Summary: The Advocate explores the expansion of the psychedelic research movement that is growing in Australia due in part to the positive results from psychedelic clinical trials happening in the U.S. “In the U.S. more than 100 studies have looked at the effectiveness of psychedelics, including MDMA for PTSD and magic mushrooms for depression,” explains The Advocate. “In a first for Australia, a research trial for the latter is underway at St. Vincent’s Hospital in Melbourne which replicates U.S. research, and will see terminally ill cancer patients receive synthetic psilocybin to reduce depression and anxiety related to death.”
Originally appearing here.
Long-term anxiety sufferer Tim* was prescribed legal pharmaceutical drugs in the hope to alleviate his symptoms, but when these drugs did not help he decided to self medicate.
The Tasmanian turned to the ancient psychedelic substance Dimethyltryptamine or DMT, an intense hallucinogenic.
What he did not know at the time is that other psychedelic drugs such as psilocybin, which is found in magic mushrooms, and another illegal substance MDMA** were gaining momentum overseas as legitimate therapies in mental health.
For Tim the decision to use a strong, unregulated and risky drug was not made lightly, but came after living with the debilitating impacts of a chronic mental health condition.
He has obsessive compulsive disorder which includes the symptoms of extreme anxiety that once triggered puts him in a hyper-vigilant state.
“The brain thinks there is a threat. Obviously the threat is not real but it seems real to me,” Tim said.
“Once I’m in that state it’s hard to come down from it. You are hyper aware of the subtleties in your surroundings, your mind thinks that everything is threatening, and you have a distorted perception of your world because you see it through fear based eyes.”
Tim said he could live in these medium to high anxiety states for months or even years.
A doctor put him on two separate medications, an antidepressant and an antipsychotic, each with a long list of possible side-effects.
“The drugs just didn’t work,” Tim said.
Treatment resistance to current pharmaceutical medications is common.
Some sufferers may spend months trialing one type, and then need to swap for another one that may or may not bring relief.
Stephen Bright, founder of the Australian advocacy group Psychedelic Research in Science and Medicine (PRISM) said treatment resistance is a major drive behind the psychedelic therapy movement.
He has worked as a psychologist for 15 years, is a senior lecturer at Edith Cowan University, and a vocal proponent in the pill testing debate.
In his experience, the public have been generally supportive of a move towards psychedelic treatments.
“Many people have a diagnosed mental illness and most would know of a loved one who has been touched by mental illness,” Dr Bright said.
“They all want to see the alleviation of suffering.”
Despite this Dr Bright said the push for these drugs to be used as treatments has been historically blocked by conservative attitudes in Australia within institutions and universities, but the tide is turning, influenced by positive overseas interest.
In the US more than 100 studies have looked at the effectiveness of psychedelics, including MDMA for PTSD and magic mushrooms for depression, with the former predicted to become a medically approved medication in two years in the US.
In a first for Australia, a research trial for the latter is underway at St Vincents Hospital in Melbourne which replicates US research, and will see terminally ill cancer patients receive synthetic psilocybin to reduce depression and anxiety related to death.
At the most basic level, these psychedelic, mind-bending drugs work by altering the emotional centres of the human brain, allowing difficult emotions to be reworked and brains to be regenerated.
Dr Bright said psilocybin turned off certain sections of the brain, which enabled new brain pathways to evolve.
“People with depression often get into rigid ways of thinking about their situation. [Psilocybin] sessions allow them to break free of these rigid thinking patterns,” he said.
“While it is often difficult for them to put into words what they have experienced, they often feel at one with the universe and when when they feel like this they believe everything is going to be okay.”
Similarly, MDMA works by increasing certain neurotransmitters in the emotional centres of the brain, thus having a positive impact on mood.
Dr Bright said this enabled PTSD sufferers to freely talk about their otherwise unspoken trauma.
“MDMA provides them with the capacity to talk about experiences in new ways, which they never have been able to do before. This can provide them with spontaneous insights, and different ways of thinking about their situations,” he said.
This has led to research results where up to 67 per cent of people treated with MDMA no longer meet the criteria for PTSD in 12 month follow ups.
University of Tasmania associate professor of psychology Luke Johnson said MDMA certainly has potential as a treatment for PTSD.
His work focuses on a different type of drug used for PTSD treatment that similarly affects memory reconsolidation, but he said the evidence in favour of psychedelic drugs was mounting.
“We are interested in developing new approaches and new therapies [for PTSD] and so in that general sense we are not opposed to it,” Dr Johnson said.
“Psychedelics in general have been in and out of human use for many years, arguably going back to ancient times … they go in and out of fashion, and part of that is driven by the need. Clearly there is a critical need for new treatments driven by evidence.”
Dr Johnson said MDMA works for people with PTSD because it increases empathy and people feel better about their situations.
It is from this cognitive level that they can reappraise circumstances or memories.
“PTSD generally affects the emotional centre of the brain which is strongly linked to fear and fear memories,” Dr Johnson said.
“That area of the brain becomes hyperactive in people with PTSD … MDMA can dampen down these heightened levels of emotional arousal and at the same time, it increases levels of activity in the parts of the brain where rethinking occurs.”
This dampening down gives the brain an opportunity to change or reappraise memories about traumatic events, which is the ultimate goal for those with PTSD.
HOW DO PSYCHEDELIC THERAPY SESSIONS WORK?
Dr Bright received research funding that enabled him to visit a clinic in the Netherlands that conducts psychedelic-assisted therapy sessions.
He said prior to these sessions, patients discuss the effects of the drugs being used, the coping strategies that might be used while under the influence, and the psycho-therapeutic intention of the sessions.
They receive three psychedelic sessions in total, which are overseen by a male and a female therapist, and which are followed up the next day by an integration therapy session.
These are conducted in a hospital environment after health checks and drug testings are conducted, the person usually wears eye shades and is listening to music, and will be under the effect of the drugs for between six and eight hours.
Dr Bright said the therapists are mostly passive onlookers during this time, where patients are generally “left to their own devices”.
“Having watched a number of these sessions the patients will come out [of the experience] spontaneously themselves, where they have made some connection and really want to talk about it,” Dr Bright said.
“So the psychedelic session is not directive. If the person goes inward for up to a couple of hours and they don’t spontaneously come out, then therapists might check in on them.
“If they haven’t moved towards their intention then they are encouraged to do so, or if they are having a difficult or troubling experience they might be encouraged to work through it.”
He said the follow-up therapy sessions are key.
“The therapists will meet the individual again and get them to talk about what their experience was, what it means to them, and how they might apply what they have learnt in their day to day lives.
“For instance the [patients] might come out and have the realisation that the issue affecting them is not their fault, and they will actually believe it.
“You can do years of psychotherapy trying to help the person come to this conclusion, but when they come to the conclusion themselves, and they truly believe it, it is a lot more powerful.”
This resetting or rewiring of the brain, encouraged by the psychedelic drugs, is something Tim also talks about following his self medicated course of DMT.
He gave himself a weekly dose over three months, and while he had an immediate and strong hallucinogenic trip, he also after each time felt anxiety free for about four days afterwards.
He said it felt like his brain was cleared out, like the DMT reset his brain chemistry.
“Each time I [had a session] I did it with a clear and set intention … I didn’t want a recreational mind-bending experience, I just wanted relief from anxiety,” he said.
“For me it had an effective, fast acting, and anti-depressive effect that was fairly reliable for about 90 per cent of the time.
“I would cease to have any intrusive thoughts related to my anxiety disorder, and I was feeling super confident and balanced, with no depression.”
Tim said during one of his experiences with DMT, he felt like his brain was being flushed of all his emotions.
“It was like if you have a blocked pipe, or a blocked network of pipes, where each pipe represented a separate emotion. It seemed like the DMT flushed the pipes through, to clear out all the s**t, and to let the neural pathways flow again, which really had a balancing effect.”
Tim said after DMT his mind went back to a pre-anxiety state, back to the way his brain worked as a child.
“It seemed to take me back to the state of mind that I was in before I ever had any experience with anxiety as a child or a teenager, when I had never had a panic attack, or never had obsessions,” he said.
“It made me feel like I was normal again, where I had this flow, this great sense of ease, this balance.”