The return of psychedelics

By Rick Holmes

Oct. 19, 2018

Cambridge, Mass. – They are the plagues that define our times: Addiction, depression, PTSD, suicide.

Drug overdoses killed 72,000 Americans last year. The death toll from alcohol and cigarette addiction is even higher.  Major depression affects more than 16 million Americans a year. Post-Traumatic Stress Disorder is epidemic among war veterans and victims of violence. Suicide has been rising sharply since the turn of the century; with some 45,000 Americans taking their lives in 2016

What are now being called “diseases of despair” are a big reason why life expectancy in the U.S. has dropped three years in a row. And mental illness doesn’t just kill; it cripples good people, destroys families and hurts the economy.

So when researchers share notes about therapies that promise to alleviate those maladies and more, it should draw a crowd. The people who crowded into a conference this month just off the MIT campus were also intrigued by the drugs at the heart of the therapies: psilocybin, LSD and MDMA, also known as ecstasy.

Fifty years ago, psychedelic drugs escaped from the lab and exploded in youth culture. Research into psychedelics was an early victim of the political reaction that followed. But the second psychedelic revolution has begun, led by scientists, not rock ‘n’ roll bands.

The research discussed at the conference is, as they said back in the ‘60s, mind-blowing.

Studies out of Imperial College London have found psilocybin, the ingredient that puts the magic in magic mushrooms, can relieve symptoms of depression resistant to antidepressants. Researchers at NYU and Johns Hopkins show sharply reduced levels of anxiety, depression and “existential angst” in patients with terminal cancer after a single psilocybin treatment, with 80 percent of the subjects still feeling positive effects six months later.

Researchers at several hospitals and universities testing the use of psychedelics to treat alcohol, nicotine and opioid addiction are reporting dramatic success.  MDMA-assisted psychotherapy for veterans with PTSD is proving so effective in clinical trials that it may be available by prescription as soon as 2021. Psychedelics are showing promise in treating other mental illnesses as well, from the social anxiety experienced by adults on the autism spectrum to obsessive-compulsive disorder and anorexia.

How can one class of chemicals treat so many ailments? Using advanced brain-scanning technology, neuroscientists have identified the “default mode network,” a section of the brain responsible for, among other things, the sense of self. In traditional psychiatric terms, the DMN is the home of the ego. Under psychedelic drugs, the DMN goes dark, and other parts of the brain light up with new connections.  

It’s like hitting the reset button on a subject’s sense of self, the scientists say. As the ego reboots, the subject can feel freed from the scars of memory and the habits of mind that appear as mental illness. Good things can happen when the ego reboots, especially with the help of a trained therapist or experienced guide.

One challenge for these scientists is keeping these drugs in the lab until they can be accepted as established tools in clinical settings. The conference was billed as psychedelic medicine’s “historic return to Harvard,” because this is where an earlier generation of psychedelic research went off the rails.

It was at Harvard that two professors researching psychedelics, Timothy Leary and Richard Alpert, succumbed to an enthusiasm common to those who study and use these powerful substances. Leary became a guru, a celebrity, an evangelist for acid. “Turn on, tune in and drop out” became his mantra, and the establishment – academic, scientific and political – freaked out.

Michael Pollan’s recent best-seller, “How to Change Your Mind,” recounts how the panic over LSD led to the drugs being outlawed and the research being suppressed, and how scientists and an underground network of activists kept the psychedelic flame burning through several dark decades before its current renaissance. At the Cambridge conference, Pollan provided historical perspective and shared his hope that ignorance and politics won’t stop medical progress this time around.

But limiting these powerful substances to clinical settings won’t be easy. Truth is, psychedelic drugs offer benefits to what the scientists call “healthy normals” as well as those with specific mental illnesses. All it would take is a few celebrities tweeting about taking LSD and seeing God and the sensationalistic press could spark another moral panic, prompting politicians to shut it all down again.

Pollan said America is better positioned to avoid another freak-out over psychedelics, in part because opinion leaders in the research community and in the culture know more about the psychedelic experience than the establishment did 50 years ago. The rise of medical marijuana and the spread of opioid addiction have, in different ways, undermined old drug war assumptions.

Besides, Pollan said, “we have a mental health crisis.” We cannot afford to suppress the tools that can make a difference in the lives of countless people struggling with diseases of despair. This time around, psychedelic drugs need to be seen as a solution, not a problem.

Rick Holmes can be reached at rick@rickholmes.net. You can follow his journey at www.rickholmes.net. Like him on Facebook at Holmes & Co, on follow him on Twitter @HolmesAndCo.