June 24, 2011
Let's say an abuse-ridden childhood has left you with PTSD that sparks panic whenever you hear shouts, even on TV. Or let's say a bad accident has saddled you with crippling anxiety and chronic pain. Now let's say that you could ease -- or even cure -- these woes with prescription psiloscybin. Prescription ecstasy. Prescription LSD.
If a growing phalanx of scientists get their way, those prescriptions could be yours within 10 years. Research into the medical benefits of psychedelic drugs is booming. An April conference on the subject at Great Britain's University of Kent featured lectures on such topics as "Ketamine Psychotherapy" and "Ayahuasca in the Contemporary World."
Leading this wave is the Boston-based Multidisciplinary Association for Psychedelic Studie s (MAPS), whose executive director Rick Doblin spoke at that conference. MAPS researchers have spent 15 years conducting international clinical trials whose results indicate that LSD and psilocybin counteract depression and anxiety and are effective pain-management tools while MDMA (ecstasy) conquers fear. Just this month, the Israeli Ministry of Health approved a new MAPS study using MDMA to treat PTSD.
"Time is on our side," Doblin says. "The world is full of aging baby boomers who are looking forward to psychedelic retirement and psychedelic hospice.
"They had psychedelic experiences in their youth that were useful to them. They gave up the drugs for family and career. Now they're thinking back to those valuable experiences and they want to get re-engaged."
But this isn't about ex-hippies seeking free highs. Rather, it's about mainstreaming these drugs, which MAPS does "by focusing on medical uses, which in our culture is the most likely way to create new legal contexts, because there is a love affair with medicine in this culture. There's a constant interest in whatever's the latest from the scientific lab."
It's not about money. Costing nearly nothing to manufacture, "these aren't the kind of drugs that you need to take every day for the rest of your life." Instead, it's about using cutting-edge technology to prove what millions around the world have been saying for thousands of years: This stuff gets to your head.
As a teenager in the early 1970s, Doblin first learned that psychedelics were being used to enhance art, spirituality and psychology.
"Then it all got shut down."
Those damn hippie freaks.
"People using psychedelics had accidents and did stupid things and ended up dying or going nuts. A bunch of famous people had extremely idealistic views that weren't particularly practical and weren't particularly patient. Timothy Leary and his ilk were making exaggerated claims, saying that if you do psychedelics you're more enlightened than others; if you do psychedelics you're better than others. One of that era's biggest mistakes was Leary saying turn on, tune in, drop out."
Richard Nixon called Timothy Leary the most dangerous man in America. Hello, backlash. Hello, War on Drugs.
"The government came out with its own exaggerated claims, saying that if you took these drugs you'd have deformed babies and brain-cell death. We now know that it isn't true, but back then it launched this huge cultural clash. You might say society had a really bad trip."
Research to the rescue. High-tech brain scans reveal that psilocybin inhibits blood flow in parts of the brain that regulate sensory input. Less blood flow means less regulation. Flooded with perceptions, a psilocybinized brain can help PTSD patients reprogram their fears, Doblin says. New tools also provide new insight into LSD's ego-dissolving "catharsis effect." And the ecstasy chemistry: MDMA reduces blood flow in the fear-processing amygdala while increasing blood flow in the prefrontal cortex, which facilitates our ability to put things into context.
"With MDMA, the fear circuitry is reduced," Doblin explains. This helps PTSD patients remember and re-examine long-buried aspects of their traumas. Aided by MDMA, "these memories don't immediately go straight to fear." Say you were traumatized by a bat-wielding, red-hatted assailant. Under MDMA, "the neural pathways connecting bats, red hats and fear are not so strong." Recontextualized in an MDMA-activated prefrontal cortex, triggers lose their power -- sometimes forever, he says.
"Under the influence of MDMA, people can make emotional changes that persist after the MDMA is out of their systems." On MDMA, "you operate on this much smoother level, and then you lose it -- but not all of it. You get so much material from that experience, which you can learn to integrate."
This doesn't mean you can recover by hitting a few raves. A key theme of the medical-psychedelics movement is that it's medical. These drugs are so strong and long-lasting that, for clinical use, Doblin says they must be administered in "a safe, supportive, controlled setting" overseen by professionals.
In one MAPS study, 10-hour LSD sessions took place in a medical office. Guided by a psychiatrist and a nurse, patients being treated for severe anxiety lay with their eyes shut, listening to music they had chosen for this purpose. According to a MAPS prospectus, each patient was encouraged to focus "introspectively on his or her sense of self and life-history in order to increase the psychological insights mediated by the LSD treatment." The nurse and psychiatrist would sometimes "use physical touch, such as holding hands." These drug sessions were followed by non-drug sessions in which patients discussed their drug experiences.
In a successful psychedelic therapy session, Doblin says, "there are times when the patient gets extremely lighthearted. You could have laughter. You could have joy. It's like a roller-coaster ride. You could have beautiful memories that give you the strength to go down to difficult memories, then come back to the surface and go back down there again, to a different level, hours later."
In old-school therapy, "it's the analyst who figures out your problems and tells you what your insights should be. But if these insights are disconnected from your emotions, it won't work." With psychedelics, by contrast, "the emotional connection is immediate and personal." Analysts can help you sort it out, "but it's an experience of yourself. The drug has simply given you a window onto yourself."
"There is a need for these substances," says Doblin, who along with his colleagues sees psychedelics as a powerful alternative or at least adjunct to SSRIs and, in the case of pain management, opiates. What's the difference between Zoloft and ecstasy? Legality. In other words: the FDA. MAPS submits its findings to the agency, which Doblin hopes "will put science before politics.
"The main problem with the drug war is the concept that there are good drugs and bad drugs," when what's actually good or bad "is the relationship between the person and the drug, and the context in which the drug is taken."
For instance, naysayers can claim "that MDMA is a drug of abuse and since people with PTSD have a high incidence of drug abuse, they shouldn't be given MDMA. But people with PTSD have a high incidence of drug abuse because they haven't been able to deal with painful emotions that they abuse drugs to escape." If those emotions could be processed via MDMA therapy, "their drive to abuse drugs would be reduced.
"We want to clarify that drugs of abuse can be used well. But the government is still too wedded to the drug war."
In that regard, the Bush-to-Obama handover "didn't really change things at all. We hoped it would."
Nonetheless, Doblin and his colleagues predict the legalization of prescription psychedelics within the decade. Until then,"we have to show society and scientists that these drugs can be used in ways that create greater benefits than harms."
In the new wave of psychedelic research, "there hasn't been a single person who has died or was driven crazy."
So far, so good.