Harvard Politics: Psychedelics in the Age After Aquarius

Summary: Harvard Political Review highlights MAPS and the Heffter Research Institute as leading organizations helping to promote and fund ongoing psychedelic research.HPR speaks with Ismail Ali of MAPS about MAPS’ MDMA research, highlighting that the FDA granted MDMA-assisted psychotherapy a Breakthrough Therapy Designation. “In the past few years we’ve gotten to the point where we are talking about [medicalization and legalization] in a concrete and regulatory way,” explains Ali. “If these therapies work, it would save the [the Department of Veterans Affairs] a lot of money on PTSD palliative care.”

Originally appearing here.

In 10th grade, I heard that if you tried LSD you couldn’t become an astronaut. A friend explained that the chemical stayed forever in your spinal cord and that the zero-gravity of outer space would loosen your nerves, letting the LSD seep into your bloodstream and making you trip. I heard that taking four or more tabs of LSD would permanently scramble your brain and make you clinically insane. I also heard that a single tab could induce flashbacks – random, uncontrollable psychedelic visions – that would haunt you for the rest of your life.

That same year, I took “Choices and Challenges,” a mandatory, one-semester long course that covered the three major taboos for sixteen year olds – having sex, drinking alcohol, and taking drugs. The teacher, our school priest, warned our class that psychedelics were Schedule 1 drugs. To qualify as Schedule I, the strictest schedule of five, he explained, a drug must have “high potential for abuse and no recorded medical benefits.” In contrast, cocaine and methamphetamine are only Schedule II.

According to the myths whispered at parties, the warnings from my teacher, and the penalties under the law, taking a tab of LSD or a gram of dried magic mushrooms seemed to amount to self-inflicting psychosis. The reputation that psychedelics have as some deranged potion that makes people eat other people’s faces still persists, even though since the early 90s, dozens of American researchers have studied the medicinal value of psychedelic drugs and debunked these psychedelic superstitions. But today, the more formidable danger surrounding psychedelics is overcompensation for the drugs’ past: In the push for medicalization, it is imperative that psychedelic advocates do not bury the drugs’ countercultural legacy under a veneer of elitism.

America’s First Trip  

About 65 years before I first learned about the supposed perils of psychedelics, a chemist named Albert Hofmann accidentally invented LSD. Hofmann synthesized the chemical in 1938 while trying to create a central nervous system depressant for Sandoz, a pharmaceutical company. After shelving the project for five years, he suddenly decided to revisit the chemical on an April afternoon in 1943. While working with the twenty-fifth fungus derivative, Lysergic Acid Diethylamide-25, he suddenly felt a bit dizzy. About forty-five minutes later, he saw the lab walls lightly pulsate and felt deeply connected to nature. This was the first LSD trip.

In 1949, Sandoz shipped the drug to research institutions in Europe, Canada, and America, hoping some scientist could find a clinical application for the extremely potent substance. Around the same time, magic mushrooms were first brought to America. Mushrooms, formally known as psilocybin, have been a centuries old staple in Latin American and African religious ceremonies. In 1955, R. Gordon Wasson, a J.P Morgan banker with a hobby for mycology, the study of fungi, traveled to Mexico to participate in one of those ceremonies and wrote about his experience in Life Magazine.

Both drugs came to America in the early 50’s with barely any legal restrictions – effectively, all it took was a PhD to secure a supply of LSD from Sandoz. Researchers from dozens of the most reputable academic institutions in the country, including Harvard, conducted various experiments with psilocybin and LSD. Dozens more experimental psychologists and psychiatrists experimented with psychedelic-assisted therapy to alleviate symptoms associated with anxiety, depression, obsessive-compulsive disorder, alcoholism, and post-traumatic stress disorder with remarkable success. Some of this research was even funded by the CIA. By the early 60’s, over 1,000 academic papers, most of which touted the psychological benefits of controlled, therapist-administered psychedelics, were published.

About a decade after this research started, psychedelic drugs started to escape the laboratory and enter the general population, in large part thanks to Harvard lecturer named Timothy Leary. In 1960, a month or so after he first tried psilocybin, Leary was hired as a psychology lecturer at Harvard. He immediately started the Harvard Psilocybin Project with a few other professors to test if psychedelics could reduce recidivism rates in prisoners and create religious experiences. But Leary soon became convinced that every person in America should slip a tab of acid under their tongue to liberate the nation from ‘conventional’ thinking. He began to very publicly advertise the drug – first to his students, and then nationally. Leary’s LSD crusade helped publically align the drug with the hippies and the anti-Vietnam-war protests; recreationally dropping acid became a way to stick the middle-finger to the system. It was this version of psychedelics – psychedelics as 1960s counterculture, not as potent anti-depressants – that was loudly advertised.

Psychedelic Renaissance

It took about two decades for most psychedelics to re-enter research labs. Rick Strassman, a psychiatrist and medical doctor, broke the hiatus in 1991 when the FDA granted him phase one study to research the psychedelic drug DMT at the General Clinical Research Center of the University of New Mexico Hospital. A year later, in 1992, the FDA also approved the Hoasca Project, piloted by Professor Charles S. Grob at UCLA, to research the psychedelic drug ayahuasca, an Amazonian plant, and the effect of prolonged use on serotonin.

These two studies, as well as Deborah Mash’s research with ibogaine at the University of Miami, ushered in the current epoch of psychedelic research. Now, researching psychedelic therapy is relatively common – NYU Langone and Johns Hopkins just finished a several-year study on single doses of psilocybin to reducing end of life anxiety in late-stage cancer patients. Since 2006, psilocybin has also been used in clinical trials to alleviate OCD symptoms, alcohol dependence, and Major Depressive Disorder – all with remarkably positive results and few to no side-effects.  

Though the substances vary between trials, the general protocol is similar – a therapist prepares a patient for the psychedelic trip with a few sessions of regular psychotherapy; the therapist administers the psychedelic drug to the patient and talks the patient through the four to six-hour high; and then the therapist helps the patient incorporate the experience and revelations into their life. “If you properly prepare someone for the experience and control the conditions, you can reliably give a profound mystical experience that has a healing effect,” explained Grob. “Individuals often come out of it with renewed sense of meaning in their life… With this treatment, patients report a new sense of meaning and purpose.” Psychedelics are used as a conduit for self-reflection and realization, not as a habitual substance to rely on for calming or mood-enhancing effects.

But despite the increase in popularity of psychedelic research and the remarkable outcomes of initial studies, finding funding is still difficult. The NYU and Jo
hns Hopkins psilocybin trials were both funded in part through crowdfunding. While the National Institute of Health, the primary national source of medical funding, is estimated to annually allocate $140 million to anxiety disorders research, $333 million to depression research, and $72 million to PTSD research, the three disorders that psychedelic research targets, it has not funded a single experiment with psychedelics.

Besides private donations, two major organizations – the Heffter Research Institute and the Multidisciplinary Association for Psychedelic Studies– help with funding psychedelic research. MAPS is currently leading research to cure PTSD symptoms in veterans and trauma patients through therapist-guided MDMA sessions. In August of 2017 the FDA granted ‘breakthrough therapy designation’ for the MDMA-assisted therapy. Ismail L. Ali, a Policy and Advocacy counsel for MAPS, told the HPR that “in the past few years we’ve gotten to the point where we are talking about [medicalization and legalization] in a concrete and regulatory way.”

Ali partly credits institutional hesitance surrounding psychedelic research to “the stigma around Schedule 1 drugs. If these therapies work, it would save the [the Department of Veterans Affairs] a lot of money on PTSD palliative care.” As psychedelics slowly re-enter America’s psychoactive diet, the persistent myths that they fry your brain like an egg and induce uncontrollable, rainbow flashbacks continue to stymie research.

As Grob explained, psychedelics have retained their association with cultural foment, and are yet to be recognized for its medicinal value in the popular imagination. Research approval and re-integration of psychedelics has thus required overcoming the stigma associated with the drugs, but Ali argued that the current incarnation of psychedelia has somewhat overcompensated for the popular imagination of psychedelics: “Now they are like a bunch of scientists with white coats. The director of MAPS went to the [Harvard] Kennedy School. Representation has gone the opposite way.”

Rx Magic Mushrooms

Medical psychedelics only really live up to their anti-establishment legacy in the way they are prescribed. Unlike conventional treatments that target anxiety, depression, and PTSD with selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines, like Xanax, patients only take the psychedelic drug between one and three times. Ali pointed out that as a consequence, the psychedelic model isn’t as profitable as other medical models, because patients don’t indefinitely rely on, and thus constantly purchase, the drugs, likely contributing to pharmaceutical disregard for the drug.

But just because big pharma is unlikely to hike up the prices of psychedelics in the foreseeable future doesn’t mean it will stay away. Psychedelics have recently re-gained traction outside research centers, specifically with the LSD microdosing trend notoriously popular in Silicon Valley. While the microdosing protocol – taking a sub-perceptual dose of acid, about 10 to 15 micrograms every three or four days – was conceived in the 60s, techies in Silicon Valley recently revived it to increase productivity and creativity. Microdosing can be prescribed indefinitely – someone might follow the protocol for a week or the rest of their life. Grob predicts that this microdosing trend might cause pharmaceutical companies to reconsider their interest (or lack thereof) in psychedelics. On the cusp of medicalization, there is a very real chance that psychedelics will become another cash crop for the pharmaceutical industry.

Furthermore, there is no guarantee that psychedelics will be a drug of the people. In an interview with the HPR, Nick Powers, an Associate Professor of English at SUNY Old Westbury and a psychedelic drug advocate, warned that, “As Johns Hopkins research and MAPS push the legalization of psilocybin and MDMA… [they] most likely will become medicine for the elite… because I imagine the treatment may or may not be covered by health insurance, it would exclude working class, middle class, and definitely the poor.” So, while the too-long overlooked benefits of psychedelics are finally gaining legitimacy, the inclusivity stereotypically associated with hippies and, by default, these drugs, is by no means guaranteed.

Powers, who has conducted extensive research with both secondary and primary sources on psychedelics, argued that psychedelics do not possess some inherently counter-cultural quality; rather, they “reflect the culture they are in.” With a medical system and a drug history that marginalizes people of color and the poor, the radicalism of psychedelia isn’t a given; equality and justice don’t just happen when people slip tabs of acid under their tongues.