology, neuroscience, nursing, pharmacology and pharmaceutical sciences, psychiatry, psychology, and social work. “The word has been spreading, especially through our educational symposia and neuroscience courses,” says Mashour. “As our colleagues learn more, the enthusiasm continues to grow and I am excited for the developments in the coming years.” He also credits graduate students for driving its formation.

Two Trailblazers in the Midwest

         When Dr. Alan Davis was hired by The Ohio State University after completing postdoctoral work at Johns Hopkins University’s Center for Psychedelics and Consciousness Research, he envisioned building a psychedelic center that kept both multidisciplinary education and research at the forefront. The Ohio State University’s Center for Psychedelic Drug Research and Education was founded in January 2022, with Davis as its director.

         Faculty affiliated with the Center are studying the effects of psilocybin therapy for veterans with PTSD, as well as people with tobacco addiction and depression. Inclusion is another major focus of the Center, and several planned studies will focus on special populations underrepresented in psychedelic medicine and research, including BIPOC, Spanish-speaking, and individuals identifying as sexual and gender minorities. Davis also plans to study the effects of 5-MeODMT on cancer patients.

         The Center is gradually ramping up course offerings, including an undergraduate Psychedelics 101 class and a graduate reading course in psychedelics bioethics. Faculty are also working towards approval for a continuing education certificate program that will include courses in subjects like history, pharmacology, and neurochemistry. With the curriculum developed for that program, the university will offer a five-course minor in psychedelic studies in 2024.

         “We want to create opportunities for the next generation of researchers and scientists,” Davis says. “Largely, the focus of work on psychedelics has been research. And we’re interested in the degree to which research questions are relevant to communities of color and across language and gender and sexuality diversity. We need representative data from these communities, and if research questions are relevant to them, they will want to be involved and know that this is a safe space to be involved.”

         Last summer, the Center hosted Psychedemia, an interdisciplinary conference they hope to hold bi-annually. After the conference ended, participants continued to work together. They plan to launch a consortium of psychedelic research centers and programs in 2023.

         The Transdisciplinary Center for Research in Psychoactive Substances at the University of Madison-Wisconsin opened in 2021. It brought together multiple strands of research across campus, including clinical studies on psychedelics and work in Latin American, Caribbean, and Ibero-American history and culture. One collaboration was born in the College of Engineering, where mechanical engineering researchers are planning a cannabis study on driving safety. The Center also participated in Phase 1 and 2 MAPS-sponsored studies of MDMA.

         Center Director Dr. Paul Hutson and his colleagues are particularly excited about “smaller investigator-initiated studies,” including a study of people who will be given psilocybin with midazolam, which will block recall of the psychedelic experience. Researchers will explore whether recall is required for therapeutic benefits for depression and other disorders. A new study now in the recruitment stage will measure the effects of psilocybin in methamphetamine users.

         The Center also created a Masters of Science (MS) program in psychoactive pharmaceutical investigation, the first of its kind in the United States. “We were hoping to get 14 enrollees, but we filled at 30 with a spring recruitment,” Hutson shares. A spring semester course on psychedelic drugs in science and society, which will include perspectives from Buddhist studies and meditation, is up to 80 enrollees.

         The Center is also hoping to develop an academic badge or additional credential, potentially in collaboration with MAPS, as part of a training program that will provide skilled expertise for patients. “We are grappling with how we can help establish credentialing expectations for people helping patients dosed with MDMA, psilocybin, and other substances,” says Hutson. “We would like for that training to be state to state, but we can’t guarantee that. We can, however, provide a great resource for Wisconsin and meet the tidal wave of demand that will come when MDMA is finally approved.”

         As part of the Center’s transdisciplinary focus, Hutson is working to bring in researchers from areas including education, human ecology, nursing, Buddhist studies, and Asian language studies. In the future, he hopes the Center will work with urban and tribal communities of Wisconsin. “We are interested in seeing how we can best provide services to them in a culturally sensitive fashion, without appropriating their own healing processes,” he says. “There will be expectations of the Center to help guide use of these drugs when they are approved by the FDA. We want to be a reputable source of information about what they can and cannot do for people. We need to be a regulated voice when these things come out, and by the same token develop the services people will need to take advantage of them.”

Paving the Way for the Next Generation

NYU’s Center for Psychedelic Medicine focuses on health-related research from basic science to clinical trials. Director Dr. Michael Bogenschutz shares that the program’s development and evolution was “a gradual process” that unfolded over more than a decade and began with Dr. Stephen Ross, who studied psilocybin-assisted treatment of existential distress.

         Bogenschutz joined the faculty in 2015. “Since then,” he says, “our research portfolio has grown steadily, supported by a combination of research grants, clinical trial agreements, and philanthropic gifts.” The Center was established in 2021.

         “We maintain a strong focus on research that may eventually change clinical practice, leading to new treatments as well as new understanding of illness and recovery,” he adds. Bogenschutz previously worked with psilocybin to treat alcohol use disorder, and has continued that work at NYU. “We recently published results of a randomized trial of 95 patients,” he says. “We are in the process of implementing a larger multisite trial sponsored by the non-profit B.More, Inc., and are planning additional studies with neuroimaging and cognitive assessments to learn more about how this treatment works.” Researchers are also developing protocols to study the effects of psilocybin in opioid use disorder.

         Other research in the planning stages include a study headed by Ross on psilocybin in cancer and pain patients. Following work with MAPS, the Center is planning further studies on MDMA for PTSD.
Funding for the Center’s training arm came from MindMed, Inc. That funding will be used “to train researchers rather than therapists,” Bogenschutz says. They also recently received a gift to work with the centers at Johns Hopkins and Yale. Faculty will develop a curriculum that can be used to provide training in psychedelic medicine to psychiatrists, which could eventually lead to the creation of accredited fellowships in psychedelic psychiatry.

         In the summer of 2022, Columbia University’s School of Social Work received a $1 million grant from the Cohen Foundation and the Joe and Sandy Samberg Foundation to develop a psychedelic-assisted therapy training program for social workers and nurses in collaboration with the University of Pennsylvania’s School of Nursing. At Columbia, the training will be the first within-degree professional program at a university in the United States.

         “Our goal is to prepare social workers who can enter into the profession of psychedelic-assisted therapy and work with any molecule on the day they graduate, without needing to take any other formal training,” says Dr. Heidi Allen, Associate Dean for Research and Associate Professor at Columbia’s School of Social Work. Graduates of the program will have many hours of practice experience through internships, as well as a second-year focus on psychedelic therapy.

Heidi Allen, photo courtesy of Horizons PBC

         Allen, who studies access to healthcare in the US, has prioritized the accessibility of these therapies as she works to create the curriculum. In 2019, she was asked to speak on the topic at the International Forum on Consciousness. “I shared concerns about potential access issues that could arise when psychedelics come to market,” she says, “and I urged leaders in the psychedelic ecosystem to consider how decisions made at every single stage will ultimately have an impact on access, from research to commercialization.”

         She points out that most psychedelic-assisted therapy training programs run between $5,000 to $10,000. “That’s a lot of money for a new social worker to pay and a significant financial barrier to participation,” she shares. “That has downstream access issues.”

         Social workers, she explains, are numerically the dominant provider of mental health care in the United States. “We are a highly trained and diverse clinical workforce and our code of ethics demands that we center the individual and right societal wrongs,” she says. “We are ideally suited for this work.”

Sandy Samberg of the Joe and Sandy Samberg Foundation, photo courtesy of UPenn

         Allen joined with Sandy Samberg, a dynamic nurse practitioner, co-founder of the Samberg Foundation, and Penn Nursing alumna. Together, they brainstormed “the synergies between social work and nursing.” Penn’s curriculum will initially be offered as a post-graduate certificate program.

         Allen is hoping to launch the full curriculum in the fall of 2025. She is also paying attention to evolving guidelines and best practices in psychedelic-assisted therapy. “I’m navigating creating the highest-quality training program and ensuring it’s aligned with emerging, but not yet defined, professional standards in psychedelic-assisted therapy training and competencies,” she explains.

         Allen’s goal is to give the curriculum freely to other schools around the country, in particular to HBCUs. “We need to try to scale up both of these workforces as quickly as possible,” she says. “I’m hoping they are first in line, if they’re interested, to start psychedelic training programs in their own schools of social work. We need a diverse field of psychedelicassisted therapists.”

         Ensuring that faculty at other schools receive the training they need to teach will require more funding. “Faculty must be prepared to take our curriculum, integrate it into their own, build relationships with internship sites in their own communities, and teach the courses once they’ve been approved,” she notes. “We want to see this scale nationally.”

The Path Forward

The need for a sustainable funding model is a near-unanimous challenge for all centers and programs, most of which have been funded so far by private foundations and pharmaceutical companies sponsoring studies. Even as interest in psychedelic research has risen, “funding remains the main limiting factor,” says Bogenschutz.

         “Getting centers started has largely happened through philanthropic donations, and that has been a bit challenging,” says Kelmendi. “Nine or 10 centers in the United States are almost exclusively reliant on philanthropic donations. Increasingly, the donor pool is shrinking.”

         Diversification of funds is happening, though. In 2021, Kelmendi and Pittenger were awarded the first NIH grant for the therapeutic use of psychedelics, a study of the neural correlates of the effects of psilocybin in OCD. They have continued to pursue grants and see a future for “more traditional academic funding” in the space, says Pittenger.

         Funding is even more challenging if a program is not doing clinical studies, Davis shares. “The funding that has started to emerge is recent and driven largely by commercial interests,” he explains. “We are interested in studying things that aren’t as commercially viable, including special populations and underrepresented individuals.”

         The excitement and opportunity of psychedelic research has itself generated some challenges as centers try to include a multitude of voices and research interests. “One issue at the University of Wisconsin-Madison is that the university is so big it’s hard to know who else is in the space,” shares Hutson. “But what we hoped to happen is happening—people on campus are contacting us and want to know how they can help.”

         While support has been overwhelming, there has also been some resistance to psychedelic research on campus, in a large part due to the stigma that still persists around psychedelics. “I think the primary challenge we—and, I am sure, others—have is to move out from the shadow of the 1960s,” says Mashour. “When many hear the phrases ‘psychedelic experience’ or ‘psychedelic drugs’ they do not think about the cutting-edge neuroscience or therapy of the 21st century. They instead think about the past, because that is the only narrative they know. This baggage creates distrust, which we are committed to overcoming by a relentless commitment to safety, rigor, responsibility, and a self-critical attitude. We must remain critical thinkers if we wish to make enduring contributions to medicine, science, and society.”

         The contributions already made by these centers, with the support of organizations like MAPS, have already reshaped the way people across the world think about medicine, therapy, and consciousness. But the promise of what lies ahead is perhaps even more inspiring. “I believe that the research that investigators in the field are doing will have a profound effect on how we understand the mind/brain, and how it can restore itself to health,” Bogenschutz says. “I am extremely grateful for the opportunity to participate in this process of discovery.”

         It’s a sentiment shared by all.

Ali McGhee

Ali McGhee has a PhD in English Literature from the University of Rochester. She is the Culture and Team Development Leader for 6AM City, and is a core faculty member at the Enneagram School of Awakening, as well as an International Enneagram Association (IEA) Accredited Professional. Her journalism has been published in outlets including Lucid News, Scallywag, and WNC magazine, and her fiction has been published in Dark Mountain, Slippery Elm Literary Journal, and Holler. She lives in Asheville, N.C.