Summary: Medical Daily explores the resurgence of psychedelic research in the 21st century, highlighting new potential treatments for depression, anxiety, posttraumatic stress disorder (PTSD), and addiction. “Many of the negative perceptions we have of psychedelics can be traced back to their prohibition in the 1970s, when The War on Drugs terminated all of the medical research being conducted on them. Nearly half a century has passed since then, and psychedelic research is only beginning to surge again, but the evidence already suggests substances like LSD (acid), psilocybin (magic mushrooms), and MDMA (ecstasy) may be able to treat mental health disorders and substance addiction better than what’s currently available,” reports Stephanie Kossman of Medical Daily.
Originally appearing here.
The word “psychedelic” can inspire visions of the 1960s — hippies dancing in mud puddles at Woodstock and Grateful Dead groupies packed into Volkswagen buses. But psychedelics may not be as dangerous and addictive as our society thinks. Many of the negative perceptions we have of psychedelics can be traced back to their prohibition in the 1970s, when The War on Drugs terminated all of the medical research being conducted on them.
Nearly half a century has passed since then, and psychedelic research is only beginning to surge again, but the evidence already suggests substances like LSD (acid), psilocybin (magic mushrooms), and MDMA (ecstasy) may be able to treat mental health disorders and substance addiction better than what’s currently available. That is, if the law will allow it.
1. Inconsistencies in Drug Scheduling
All legal and illicit drugs are categorized into five groups, called schedules, which are based on available medical uses and potential for abuse. According to the Drug Enforcement Administration (DEA), “ schedule I drugs are considered the most dangerous class of drugs with a high potential for abuse and potentially severe psychological and/or physical dependence.” These drugs also have “no currently accepted medical use.”
LSD, psilocybin, and MDMA are all placed in schedule I; however, many psychedelic experts agree that these substances are not addictive and have a low potential for abuse. In fact, they may just be the total opposite.
“The curious property of psychedelics is that they’re anti-addictive,” Dr. James Fadiman, author of The Psychedelic Explorer’s Guide from Santa Cruz, Calif. told Medical Daily. Fadiman has been researching psychedelics since the 1960s, and over the decades, he’s observed that the drugs are difficult to abuse because they are incapable of producing psychoactive effects when used in succession.
“You can take 100 micrograms of LSD, [a typical dose], on Monday and have an experience. Then if you take 100 micrograms on Tuesday, you’ll maybe get one tenth of that experience. Take 100 micrograms on Wednesday, [and you’ll get] no experience. Take even 1,000 micrograms on Thursday, zero experience. It’s as if your system says, ‘this is not appropriate!’”
Meanwhile, many drugs that are widely regarded as extremely addictive or dangerous are placed in less restrictive schedules than psychedelics. Cocaine, for example, has been ranked by a panel of addiction experts as one of the most addictive drugs, yet it is placed in schedule II, along with methamphetamine. And all the way down on schedule IV is Xanax, a highly addictive benzodiazepine frequently prescribed for anxiety disorders.
“I never, ever write a prescription for a benzodiazepine without telling the patient that they are addictive, and that there is a risk that they will become addicted,” Dr. Howard Forman, director of the Addiction Consultation Service at Montefiore Medical Center in the Bronx, New York, told Medical Daily. “My goal is not to have these people on medications for 50 years. Benzodiazepines are essential for the right patients, but it’s a heavy responsibility to prescribe them.”
So why are psychedelics classified as schedule I if they have a lower potential for abuse than some schedule II or IV drugs?
Terrence Boos, chief of the DEA’s Drug & Chemical Evaluation Section, told Medical Daily: “ They are placed there because they do not have a medical use,” adding that this has been supported by ongoing research. However, the DEA did not provide any details regarding this research during an interview with four of the agency’s members, nor did they respond to follow-up requests. The Food and Drug Administration (FDA), which oversees the research, told Medical Daily it would not make information regarding investigational new drugs available to the public.
Independent and small-scale research studies, however, have demonstrated that psychedelics can effectively treat mental health disorders like depression, anxiety, and PTSD. Moreover, the research often indicates that psychedelics can be even more effective than the medicines that are currently prescribed. For example, typical treatments for depression have been shown to fail in some instances among patients; but with psychedelics, they’ll respond well. In a study currently being conducted by the Beckley Foundation, 12 people with treatment-resistant depression were relieved from their symptoms for months after receiving just a single dose of psilocybin.
Antidepressants and benzodiazepines, the most common medications used to treat mental disorders, must also be taken daily, and often over the course of a lifetime. Psychedelics, on the other hand, make long-lasting, positive changes in the brain after as little as one dose. In 2011, Johns Hopkins University discovered that a single dose of psilocybin could make people more open-minded for up to a year. And in April, research directed by the Beckley Foundation found that LSD creates more flexible patterns of thinking by increasing the communication between different brain networks.
“Normally, a brain operates in a well-defined, organized manner, while still maintaining a degree of flexibility or adaptability,” Anna Ermakova, a science officer at the Beckley Foundation, explained to Medical Daily. “ Certain mental illnesses, such as depression, addiction, or obsessive-compulsive disorder are associated with inflexible or excessively organized patterns of activity. Psychedelics are thought to break down these organized patterns.”
The results of these studies may be promising, but because they aren’t FDA-sanctioned, they cannot be considered for rescheduling psychedelics. The FDA requires a series of approved studies to be conducted in order for a new prescription medicine to be developed. The last step alone, called a phase III clinical trial, requires anywhere between 300 and 3000 participants, and must last between one and four years.
MDMA is among the first schedule I drugs to be tested in a phase III trial; in 2017, the Multidisciplinary Association for Psychedelic Studies (MAPS) will test the drug as a treatment for post-traumatic stress disorder (PTSD). If it’s successful, the FDA may move to legalize MDMA-assisted therapy.
Past research has already shown that MDMA-assisted therapy — therapy sessions during which patients are administered a dose of MDMA — is a long-lasting, effective treatment for PTSD. Across a series of studies conducted by MAPS, 136 patients who all suffered from PTSD for an average of 19 years, and were unresponsive to typical treatments, found lasting results from just two MDMA-assisted therapy sessions. The success rate was 83 percent, compared to just 10 to 20 percent for SSRIs, the class of antidepressants often used to treat PTSD. After four years, nearly all of the patients had remained PTSD-free, and those who relapsed were cured after a single additional MDMA-assisted therapy sess
Unlike the more classical psychedelics, MDMA does not produce hallucinogenic effects. Instead, MDMA makes you “become very aware of the feelings inside your body,” Brad Burge, director of communications and marketing for MAPS, told Medical Daily. Burge explained that MDMA suppresses activity in the amygdala, the brain region responsible for producing fear. This allows patients to be less fearful of recalling their painful memories during therapy. MDMA also initiates the release of two hormones, oxytocin and prolactin, which can increase one’s sense of connection and trust, helping patients bond with their therapist more easily.
2. The Consequences of Prohibitive Drug Policy
The phase III clinical trials of MDMA are expected to last three to four years, completing in 2021. But even if the trials are successful, psychedelics will not immediately be taken out of schedule I. After the FDA completes a medical evaluation of a drug, it sends a recommendation to the DEA that states which schedule it believes the drug should be placed in. The ultimate decision to reschedule a drug, however, is made solely by the DEA administrator. In the 46 years since drug schedules were first created, the DEA has only rescheduled substances 39 times. Only five of those were instances when a drug was moved from schedule I to schedule II, and many were instances when a drug was moved to a more restrictive schedule.
With that in mind, consider a drug that is on the brink of shattering drug classification legitimacy in the United States: marijuana. Despite the fact that medical marijuana has been legalized in 24 states, the plant remains classified as schedule I. Marijuana and psychedelics were both assigned to schedule I through the passing of the Controlled Substance Act (CSA), a statute signed into law in 1970 by Richard Nixon, just before he declared the “War on Drugs.”
“America’s Public Enemy Number One in the United States is drug abuse,” Nixon famously stated. “In order to fight and defeat this enemy, it is necessary to wage a new, all-out offensive.”
As much criticism as the War on Drugs faces, Nixon’s policies weren’t totally unjustified. During the era of his administration, the rates of drug use and overdoses were skyrocketing.
“In New York City more people between the ages of 15 and 35 years die as a result of narcotics than from any other single cause,” Nixon stated to Congress. “As part of this administration’s ongoing efforts to stem the tide of drug abuse, which has swept America in the last decade, we submitted legislation in July of 1969 for a comprehensive reform of federal drug enforcement laws. Fifteen months later, in October, 1970, the Congress passed this vitally-needed legislation, and it is now producing excellent results.”
The problem is that the results haven’t been excellent. The War on Drugs has failed to reduce any drug use at all, even after drug control spending was dramatically increased. It also has resulted in over four decades of mass imprisonment of the American people for nonviolent crimes, granted America the world’s highest incarceration rate, created a surging and violent black market for drugs, and fueled the Mexican drug cartel.
Even John Ehrlichman, Nixon’s own domestic-policy adviser, recently discredited the entire War on Drugs by suggesting it was a corrupt plot against Nixon’s adversaries — those who opposed the Vietnam War and supported the civil rights movement. He stated in an interview with Harper’s Magazine that “by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
Ehrlichman’s statement against the War on Drugs, as well as its track record, certainly calls its legitimacy into question. But many physicians still believe we should exercise extreme caution before accepting psychedelics, or any illicit drugs, as medicine.
“On one hand, we cannot deny the racist ideology behind the criminalization of drugs throughout the history of our United States,” Forman said. “At the same time, the idea that people can bring life-destroying drugs into a community without any sort of penalty is also very scary. Given our experience with the opiate epidemic, I think we as physicians should be extremely hesitant about any miracle medicines that would be tremendous help without any harm.”
It’s true. Psychedelics, like all drugs and medicines, are not completely harmless. When they’re taken in uncomfortable settings or before the patient is mentally prepared, psychedelics can cause “ bad trips.” These experiences are especially traumatic, bringing about disturbing hallucinations and intense feelings of anxiety, fear, and confusion. For this reason, advocates have pushed for psychedelic use only in controlled therapy sessions, where bad trips are easier to control with the help of a psychiatrist.
Despite the widespread belief that psychedelic drug use will destroy your brain — remember the “This is Your Brain on Drugs” campaign? — an analysis of the National Survey on Drug Use and Health reported that lifetime users of psychedelics are actually less likely to develop mental health issues than the rest of the population.
There also hasn’t been adequate research conducted on psychedelics in the modern era. Before psychedelics were outlawed, psychedelic research was more than plentiful. Aside from the thousands of studies conducted on psychedelics and mental health, scientists were also studying the use of LSD as a method of overcoming substance addiction. Participants from these studies reported that LSD gave them a newfound motivation to address their addiction to alcohol, as well as greater insight, self-acceptance, and faith. And In 2014, a new study supported that research when 12 out of 15 tobacco smokers were able to quit smoking after only three psilocybin-assisted therapy sessions.
Even Bill Wilson, the founder of Alcoholics Anonymous (AA), tried LSD after creating AA and found the drug to be revolutionary in the treatment of addiction as well as depression. Wilson actually pitched the addition of LSD to the 12-step program to the AA board, which rejected the idea.
The AA board was only one of many groups who shut out psychedelics from scientific discourse. Once Nixon passed the CSA, psychedelic researchers across the country discontinued all of their studies. The illegality of psychedelics, followed by a plethora of anti-drug campaigns like Nancy Reagan’s “just say no” movement, led scientists to believe that psychedelic use was not only impermissible, but unethical.
It ultimately took two decades for psychedelic research to begin again, when Dr. Rick Strassman studied DMT in 1992. DMT is a psychedelic compound that can be taken on its own, but it is also the psychoactive component of ayahuasca, a psychedelic tea brewed by the indigenous population of Peru. Unlike the more widely known psychedelics, DMT had much less of a stigma, allowing Strassman to get his studies approved far more easily. In the same year, the FDA also passed the Prescription Drug User Fee Act that year, which encouraged new drugs to be researched.
Since 1992, psychedelic research has been a slow-growing movement. But for the first time since psychedelics were outlawed, as the research begins to flourish again and the stigmas vanish, the future seems bright for psychedelic advocates.
“For many years there wasn’t even a tunnel, let alone a light at the end,” Fadiman said. “Now the light is so bright you can hardly see.”