Mental Health, With a Side of Psychedelics?
By Zuzia Whelan
Sleep, exercise, therapy and antidepressants are some of the top remedies prescribed to assist the 1 in 4 Americans who struggle with mental health issues. But while these are all critical and effective tools, are they enough? After all, suicide is among the leading causes of death in the U.S., especially among the younger population.
As we mark Suicide Prevention Awareness Month, perhaps it’s time we tried something different. How about magic mushrooms? Or LSD? Oregon made history in November when it legalized psilocybin in supervised, licensed facilities. Texas and Connecticut have recently done the same, and California is hot on their heels. Then there’s the growing evidence of MDMA’s efficacy in treating PTSD after it was given the green light for research in 2016.
In today’s Daily Dose, you’ll meet a man advocating for psychedelic therapy, see how psychedelics could upend medical treatment and learn how they could become a beacon of hope for veterans struggling with post-traumatic stress disorder.
THE BEGINNING, MIDDLE AND FUTURE
A (Very) Short History
Natural psychedelics have been around forever, and for centuries they have been used by Indigenous cultures. In 1938, while isolating compounds from a species of fungus, Swiss chemist Albert Hofmann synthesized LSD — revisiting it in 1943, he accidentally absorbed it and experienced its effects. After coming to prominence in the West in the 1950s, LSD underwent a hippie makeover by the ’60s, — and research consequently ground to a halt. Now, following decades of stigma, criminalization and appropriation, we’re again seeing a bloom of innovation in psychedelic research. Studies and clinical trials, beginning at Johns Hopkins University, the first institute in the U.S. to get permission to restart psychedelics research, are showing how psychoactive compounds can support treatment plans for depression, addiction and PTSD.
The MDMA-PTSD Connection
PTSD is a complex condition, and one we now know is not limited to war zones. In the U.S., it disproportionately affects women, the Latino community, African Americans and Native Americans. One of the most common Food and Drug Administration-approved treatments for PTSD is SSRI (selective serotonin reuptake inhibitor) therapy — antidepressants like Zoloft and Paxil. This class of drugs is effective in 40% to 60% of cases, but it also has a number of common and potentially unpleasant side effects. A study published in May in the medical journal Nature Medicine has another promising suggestion: MDMA. Not only does it help our brains release serotonin, but it also helps “enhance fear memory extinction” and “modulate fear memory reconsolidation.” The study called it “highly efficacious” in treating severe PTSD and a “potential breakthrough.”
Ketamine: Not Just for Horses
Deployed as an FDA-approved battlefield anesthetic during the Vietnam War, today “Special K” is better known as a party drug (or a horse tranquilizer) that’s especially popular in the U.K. and increasingly in Southeast Asia. Now, however, medical research is revealing that ketamine, popular for its dreamlike trippiness, could serve as a new way to treat depression. As with MDMA, it’s not yet clear how its biochemical mechanism works — but that’s also often true of conventional antidepressants. Still, ketamine does seem to be highly effective in rapidly decreasing suicidal thoughts and aiding severe treatment-resistant depression and anxiety, while conventional treatments can often take weeks or months to start working. Since at least 2013, it’s already been used to help people with severe depression.
Magical (Mushroom) Realism
Psilocybin — the hallucinogenic substance in “magic mushrooms” — dates back 3,000 years, when it was an important part of shamanic ceremonies in Mexico. More recently, it made headlines in May after actor Kristen Bell spoke about using it to treat her depression. Based on results of clinical trials, psilocybin is considered by some to be the safest of the psychedelics as it has low toxicity, almost no lasting side effects and is effective in the treatment of alcoholism and treatment-resistant depression. It’s not difficult to see why magic mushrooms have been considered sacred for centuries, given their ability to help the user alter their perspective. But Western medicine has some catching up to do — and clinical trials are increasingly promising.
French-born psychologist Françoise Bourzat has spent three decades collaborating with Indigenous healers in Mexico to help bridge the gap between Western psychology and psychoactive experiences. Having developed close relationships with the Mazatec people and with their permission, Bourzat helps train new professional “guides” in psychedelic-assisted therapy via the Center for Consciousness Medicine in California, which she co-founded in 2020. The center’s members trace their lineage back, via apprenticeships and teaching, to the mushroom healers and ceremonialists Maria Sabina Estrada and Regina Carrera Calvo, who were active in the 1950s and 1960s. The center’s mission is to develop safe, effective and legal ways to use psychedelics medically while keeping Indigenous knowledge at the core of its teaching practices.
The Racial Trauma Researcher
Monnica T. Williams is a rare Black researcher in the field of psychedelic therapy. An associate professor in psychology at the University of Ottawa, Williams is trying to bridge the racial gap in the subject. She has done extensive research on and spoken about how psychedelics can help ease racial trauma — and how people of color have been left out of the narrative and clinical trials. Williams was once asked by the Multidisciplinary Association for Psychedelic Studies (MAPS) for advice about how it could diversify its research. Her response was to jump into the field herself.
The Psychiatrist Suing the DEA
Psychiatrist Sunil Kumar Aggarwal, a Seattle-based palliative care specialist, is leading a landmark case against the U.S. Drug Enforcement Agency. He’s seeking access to psilocybin for two of his terminally ill cancer patients. “It is a first-of-its-kind lawsuit,” said Kathryn Tucker, the lead attorney on the case. After the DEA rejected Aggarwal’s 2020 application to obtain the drug under the Right to Try (RTT) Act, he, Tucker and others filed the suit. “Our focus is on maximizing quality of life at all costs,” Aggarwal has said. The first oral argument in the case took place at the beginning of September, where much of the discussion centered on whether or not the DEA could even provide an RTT avenue. A ruling could be made by the end of the year.
WHERE ARE WE NOW?
One thing psychoactive compounds have going for them in the current early stages of research is their relative safety — low or no toxicity and low addiction risk — when compared to many conventional prescription drugs. But mind-altering substances are not for everyone. Among the risks associated with psychedelic use are psychosis, long-term mental health issues and hallucinogen persisting perception disorder — which causes frequent, unsettling flashbacks. However, researchers in the field maintain that many worrisome side effects arise chiefly due to contaminated drugs and a lack of formal, professional supervision of users that would change if regulated adequately. The bottom line? Things are moving fast, but it’s still early days.
A 50-Year Void?
Psychedelic treatment for mental health conditions isn’t exactly a concept that’s beloved by the medical research world. It’s underfunded and soaked in decades of stigma. In March, the Australian government earmarked about $11 million for clinical trials into the effectiveness of MDMA and psilocybin. Australia, however, has also delayed the long-awaited reclassification of MDMA and psilocybin as controlled medicine (they are currently categorized as prohibited substances). Speaking to The Guardian, Dr. Arthur Christopoulos of Monash University bemoans the lack of pathbreaking treatment options for the last 50 years. “We have had enormous advances in the destigmatization of mental illness . . . but there have been effectively zero new additional therapies,” he said.
Some parts of the world, however, are seeing forward movement. Come 2023, residents of Oregon may be able to access psilocybin treatment in purpose-built “psilocybin service centers.” Last year, the Oregon Health Authority set up the Oregon Psilocybin Advisory Board to make recommendations on “research on the safety and efficacy of psilocybin in treating mental health conditions” for anyone 21 or older. Known as Measure 109 on the ballot, the proposal was tabled last year by physicians impressed by the body of research showing the benefits of psilocybin therapy in people with addiction and mental health issues. A two-year development period began in January to work out licensing, regulation and implementation. But it’ll be at least January 2023 before the OHA opens up applications for manufacture or provision of services.
- Zuzia Whelan, OZY Author Contact Zuzia Whelan