Hundreds of millions of people worldwide coping with debilitating mental health disorders could have access as soon as 2021 (MAPS) to a range of psychiatric treatments that scientists say could significantly improve their lives. These treatments are based on substances whose original medicinal value was eclipsed by their mainstream popularity and the ensuing decades-long crackdown by authorities: psychedelic drugs.
Psychedelics – particularly LSD – burst into the public eye in the 1960s on the back of an anti-establishment counter-culture opposed to conservative values and Western military ventures in Southeast Asia. The Harvard psychologist and psychedelics guru Timothy Leary urged people to “turn on, tune in and drop out.” When authorities reacted, they did so swiftly and decisively. Then-U.S. President Richard Nixon labeled Leary “the most dangerous man in the world” and endeavored to paint psychedelics as a public menace to society.
Psilocybin, LSD, and other compounds were classified under international law as substances with no medicinal value and high potential for abuse despite evidence that showed otherwise. After MDMA rose to popularity in the 1980s, authorities included it in the list of Schedule I drugs.
A new hope
But since the early 1990s, a smattering of scientists, researchers and drug policy reformers working at a handful of institutions – mostly in the UK and the U.S., but also in Brazil and the Netherlands – have been researching potential psychiatric applications for psychedelics. They say compounds like psilocybin (the active ingredient in magic mushrooms), LSD, MDMA (ecstasy), and ketamine could – under strict medical supervision, and subject to further clinical trials – revolutionize how we understand and deal with mental health conditions. With depression as the leading cause of disability worldwide (WHO), and one-third of sufferers resistant to common medications, psychedelics seem to offer an unconventional source of hope.
“It’s incredibly exciting to be able to provide a new paradigm shift for psychiatry and the treatment of mental disorders which are actually becoming an epidemic in the West,” said psychedelics researcher Amanda Feilding, who’s also the director and founder of drug policy reform and research think-tank The Beckley Foundation.
Feilding, 75, has been studying psychedelics like LSD since the 1970s (Wired); she works with top universities in the UK and abroad to research psychedelics’ potential medical applications. While delighted at the growing interest in this field, she stressed toWikiTribune that there was still a lot more research to be done.
Scientists on both sides of the Atlantic are increasingly confident. Working within established scientific and medical parameters (NYT Magazine), the early yet scientifically promising results of their research will prove the medicinal value of incorporating proscribed psychedelic drugs into psychiatric treatments for mental health conditions – and prompt even more research.
A global mental health ‘epidemic’
Mental health issues are widespread, cause long-lasting suffering, and cost developed societies billions of dollars a year. In England, one in six adults met the criteria for a common mental disorder in 2014 – for women, the number is one in five (NHS Digital). In the United States, the figures are slightly higher, with around 44 million people experiencing a mental illness in a given year, according to the National Alliance on Mental Illness.
Psychiatric treatments for common but devastating illnesses such as depression haven’t advanced greatly in decades, not since the development of SSRI antidepressants in the late 1980s (NYT Magazine). In March 2017, the World Health Organization said depression affects over 300 million people worldwide and was the leading cause of disability globally, having risen almost 20 percent from 2005 to 2015.
Anti-depressants are still the go-to treatment for moderate to severe depression. Although relatively effective (The Lancet), they come with adverse side effects and don’t work for roughly a third of people (NCBI) suffering from what’s known as treatment-resistant depression. Additionally, long waiting times for psychotherapy make it difficult for many people who can’t afford private healthcare to access treatment for mental health disorders (The Independent).
“It’s almost like a perfect storm,” Robin Carhart-Harris, head of psychedelic research at Imperial College London, told WikiTribune. “You have this major problem that the mainstream aren’t being able to solve, and then you have this novel treatment approach … it’s about taking the best of both worlds, if you want, taking a drug and therapy and combining them in this special way.”
This helps explain why drug-regulating agencies in the U.S. and the European Union have started to show serious interest in psychedelic drugs. Recently published research into the effects of psilocybin on people suffering from severe depression showed promising results. In October 2017, Carhart-Harris’s team at Imperial, alongside Feilding’s Beckley Foundation, published results from a small trial where they found that psilocybin was effective in treating treatment-resistant depression. Imperial is planning two further studies this year.
“We have shown for the first time clear changes in brain activity in depressed people treated with psilocybin after failing to respond to conventional treatments,” Carhart-Harris said at the time (Imperial). “Several of our patients described feeling ‘reset’ after the treatment… Psilocybin may be giving these individuals the temporary ‘kick start’ they need to break out of their depressive states”.
Psilocybin trials for depression are also under way in the U.S., while, separately, British start-up Compass Pathways with $13 million (NYT Magazine) in funding is planning to start a psilocybin experiment this year. It will be held in eight European countries, for a total of 400 people with treatment-resistant depression ( Financial Times, may be behind paywall).
Meanwhile in the U.S., MDMA has reached the last stage of clinical trials for treatment of post-traumatic stress disorder (PTSD), a condition that affected roughly 12 million Americans in 2017 (National Institute of Mental Health). Researchers in America also found ketamine to be effective at alleviating symptoms of severe depression in the short-term. A handful of private clinics in the U.S. (Business Insider) and the UK are prescribing it for off-label use to treat depression and anxiety.
Scientists still face two main challenges. The first is raising funds to conduct costly clinical trials. These costs are usually borne by big pharmaceutical companies, who invest tens of millions of dollars in research in the hopes of developing new medicines for a profitable return. But because the licenses for psychedelics like LSD expired long ago – while others like psilocybin are found in naturally occurring magic mushrooms – the lack of exclusivity means there is little commercial incentive to bet on these drugs (NYT Magazine).
‘The biggest impact the ‘war on drugs’ has had has been the stigmatizing of these substances’ – Natalie Ginsberg
Many researchers also benefit from publicly-funded grants. But these are hard to come by for researchers studying psychedelics, according to Feilding and other researchers WikiTribune interviewed.
“We won money from the Medical Research Council for a [psilocybin] trial,” Carhart-Harris told WikiTribune. “That was quite unprecedented, as well, because in the U.S. there hasn’t been any mainstream funding for psychedelic research.” MAPS, the organization conducting the Phase 3 trials with MDMA as a potential therapy for PTSD, gets most of its funding from private investors, including over a million dollars from the cryptocurrency community (see WikiTribune’s cryptocurrency coverage).
The second, related challenge facing scientists in this field is that the majority of psychedelics remain classified under international law as Schedule I substances with no accepted medicinal value and a high potential for abuse. Although the international regulatory framework doesn’t technically forbid their research, scientists and drug policy reform advocates say it perpetuates an anti-psychedelics stigma that followed the counter-cultural revolution of the late 1960s.
“The biggest impact the ‘war on drugs’ has had has been the stigmatizing of these substances and moving us all away from any evidence-based assessments of drugs,” said Natalie Ginsberg, policy and advocacy director at the non-profit Multidisciplinary Association for Psychedelic Studies (MAPS).
Ginsberg told WikiTribune: “I think that has had a major chilling effect and it has made so many otherwise brilliant doctors and researchers, who do otherwise trust science, completely dismiss and shut down any possibilities that these substances could be a treatment [for mental health disorders].”
From mind benders to mind menders
From the mid-1970s until the 1990s, legal research into the potential medical applications for psychedelics was “virtually impossible,” said Feilding. The moral panic that followed the counter-cultural revolution of the late 1960s in the Western world made it extremely difficult to discuss psychedelics for serious health uses.
“It’s really in the last two or three years that the big change has happened. Suddenly, psychedelics are beginning to be recognized as potentially very valuable tools by scientists and by an educated proportion of the public,” said Feilding.
As mental health is ever more an issue across the globe, psychedelics provide solid hope, their supporters argue. But the field is developing, without absolute certainties. Philip Gerrans, an Australian academic who has studied neuroscience through philosophy, told WikiTribune: “Neuroscience is probably not even where Galileo and Copernicus were with astronomy.”