First Medical Marijuana, Next Medical Psychedelics?
Western societies are marching toward a world where the use of psychedelic drugs in medicine will be commonplace. Some of the applications for these drugs are discussed below:
In March, the U.S. Food and Drug Administration approved esketamine [an isomer of ketamine]…, to treat depression—the first psychedelic ever to clear that bar. Meanwhile the FDA has granted “breakthrough therapy” status—a designation that enables fast-tracked research—to study MDMA (also called “ecstasy”) as a treatment for post-traumatic stress disorder and psilocybin as a treatment for major depression. __ https://blogs.scientificamerican.com/observations/psychedelic-medicine-is-coming-the-law-isnt-ready/
Psychedelic drugs that are being studied for possible medical use include LSD, psilocybin, DMT, MDMA (ecstasy), ketamine, and related drugs.
Johns Hopkins University in Baltimore is the foremost US research centre for the use of psychedelic drugs in medicine:
At the Center for Psychedelic and Consciousness Research, researchers will focus on how psychedelics affect behavior, mood, cognition, brain function, and biological markers of health. Upcoming studies will determine the effectiveness of psilocybin as a new therapy for opioid addiction, Alzheimer’s disease, post-traumatic stress disorder (PTSD), post-treatment Lyme disease syndrome (formerly known as chronic Lyme disease), anorexia nervosa and alcohol use in people with major depression. The researchers hope to create precision medicine treatments tailored to the specific needs of individual patients. __ https://hopkinspsychedelic.org/
The Centre for Psychedelic Research at Imperial College London is likewise actively researching various ways of using psychedelic drugs in mainstream medical practise.
Led by Dr Robin Carhart-Harris, the Centre focuses on two main research themes: the use of psychedelics in mental health care; and as tools to probe the brain’s basis of consciousness. It will also investigate their potential for treating other conditions, including anorexia.
… Psychedelics are set to have a major impact on neuroscience and psychiatry in the coming years, and the Centre operates at the forefront of one of the most exciting areas in medical science. __ https://www.imperial.ac.uk/psychedelic-research-centre/about-us/
LSD: Has shown promise in the treatment of alcoholism and for treating the anxiety and pain of terminal illness.
MDMA (ecstasy): A pharmaceutically pure form of this often-adulterated-on-the-street drug has been recently shown effective in the treatment of post-traumatic stress disorder (PTSD).
Ketamine: This dissociative anesthetic was shown to be effective treatment for combined PTSD and treatment-resistant depression.
Ketamine is now being studied as a treatment for alcohol addiction.
DMT: This and closely related short-acting psychedelic drugs have the potential to be used inside a 60 to 90 minute therapeutic session. Psychedelic drugs are best used under supervision, and short-acting drugs of this type lend themselves to a conventional therapeutic setting — in the treatment of the same types of disorders as psilocybin.
These drugs are coming, sooner or later. They have shown more or less promise over the years, but have also shown that they deserve to be treated with caution.
Dangers and Opportunity
Clearly the greatest dangers of psychedelics are to the young and inexperienced — those who are most likely to seek them out. The human brain matures somewhere around the age of 25, in terms of cerebral myelination. Informed neuroscientists and mental health clinicians understand the dangers of adolescent use of psychedelic drugs and psychoactive street drugs of any kind.
To those with a lifetime of depression, bad habits, and bad memories, psychedelics offer a possible way out — or at least a possible way up. If psychedelics can assist the terminally ill to live with what is happening to them, there is a possibility that they can assist those who may regret being likely to live another few decades with similar issues.
Psychedelic drugs are powerful medicines, with a huge range of possible uses that have not been well thought out. We should take plenty of time to make sure we make wise policies to minimise the harm and steadily increase the benefit.
Needless to say, much of the human research with these drugs will happen below the public radar. At the Al Fin Institutes for Psychopharmacology, we do not take a stand regarding the legalisation of this type of drug for general use. For children and adolescents, we continue to recommend abstinence from marijuana and psychedelics, due to the dangers of profound disruption of development and maturation.
Recent studies have produced significant evidence for the therapeutic utility of psychedelic drugs in treating a wide range of mental health issues (Tupper et al., 2015; Lieberman and Shalev, 2016; Carhart-Harris and Goodwin, 2017), including anxiety and depression (Grob et al., 2011; Gasser et al., 2014; Carhart-Harris et al., 2016a, 2017a; Dos Santos et al., 2016; Griffiths et al., 2016; Ross et al., 2016), obsessive-compulsive disorder (Moreno et al., 2006), and addiction (Bogenschutz and Johnson, 2016) to alcohol (Bogenschutz et al., 2015) and tobacco (Johnson et al., 2014). In many clinical studies, ego-dissolution experience has correlated with positive clinical outcomes (Griffiths et al., 2008, 2016; Majić et al., 2015; Ross et al., 2016; Roseman et al., 2017).
Remarkably, as mentioned above, a single psychedelic experience can increase optimism for at least 2 weeks after the session (Carhart-Harris et al., 2016b) and can produce lasting changes in personality trait openness (MacLean et al., 2011; Lebedev et al., 2016). A study of regular (weekly) ayahuasca users showed improved cognitive functioning and increased positive personality traits compared with matched controls (Bouso et al., 2015). Interestingly, these outcomes may expand beyond sanctioned clinical use, as illicit users of classic psychedelic drugs within the general population self-report positive long-term benefits from their psychedelic experiences (Carhart-Harris and Nutt, 2010), are statistically less likely to evidence psychological distress and suicidality (Hendricks et al., 2015; Argento et al., 2017), and show an overall lower occurrence of mental health problems in general (Krebs and Johansen, 2013). __ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5853825/
A large body of modern research on this topic goes back almost 70 years.