COULD PSYCHEDELIC DRUGS CURB RISING RATES OF MENTAL ILLNESS?

According to an analysis of federal data by The New York Times, 15.5 million people
have taken antidepressants for at least five years. That's three times more than in 2000.

Three months before his high school graduation, Matt Lee* lost his brother to a drug overdose. Struggling with grief, insomnia and depression, he had to make arrangements with his teachers to let him finish the school year from home.

Lee’s brother was his best friend and the empty space he left in the bunk bed they shared was overpowering. Above anything, it was hard for him to grasp that his brother was gone forever.

“I would go to sleep and forget that he had died, so I would text him. Then I would remember and I would have to process it all over again,” he said.

A month after his brother’s death, Lee tried to process his grief by turning to something dangerously common in his family: drugs. He convinced himself that his drug of choice, lysergic acid diethylamide (LSD), was different, and it wasn’t as dangerous as the Xanax, heroin and cocaine that had killed his brother.

Lee claims LSD broke the barrier between his consciousness and subconsciousness and it allowed him to feel everything he had been repressing since his brother’s death.

Two years later, Lee sits in a study room at the University of Southern California, where he’s majoring in creative writing. His eyes glaze over as he stares out the window, losing himself in memories.

“The only time I have ever been more emotional than the first time I did LSD was like, right after I found out that my brother died. Every day it was waking up with so much emotional pain, LSD helped me get over that, or at least accept it,” Lee said.

Lee’s story of how LSD helped him come to terms with his brother’s passing is not uncommon. In fact, since its discovery in 1938, researchers have argued that LSD – among other psychedelics such as MDMA, ayahuasca and psilocybin – have a therapeutic potential that is being largely overshadowed by the drugs’ bad reputation.

Claiming they have “no medical use,” and a “high potential for abuse,” psychedelics were classified as schedule one drugs by the FDA in 1966. They were made illegal unless approved for research, but the War on Drugs made getting that approval and consequent funding virtually impossible.

Now, almost 50 years after they were initially banned, psychedelic drugs are making a comeback, although research is still sparse. In Silicon Valley, tech entrepreneurs are using micro doses of LSD to enhance their creativity; ayahuasca can now be used for religious purposes, and the third phase of a legal clinical study for the effectiveness of MDMA in treating PTSD will begin the summer of 2018.

As interest grows, psychedelics’ potential therapeutic benefits make their way back into the conversation. According to the National Alliance on Mental Illness, one in five adults experiences a mental illness, yet only about half of the people who get treated with medication actually feel relief. Proponents of psychedelics argue that the drugs’ ability to help patients access repressed feelings could be key in treating a variety of mental illnesses that stem from unprocessed trauma.

“Imagine an injury in your skin that gets sealed over and you have bacteria that is growing around it and it keeps festering and it’s infected and it needs to be cleaned and drained and all the bugs have to be taken out of there,” said Dave Nichols, Ph.D., a pharmacologist and prominent figure in psychedelic research.“I think psychedelics may work like that on those situations, where you have something that is tucked away in your mind and it needs to come out and you need to get it resolved.”

During the early 50s, psychedelic drugs were seen as promising for a wide range of psychological and psychiatric conditions, including depression, anxiety and post traumatic stress disorder. Research on their therapeutic effects garnered significant international interest, and drugs like LSD were soon experimented with abroad.

When psychedelics made their way out of science labs and controlled trials and into the hands of young college students at universities and music festivals, they were outlawed by the government. High on the drugs’ euphoric and hallucinogenic effects, the younger generations abused what was originally intended to be therapeutic. Then the Vietnam war caused an uprising in the country’s youth, and psychedelic drugs were blamed for causing social upheaval and political dissent.

“A lot of people thought that using psychedelics was making people turn against America and become hippies. So, there was a perception that [was] fueled by the media that psychedelics were dangerous and would screw your mind up, but that isn’t entirely true, it’s an exaggeration,” Dr. Nichols said.

Newfound interest in psychedelic use in the treatment of trauma and mental illness can be attributed to several factors, most importantly a changing attitude towards a group of drugs that has been publicly misunderstood.

 

Alicia Vera García’s therapist recommended she try ayahuasca to help her treatment-resistant PTSD, the result of a traumatic childhood. The nightmares, crying fits and flashbacks kept García from being able to work for over two years; and desperate for relief, she trusted her therapist and tried the ayahuasca, something she claims has saved her life.

“[Without the drug] I wouldn’t be sitting with you here right now. I’m not 100 percent better, but I have more trust now, and I know that I’ll be fine but I have to be patient with myself. I was at such a low point in my life, I don’t know what would’ve happened,” she said.

During her second of a total of 13 ceremonies, García hallucinated she was in Rio de Janeiro, celebrating at the city’s annual carnival. She said the ayahuasca transformed into some sort of feminine energy and told her that she needed to enjoy her life more.

 

Bedridden with depression, García said she did not know how to live her life to the fullest.

“She told me life is a party, but you must bring the decorations yourself,” García said. “I was lying on my mattress and suddenly I started dancing, right there.”

The ayahuasca helped García take a different approach to managing her mental illness. Although García underwent several ceremonies in addition to psychotherapy, her behavior was soon very different, her mood lifted and certain negative belief patterns reset.  

Researchers like Dr. Nichols believe that when trauma occurs, it disturbs communication patterns within the brain. Once that pattern is set, it just keeps reinforcing itself, causing a sort of malfunction similar to computer malware, you don’t know it’s there but it keeps your computer from working properly.

Psychedelics are believed to be able to break these patterns by making the brain work in ways it wouldn’t have otherwise. Communication within the brain is usually confined to particular communities of neurons that interact with themselves but not with each other. Studies have shown that psychedelics can cause these communities of neurons to lose their boundaries and start communicating more globally, creating mind altering experiences that breed new patterns of thoughts and help patients, like García, gain a completely different life perspective.

“It’s hard to explain how that happens, but psychedelics can do that – they can bring back childhood memories, they can bring back traumatic memories and you just see them from a different perspective,” Dr. Nichols said.

Photo courtesy of Dr Dave Nichols from the study "Psychedelics as Medicines: An Emerging New Paradigm," published February 2017 on State of The Art.

However, psychedelics directly stimulate and activate the cortex, creating highly potent psychological effects that can make these drugs particularly dangerous if abused. In fact, psychedelics have gained a bad reputation throughout the years due to their ability to cause ‘bad trips,’ or psychedelic experiences that cause paranoia, anxiety and panic attacks.

To prevent such trips from happening, psychedelics must be used under controlled settings and with sober supervision. Clinical trials of psychedelic assisted therapy usually have subjects isolated in a room, wearing sleep masks and listening to classical music. They shut down all external stimuli so their experiences can be purely introspective. The only other person present is a therapist, who helps guide them through possible frightening hallucinations, panic attacks, or anxious thoughts.

Although preliminary studies on psychedelics have shown promise, a lack of comprehensive clinical trials is still keeping the drugs under schedule one. Studies tend to lack placebos and participants have not been followed long enough to determine whether or not relief was long lasting.

Many people are associate psychedelic drugs with panic attacks, frightening hallucinations or depressive episodes. However, advocates of psychedelic-assisted therapy are reframing the way "bad trips" are understood. Refering to them instead as "challenging trips," psychedelic integration coach Ashley Booth explains how these experiences can be goldmines in healing from trauma.

To get through the intricate process of rescheduling them, the drugs would have to show therapeutic benefits through FDA-approved and controlled clinical trials. But no funding for this research is yet available from the government, pharmaceutical companies or major foundations; making the multi-million dollar trials extremely hard to fund.

In May 2018, the non-profit organization MAPS (Multidisciplinary Association for Psychedelic Studies) published the results of an independently funded clinical trial on The Lancet Psychiatry, a peer reviewed British journal. The study was the second phase of an FDA-approved trial where they administered MDMA to 26 veterans and first responders with treatment-resistant PTSD. Participants were randomly assigned one of three dosages, which they had to take twice in conjunction with psychotherapy. A year after taking the drug, 67 percent of participants no longer qualified for PTSD.

However, because MAPS relies solely on private donations they still need $26 million to complete the third phase of their trial, where they’re studying if the effectiveness of these drugs can be applicable for a wider pool of participants. If successful, this could potentially make MDMA a legal medication for post traumatic stress disorder.

Meanwhile, Lee enjoys the benefits of these drugs, albeit illegally, along with the 32 million people in the United States who reported lifetime use of psychedelics in 2010.  Granted, many of those probably did it recreationally, but the drugs’ therapeutic benefits are nonetheless starting to get national attention.

As LSD guided him through the grieving process, Lee learned that there was a side to drugs that could make them valuable, when controlled. He now micro-doses on LSD and occasionally takes full doses of magic mushrooms, both of which have increased his creativity and made him a stronger, more precise writer.

“I’m good at pushing my emotions down so deep that sometimes I forget about the thing that was emotionally hurting me,” Lee said, “[But] every problem I have that I think is daunting, if I take LSD it becomes so simple. Why was I thinking like this when the answer was right in front of me?”

 

 

*Matt Lee requested his real name be kept anonymous for private and legal concerns