Psychedelic Therapy

While the time of free love and shag carpets has expired (for some), perhaps the lab work for experimental drugs is just beginning.

Could it be that magic mushrooms, LSD and ecstasy users were right all along?

Since the early 2000s, psychedelic research has picked up where scientists left off in the 1970s, when most Western governments classified psychedelics as prohibited. New studies, conducted mostly in the US, Britain, Switzerland and Israel show that a wide range of psychedelics could help fight against a vast number of illnesses, from depression to addiction to severe posttraumatic stress disorder (PTSD).

A 2006 study conducted at the University of Arizona showed that patients suffering from obsessive-compulsive behaviour saw their condition improve immediately after taking psilocybin, the active agent in magic mushrooms. Results of a study about MDMA (the pure form of ecstasy)-assisted therapy for trauma victims, conducted in collaboration with the Medical University of South Carolina, showed such promising results that researchers are now working with veterans suffering from PTSD. Another ongoing study at the Johns Hopkins University in Baltimore is testing the potential of psilocybin-assisted psychotherapy to treat cigarette addiction. Preliminary results show a 100% success rate.

The list goes on and on. Substances like LSD, MDMA, psilocybin and even ketamine, a hallucinogenic substance currently used as a medical anesthetic and a party drug known as ‘Special K’, have all shown hard to ignore dramatic effects. In the case of ketamine, patients suffering from long-term, severe depression reported a considerable improvement in their condition mere hours after receiving the IV treatment, to the point that their suicidal thoughts disappeared overnight, something conventional anti-depressants have never been able to achieve. Researchers are now investigating the use of ketamine in the treatment of bipolar disorder. This might be one of medicine's most exciting areas of research.

That psychedelic drugs should now be considered as a serious, legitimate object of study might come as a surprise to many, but those who were alive during the 60s might recall that they haven't always been the prohibited party drugs that we have come to know.

Past, Present and Future

Research on psychedelics first started in 1897, when German chemist Arthur Heffter isolated mescaline, the main compound found in the peyote cactus. In 1943, Swiss scientist Albert Hoffman discovered the psychedelic properties of LSD, and 15 years later isolated psilocybin from the magic mushroom Psilocybe mexicana. Close to 1 000 research papers were published until the early 70s demonstrating the potential of hallucinogenic chemicals, notably in the treatment of alcoholism, anxiety and other psychiatric disorders.

Then came the 70s, and with them a serious backlash against everything related to counter-culture, as well as the beginning of an international, US-led ‘war on drugs’ that would come to see all drugs as equally dangerous and reprehensible. It didn't help that certain studies were conducted in not-so-safe conditions. Timothy Leary, the American psychiatrist who went off the rails with his LSD experiments, was once famously called “the most dangerous man in America” by then-US President Richard Nixon.

Psychedelic research was progressively halted as the drugs were, one after the other, classified into the ‘Schedule I’ category by the US Drug Enforcement Administration, which includes substances that have a “significant potential for abuse and dependence” and “no recognized medicinal value,” even though years of medical research proved otherwise. Senator Robert F. Kennedy, whose wife had gone through LSD-assisted psychotherapy, criticized the direction the government was taking during a 1966 congressional hearing. “Perhaps to some extent we have lost sight of the fact that [LSD] can be very, very helpful in our society if used properly,” he declared.

Scientists complied out of fear of losing their jobs and credibility. Those who persisted were treated as charlatans. Still, many people in the scientific and medical community knew that there was something too compelling, too powerful, in the overwhelming results they had collected, to be put aside just like that. One of them, James Fadiman, currently a consultant in psychology for the corporate sector, was involved in psychedelics research as a PhD candidate and later a researcher in the 60s. In 2010 at age 70, free of fears regarding his career, he released The Psychedelic Explorer’s Guide: Safe, Therapeutic, and Sacred Journeys. He has resumed small-scale studies on LSD.

People like James Fadiman were joined in their renewed interest for psychedelics by a growing number of physicians and psychiatrists frustrated by the lack of efficient treatments available to them. In the 40 years following the freeze on psychedelics research, modern science—or the pharmaceutical industry, depending on how you look at the problem—hasn’t been able to come up with satisfying treatments for a whole range of physical and psychological ailments, no matter how well we have come to understand them. One such example is the case of PTSD, which has become a critical issue in the US as the number of suicides among soldiers has risen sharply, partly due to the military operations in Iraq and Afghanistan. In 2012 alone, 349 US soldiers on active duty took their own life─that’s 50% more than the number of troops killed in action in Afghanistan.

“The medical treatments that I've been trained in [throughout] my medical training are notoriously unhelpful when it comes to dealing with [...] a whole range of mental health issues and physical health issues,” says Dr. Gabor Maté, a physician and leading expert on addiction, attention deficit-hyperactivity disorder (ADHD) and the stress-disease connection.

Re-starting the Engine

Quietly, clinical trials started getting government approval again. The first one, in 1992, looked at the impact of dimethyltryptamine (DMT), a psychedelic compound found in certain plants, impacts consciousness. Dozens more have been completed since then. But funding is still scarce, and studies have been mainly supported by independent foundations such as the Multidisciplinary Association for Psychedelic Studies (MAPS) and the Heffter Research Institute in the US, the Beckley Foundation in Britain and the Russian Psychedelic Society. Most studies are, for now, trying to replicate and further the work that was done in the 60s. Scientists think that by building on what’s already been started and has already showed good results, they'll be able to slowly gain the credibility needed to tackle more ambitious work.

Certain natural substances are already being used in a therapeutic context. That's the case of ayahuasca, a hallucinogenic potion used by shamans in the Amazon and whose main active compound is DMT, and iboga, a plant originally from Gabon, in Africa. Both have shown surprising results in the treatment of addiction, and have made their way into informal treatment programs in North America.

Dr. Gabor Maté, who worked for over ten years as a physician in the Downtown Eastside, Vancouver’s drug-plagued neighbourhood, has been working with ayahuasca. He has organized retreats during which the traditional shamanic healing ritual is reproduced. “Most of them ranked the retreat as being amongst the most important experiences they’ve had in their lives,” says Philippe Lucas, a drug researcher who coordinated a study on the effect the retreats had on addicts who participated. “Many of them had gone through multiple drug treatment protocols in the past, unsuccessfully, some of them as many as six or seven times. They consider this to be considerably different.”

Ayahuasca produces powerful visions, during which the subjects often relive traumatic events of their lives. Under proper guidance, these experiences allow them to change their understanding of these events and how they’ve affected them, thereby modifying the unhealthy habits that have derived from these events. In his book, In the Realm of Hungry Ghosts: Close Encounters with Addiction, Maté revealed that addiction is directly connected to brain chemistry. The brain’s circuitry, he believes, can be negatively affected by external factors, such as an adverse or stressful environment. Traumatic events happening during one’s childhood, he noted, can dramatically impact early brain development and one’s ability to produce mood-regulating chemicals like dopamine or serotonin—what addicts attempt to fix by using drugs or engaging in behaviours that stimulate the production of these chemicals. That’s why fixing one’s addictive tendencies begins with looking at one’s past.

This Is Your Brain On Drugs

How each psychedelic substance works is not clearly understood yet, but they all seem to have the ability to instantly act on the brain’s chemistry, either by stimulating or blocking the release of certain neurotransmitters. This action is also responsible for causing the hallucinations psychedelics are known for. Ketamine, which inhibits the NMDA receptor, can suppress depressive feelings in a matter of hours (the NMDA receptor acts on the glutamate neurotransmitter, whereas conventional antidepressants act primarily on dopamine, serotonin and norepinephrine) while triggering out-of-body experiences. Ibogaine, the active compound in the iboga plant, seems to be binding to every known receptor and notably to opiate receptors, thereby greatly limiting symptoms of drug withdrawal.

Psychedelics also seem to act on neuroplasticity—the ability of the brain to create new connections over time. This is how patients, under the high of ‘feel-good’ chemicals like dopamine, can create new, healthy pathways that will eventually replace the disrupted ones that lead to stress or addiction. This action is reinforced when accompanied by visions from the past; when re-experiencing traumatic events under a rush of dopamine, one might be able to associate them with more positive feelings. In other words, it allows the patient to ‘get over it.’

More interestingly, certain substances seem to affect areas of the brain that have been associated with consciousness and spiritual feelings. Brain imaging studies conducted in Switzerland showed that patients under the influence of psilocybin, the ‘magic mushroom’ compound, have a brain activity similar to that of meditating monks. This could explain why patients undergoing psychedelic treatment commonly report having achieved spiritual breakthroughs during sessions. Terminal cancer patients who participated in psilocybin-assisted therapy studies in the US reported having gone through mystical experiences that allowed them to achieve peace of mind as well as a greater appreciation of the present moment and a reduced fear of death. “People get a sense that there’s a much greater reality than their greater egoic selves, and that’s what we call the sacred, I think,” says Maté. “It takes a different form for people but they get a sense of the magnificence of the reality to which they belong and from which they’ve always thought themselves separated.”

Spirituality Matters

All specialists involved in research on psychedelics agree that such positive experiences are ensured by being held in the right context, that is, in a quiet environment facilitating introspection, and under the supervision of a knowledgeable guide. This is why, taken in the wrong circumstances, drugs like LSD or MDMA can lead to the ‘bad trips’ we’ve all heard about.

The ‘right context’ is something traditional shamanic rituals have been perfecting for thousands of years. The chants and ceremonies performed during peyote or ayahuasca sessions in aboriginal communities are meant to soothe subjects and guide them through the impressive and often traumatic visions they might be experiencing (in a spiritual context, psychedelics are called entheogens). This is why people like Maté prefer to stick to this millennial knowledge instead of trying to make psychedelics fit into the medical model. Others disagree, thinking the only way psychedelics will gain acceptance into society is to have their use standardized for science. Some of them are orienting their work toward suppressing the hallucinogenic effect of these drugs, deemed too unpredictable and unsettling for the patient to establish clear treatment protocols. Pharmaceutical companies, they think, won’t show any interest in psychedelic therapy as long as hallucinations are in the picture.

They might be missing the point. The latest advancements in the field of neuroscience have allowed for a better understanding of how hallucinations work (This is the subject of renowned neurologist Oliver Sacks’ latest book, Hallucinations). Long believed to be a symptom of madness, they have now made the link to brain chemistry, notably to the activity in the frontal lobes, an area that has been associated with religious experience. This explains why certain cases of epilepsy and schizophrenia are sometimes accompanied by hallucinations with religious content.

Neuroscience has indeed revealed that the brain is wired to have spiritual experiences. “[We] saw evidence of a neurological process that has evolved to allow humans to transcend material existence and acknowledge and connect with a deeper, more spiritual part of ourselves perceived of as an absolute, universal reality that connects us to all others,” wrote Andrew Newberg and Eugene D’Aquili, two pioneers of the neuroscience of religion, in Why God Won’t Go Away: Brain Science and the Biology of Belief.

If the brain is wired for spirituality, what happens when it isn’t getting any?

“There’s a growing understanding and acceptance that some of our overall physical and psychological malaise may be tied to spiritual malaise as well,” says Philippe Lucas, a Vancouver-based drug researcher.

The thousands of Westerners who flock each year the ashrams of India and the Buddhist monasteries of Eastern Asia won't disagree, nor will the thousands more who engage in the practice of yoga and meditation back home. The impressive propagation of certain religions such as Evangelicalism and Islam, in a society that supposedly “killed God”, as per Nietzsche’s word, also speaks to the malaise Lucas is referring to. So are skyrocketing rates of depression, anxiety and addiction, as well as the growing popularity of alternative therapies such as Chinese and Ayurvedic medicines, which have been based on an understanding of how body and mind interact for over 2 000 years. What psychedelic therapy seeks to address, ultimately, are the physical manifestations of this malaise.

“When I work with ayahuasca, I don’t just work with addiction, I work with people with multiple sclerosis, or cancer, or depression, or auto-immune disease, or whatever. Because what the plant experience, in the right context, allows people, is to really unify themselves, to find the unity within themselves,” says Gabor Maté.

He notes that ayahuasca is not the only way to achieve this, but a considerably quick and dramatic one. Meditation, as we’ve seen, has a similar action on the brain, but acts over a longer period of time. Maté says these types of tools should be considered as part of a broader approach involving the maintenance of healthy lifestyle habits, including spiritual and creative work.

Some advocates of psychedelic therapy have gone so far as to propose the use of psychedelics for personal growth, as opposed to limiting them to the treatment of illnesses. Few in the medical community agree, at least in public, partly because governments are very, very far away from allowing such a thing. “Why confine this to just the dying?” asked Rick Doblin, the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS), in a New York Times article about the psilocybin-assisted psychotherapy study. “This powerful intervention could be used with young adults who could then reap the benefits of it much earlier.”

James Fadiman has been coordinating an unofficial study looking at the effects of regularly taking micro-doses of LSD. Such tiny amounts are too low to provoke hallucinations and barely produce any effect at all, but subjects have reported an increase in “focus, creativity and emotional clarity,” according to an article published in The Morning News, which in turn increased their overall enjoyment of the day. During the 60s, Fadiman had been involved as a researcher in a study about LSD and creativity—this type of research was commonly envisioned back in the golden days of psychedelic research.

Today, getting government approval and the necessary funding to launch a new study can take months. Researchers hope that the increasing number of overwhelmingly positive results will lead to the rescheduling of psychedelic drugs to a less-restrictive category. This would, in the long run, open the way for making this kind of therapy available to the public, possibly under a license-based model in which health practitioners would be authorized to administer treatments. Nobody knows if and when this will eventually happen.

This leaves Gabor Maté, who’s been ordered by Canadian authorities to stop administering ayahuasca, fuming.

“[Ayahuasca] is not a standard medical treatment. To try to think of it that way is to try to put it into a box in which it doesn’t belong,” he explains. “There’s no reason or way to regulate it, as far as I'm concerned. But certainly, when it comes to people that are trained in it and are committed to it and are responsible, why stand in their way?”

Whether it wants to or not, the government will have to step in. Ayahuasca and iboga have made their ways to major North American cities, where underground ceremonies are conducted for Westerners looking for a cure to their addictions or simply wanting to trip out. Informal iboga clinics have been popping up in Canada, where the plant is unscheduled (meaning, not regulated by the government and therefore remaining in a legal void). Often, these plants are administered in an unsafe context, by untrained and insufficient staff and without the necessary follow-up. It is only a matter of time before something negative happens, undermining the efforts of entheogen advocates.

Things might change sooner than we think. South American countries are leading the way in reconsidering the war on drugs and its impacts both on users and the general public. European countries have been radically changing their approach to addiction treatment, now focusing on harm reduction and treatment rather than on prohibition. The debate has also been opened in the US, with states such as Washington and Colorado recently decriminalizing the consumption of cannabis. Attitudes toward the potential therapeutic use of certain illegal drugs are shifting. What psychedelic therapy now needs in order to advance is for us to understand that body and mind cannot be treated separately, and that the spirit needs healing too.

The understanding of these old medicines has been refined over centuries, in some cases, millennia, through experimentation, learning and reflection. Only recently have cautious policies interrupted the evolution of the science, encouraging public disfavour and thus, funding. Rediscovering value in a larger historical context is not limited to healthcare opening up to find what works, as it is essential for any industry to think laterally to source innovative solutions. Furthermore, the ‘personal growth’ aspect may also show heightened activity when taken alongside the rising trend of ‘The Quantified Self,’ where self-medication/treatment is quickly growing in importance — AR

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