Summary: San Francisco Chronicle draws connections between the resurgence in psychedelic research and the recent vote to decriminalize psychoactive plants, cacti, and fungi in Oakland, CA. The article suggests that promising results from clinical trials of psychedelic therapy could be contributing to the shift in public perception towards the therapeutic potential of psychedelics. “We’re talking about a paradigm shift with mental health care,” explains Ismail Lourido Ali, J.D., of MAPS.
Originally appearing here.
UCSF psychiatrist Brian Anderson is studying an experimental therapy to help long-term AIDS survivors — people who were infected with HIV in the 1980s and never expected to live this long — who are feeling sad and demoralized.
In a clinic outfitted with a comfortable couch, soft lighting, throw pillows and blankets, the participants of his study are given psilocybin, the hallucinogenic compound found in magic mushrooms. They lie down for a few hours, a mask over their eyes and soothing music playing in the background, and experience a psychedelic trip.
The next day, they talk to Anderson or one of his colleagues about the trip. Then they start group therapy to talk about issues around survival: long-held grief over the loss of friends or partners, deeply rooted stigma of being gay and HIV-positive, their fear of dying. For several of the 18 men in Anderson’s initial study, it was their first time talking about these hard issues.
“We know from other trials that people seem to talk more openly about very challenging emotional material during the drug experience and after the drug treatment,” Anderson said. “Our participants told us they started to really process some events from the distant past or face things that they’ve been avoiding.
“Was it because they went through the drug experience? We don’t know,” he added. But the results were compelling enough that he’s planning a second study with female long-term survivors.
Anderson’s work is part of a resurgence in psychedelic study that has been brewing over the past decade — and that is now, at least to some degree, fueling grassroots efforts around the country to decriminalize use of certain psychedelic drugs.
The Oakland City Council is considering a decriminalization measure, which if passed would make the East Bay city the second in the United States to pass such policy; the first was Denver last month. Statewide measures are being discussed in California and Oregon.
The decriminalization efforts are focused on natural psychedelics — mushrooms, along with herbs, cacti and other plants from which hallucinogenic compounds can be extracted. Whether the movements will expand to include synthetic psychedelics such as LSD and MDMA — also called ecstasy — or eventually lead to efforts to legalize the drugs, remains to be seen.
The activity — both in politics and in medicine — represents a sort of national psychedelic revival. Though several studies in the first half of the 20th century had shown promise in using psychedelics for treatment of mental health and neurological disorders, the drugs were broadly maligned in the 1960s and ’70s, largely because of public concern over recreational use of LSD.
Antidrug campaigns that leaned on horror stories of bad trips and tales of healthy people turned psychotic led to the outlawing of LSD in 1966. Later, all psychedelics were placed under the government’s Schedule 1 category of drugs, officially designating them as having no therapeutic use. Almost all formal study of psychedelics ended.
An underground community of psychedelic providers and users remained, and actually thrived in places like the Bay Area, where counterculture activities have always found support. MDMA was popular through the 1990s and 2000s in the Bay Area’s club and rave scene. More recently, microdosing — the practice taking small, carefully controlled amounts of a psychedelic — has taken off among Silicon Valley techies and university students who believe it boosts productivity and creativity.
All over the region are informal networks of people who will provide psychedelics to those who are dealing with intractable mental health issues, for whom approved pharmaceutical drugs and mainstream therapy has fallen short. People grow hallucinogenic plants in community gardens or their backyards, and they create safe spaces in their homes for others who want to use the drugs.
But in the academic community, the resumption of medical research really only started a few years ago. Now a new generation of scientists is picking up where their predecessors left off.
“I came across the older era of psychedelic research in the late ’90s, when I was in college. I recognized it as this fascinating scientific history for which these threads were left dangling,” said Matthew Johnson, an associate professor in psychiatry and behaviorial sciences at Johns Hopkins University who has studied using psychedelics to change behavior.
LSD is still largely ignored in medical research. But scientists across several fields, mostly in mental health, are taking renewed interest in the potential of other psychedelic drugs to treat everything from addiction and social anxiety to chronic depression and post-traumatic stress.
Most of the research has been focused on two synthetic drugs: MDMA and a lab-made version of psilocybin that mimics the compound found in hallucinogenic mushrooms. Some scientists are asking that psilocybin be taken off the Schedule 1 list, which would ease access to federal research funds and potentially make it easier to get approval for medical applications. Almost all studies at the moment rely on private donations for funding.
Even if studies prove that psychedelics are useful for treating certain conditions, it would probably be years before they win federal approval and — legally — reach consumers. The closest to getting there seems to be MDMA, specifically as a treatment for post-traumatic stress syndrome.
Two years ago, the Food and Drug Administration designated MDMA a “breakthrough therapy” for PTSD, which could speed the approval process. Early clinical trials have found that the drug is effective for two-thirds of study participants. Phase 3 studies — the final stretch before seeking approval — have started, with plans to enroll at least 200 participants. Researchers have asked that the FDA allow compassionate use for patients who suffer extreme symptoms of PTSD and for whom no other treatments have worked.
“We’re talking about a paradigm shift with mental health care,” said Ismail Lourido Ali, policy and advisory counsel for the Multidisciplinary Association for Psychedelic Studies, which is running the PTSD trial. “Our results are about twice as effective as the next closest available treatment. We’re in the process of studying MDMA therapy for social anxiety in adults with autism, and MDMA for eating disorders.
“The momentum is great, but at the same time, we’re not talking about silver bullets here,” he added.
Studies are still limited, but they’re happening at universities around the country. There’s Anderson’s long-term survivors trial at UCSF. At Johns Hopkins, Johnson and his colleagues reported about an 80% success rate in using psilocybin to help people quit smoking in one small study. Research out of UCLA has found that psilocybin may help cancer patients with depression and anxiety.
But it’s far too soon to suggest that psychedelics are going to be a panacea for a bundle of mental health and neurological conditions, said Keith Humphreys, an addiction specialist at Stanford.
Psychedelics aren’t addictive, he said, but they carry other risks, including the potential for a small subset of people to suffer chronic psychosis after using them. Some users can have psychedelic trips that are terrifying or cause them to hurt themselves or others.
Mostly, though, Humphreys said he’s not convinced that the drugs will end up being all that useful. Most of the evidence so far is from trials with just a handful of participants, or from observational or anecdotal reports.
“It’s very common in psychiatry to have a small clinical trial, and everyone is so desperate for a new treatment and this looks like the answer — and then we do bigger and better designed studies and the bloom comes off the rose,” Humphreys said. “It has nothing to do with the history (of psychedelics) or that these drugs come from plants. I could list a dozen medications we’ve seen it with. It’s hype.”
How psychedelics may help people with mental health issues isn’t clear. People who have had a psychedelic trip often say they were able to evaluate parts of their lives — past trauma, relationships with others, ongoing existential crises — from a detached point of view while on the drugs. That gave them new perspective or allowed them to place certain problems in a new context.
“People often report examining parts of their past memories or strong emotions in ways that they weren’t able to without help of the drug,” Anderson said of the participants in his long-term survivors study. “They create a new meaning about what happened to them.”
Andre Humphrey, 38, said psychedelics helped him confront years of abuse from his childhood that left him so traumatized that it affected his ability to go to school, keep a job, maintain positive relationships and even stay physically safe and healthy.
He was so moved by his psychedelic experiences that he eventually quit a job in real estate and decided to open a clinic in Oakland to help children from at-risk communities who have experienced trauma access yoga, meditation and other “metaphysical healing” therapies — though not psychedelics. He’s calling his operation Inner City Bliss.
The most profound of his psychedelic trips came when he consumed ayahuasca, a South American beverage made from several plant-based ingredients. While he was under the influence, a child came to him that he recognized as himself.
“I told him that I forgave him. It was life-changing,” Humphrey said. “It made me realize that I needed to love myself more, be easier on the little child. It made me realize that inner child is real and I need to handle him differently. I need to love him.
“After the ayahuasca,” he said, “I cried for like two hours.”
