Are Psychedelics the Future of Therapy?
Are Psychedelics the future for treating anxiety, depression and addiction?
The use of psychedelics to treat many chronic mental illnesses is gaining a significant amount of interest and popularity in recent years. The potential of psychedelic drugs has been known since the mid-1900s. With worldwide bans of psychedelic rugs and compounds in the late 1960s and early 70s, research on a global scale was completely halted.
Current psychiatric treatment methodologies, while still incredibly beneficial, have received flak for being inadequate for complete and lasting recovery. Since the mid-2000s, however, a few entities and organizations have been at the forefront of a scientific renaissance, conducting studies and research on psychedelics, and their unimaginable benefits for the treatment of mental illnesses.
Psychedelic drugs, however, are often associated with hipsters and counterculture movements, rather than scientists in lab coats determined to understand how it can revolutionize psychiatric treatment as we know today.
A Brief History
In 1938, a Swiss chemist by the name of Albert Hoffman attempted to create a stimulant while working at Sandoz Pharmaceuticals. He unknowingly synthesized lysergic acid diethylamide, more popularly known as LSD. Although the chemical showed an increase in the excitement levels of test animals, it was not the circulatory system stimulant that Sandoz hoped to synthesize.
He set aside the chemical, and only went back to it after 5 years when he accidentally absorbed a tiny dose through his fingertips. After experiencing a radical shift in consciousness, Hoffman decided to experiment with LSD further and concluded that it was ideal for psychotherapeutic use. He sent samples to some of the leading research labs, universities, and clinics across the globe, and a decade of exciting and promising research began.
Breakthroughs in the treatment of mental illnesses followed, owing to a better understanding of the brain's neurochemistry, with thousands of papers being published on its therapeutic effects. Hoffman also sent samples of the drug in 1960 to renowned psychologist Timothy Leary, a clinical psychologist at Harvard University.
Despite the promising research and results, by the early 1970s, LSD was illegal in most countries across the world. Psychedelic research, still in its infancy, was shut down altogether. Leary went on to become one of the leading advocates of the use of psychedelic drugs in psychiatry and popularized his beliefs through several books and movements.
Nearly 70 years after Albert Hoffman first studied and popularised the effects of psychedelics, they are making a comeback.
Why Psychedelic Therapy is Gaining Popularity
The antidepressant market alone was valued at $14.3 billion in 2019. It is expected to grow exponentially in the coming years, owing to a wider acceptance and understanding of mental illnesses and their treatments. The potential to dominate the psychotherapeutic drug market is encouraging companies and organizations to seriously invest in psychedelic research.
The internet is enabling the results of research to be more transparent and attainable than ever before. This is all the more true for psychedelic research and therapy. Increased interest, combined with a wider acceptance of the use of these compounds for medical purposes, as compared to the late 1990s, and early 2000s has played a pivotal role.
Ineffectiveness of Traditional Drugs
The latest class of antidepressant and psychiatric drugs are ineffective in nearly 30 percent of the patients suffering from serious mental illnesses. Traditional antidepressants require a few months to effectively work on the receptors in the brain. With research showing that psychedelics can make a stark difference almost immediately, we are moving towards an era where these drugs may become the de-facto treatment methodology for depression and anxiety disorders.
Power of Microdosing
Microdosing refers to the act of ingesting a tiny dose of psychoactive compounds such as psilocybin, cannabis, or LSD. It triggers the therapeutic effects of the drug, without any of its disruptive effects. There is some evidence that microdosing can improve athletic performance and creativity, and may even improve mood. The concept of microdosing forms the crux of therapeutic treatments for mental illnesses.
The growing popularity of psychedelic therapy is encouraging researchers and organizations across the world to explore its potential. Hundreds of startups and centers are being established with the goal of reviving this field of research that Dr. Hoffman began more than half a century in the past.
Acceptance by Leading Research Centers
Although dozens of entities are deeply involved in cutting-edge research in the field of psychedelic therapy, a handful of research centers stand out.
Center for Psychedelic Research at Imperial College
Founded in April 2019, the Center for Psychedelic Research at London's Imperial College is one of the first of its kind. It is headed by Dr. Robin Carhart-Harris, a leading researcher in brain science with over 15 years of experience studying how drugs such as psilocybin,
LSD, MDMA, and DMT work in the brain, and how they can be harnessed to treat mental illnesses. What Dr. Carhart-Harris finds promising is that psychedelic therapy is extremely different from the traditional treatments for mental disorders.
The drugs that have dominated psychotherapy for years have barely changed since their discovery several decades in the past, and have numerous side effects on those who take them. They are more of a palliative remedy, hinging on the fact that people suffering from these diseases can only keep extreme symptoms at bay, rather than a curative one, which Dr. Carhart-Harris believes is possible with psychedelic therapy.
The Center for Psychedelic Research aims to develop a dispassionate and scientific approach to psychedelic research, to advance the scientific understanding of these compounds.
Center for Psychedelic Studies at John Hopkins
Since the mid-2000s, John Hopkins University, one of the most renowned and the oldest research universities in the United States, has shown an avid interest in the field of psychedelic research. Towards the end of 2019, the university set up a dedicated research center.
The Center for Psychedelic and Consciousness Research aims to enforce the strictest standards while studying and experimenting with one of the most controversial subjects in the world. The center currently is exploring psilocybin for the treatment of ailments ranging from smoking addiction to depression and Alzheimer's disease. Dr. Roland Griffiths heads this new facility and is an expert in the field of mood-altering drugs, having published over 400 journal articles on various subjects.
Dr. Griffith believes that research into psychoactive compounds can also help us understand how these drugs affect brain activity and shape worldviews, which can go a long way in permanent treatments.
Multidisciplinary Association for Psychedelic Studies
Also known as MAPS, the educational and research organization was founded in 1986. MAPS aims to establish a cultural, legal, as well as medical context for those who can benefit from the appropriate use of controlled psychedelics and marijuana. Having received over $70 million from sponsors and investors across the world,
MAPS is one of the leading research entities that is actively working with government organizations, such as the US Food and Drug Administration (FDA) to legalize psychedelic treatment and therapy. Their main focus is developing MDMA-assisted psychotherapy for the treatment of PTSD anxiety disorders in conjunction with the FDA. The Phase 3 trial of the treatment is expected to finish by 2021, with the possibility of approval from the FDA by as early as 2022.
Breakthroughs and Research
Decriminalization of Psychedelic Usage for Medical Purposes
Hundreds of cities in the United States are fighting to decriminalize the use of psychedelics for psychotherapy. Denver and Santa Cruz are two cities where decriminalization laws have already been passed.
At the beginning of 2020, Washington DC's district Board of Elections granted initial approval to a ballot initiative that will allow voters to decide whether plant-based compounds such as psilocybin mushrooms, ayahuasca, and peyote can be decriminalized.
This initiative does not completely legalize the use of psychedelics but rather makes the checking of possession for psychedelic compounds the lowest priority for law enforcement. Once published in the DC Register, organizers will have 180 days to collect 25,000 signatures to approve this ballot. Although there is a long way to go for the complete legalization of psychedelics, this is a promising first step towards law reform regarding psychedelics.
Matthew Johnson, a John Hopkins researcher, led a small study in 2014 to see how psilocybin could be used to treat smoking addiction. Psilocybin is the psychoactive compound in psychedelic mushrooms. The study was open-labeled, meaning that participants knew what they were getting into. The participants were prepared for what they might experience, and they were administered psychedelic treatment, in addition to cognitive-behavioral therapy to change their patterns of thinking.
After six months, it was seen that 80 percent of the smokers had stayed away from cigarettes for at least a week, a marked improvement over the 35 percent observed with other therapies. Johnson and colleagues conducted a follow-up study and reported that two-thirds of the participants had quit smoking for more than 12 months and that 60 percent has abstained from smoking for more than 16 months. A larger 5-year study of 80 people who are randomly given a nicotine patch or psilocybin is being conducted at the John Hopkins center, to show more conclusive evidence.
Although the exact reasons for how and why the psychedelic therapy worked is still unclear, the results are promising. With plans to conduct a large-scale double-blind placebo-controlled study in the future, Johnson is extremely optimistic about the future of psychedelic treatment.
The Center for Psychedelic Research at Imperial College London is currently involved in studying a large-scale clinical trial looking at depression. It compares therapy assisted with psilocybin, with that of a selective serotonin reuptake inhibitor (SSRI), which are traditional antidepressant drugs. Preliminary analyses indicate substantial improvements with psychedelic therapy, as compared to the traditional methods.
One of the most well-known studies on psilocybin looks at 51 cancer patients who had symptoms of depression and anxiety. On administering a single dose of psilocybin, there was a substantial and enduring decrease in the symptoms of anxiety and depression in the patients. An astonishing 80 percent of patients saw a clinically significant decrease in depression following 6 months of treatment.
Another extremely promising study looked at the effects of psilocybin on 12 patients suffering from moderate to severe unipolar depression that was incredibly difficult to treat. Symptoms of depression were then regularly assessed from 1 week to 3 months post-treatment.
A marked reduction in depressive symptoms was observed compared to the baseline, in addition to sustained improvements in anxiety levels. The study, however, did not have a control group, and only serves as a support for more rigorous and thorough trials.
Another piece of research headed by Dr. Robert Carhart-Harris indicates that psilocybin can help 'reset' the brains of individuals suffering from difficult-to-treat depression, and help them overcome self-destructive and rigid thinking patterns.
Some leading researchers suggest that there is evidence of psychedelic-assisted therapy aiding with the improvement of psychological flexibility. Psychological flexibility refers to an individual's ability to stay in the present and manage their emotions and feelings.
One such study surveyed more than 2000 individuals who had previously used some sort of psychedelics, such as DMT, LSD, or psilocybin (from psychedelic mushrooms). Nearly 45% of these individuals said that their psychedelic experience resulted in a change to their anxiety levels and depression. The researchers understood from the survey that these experiences helped people obtain meaningful insights into their life and that they tended to report about increased psychological flexibility following the experience.
As mentioned in the study related to depression, psilocybin is known to affect two key regions of the brain - the amygdala, and the default-mode network. The amygdala plays a crucial role in how humans process emotions such as anxiety and fear. Psilocybin tamps down the activity of the amygdala, thereby lowering the feelings of anxiety in an individual.
MAPS, as mentioned previously, is one of the foremost organizations that is mainly focused on using psychedelics, specifically MDMA, for the treatment of PTSD. In current trials, the treatment protocol involves a 12-week course of therapy with trained specialists.
Patients are administered MDMA in calibrated amounts for two or three-day sessions. Talk-therapy then follows when the effects of the drug wear off, allowing patients to process impressions and thoughts that came up under the influence of the compound.
Colorado-based psychologist, Saj Razvi, one of the clinical investigators in the Phase 2 trials, explains that MDMA allows an individual to get in touch with sensations and feelings in a much more direct and clear manner.
He goes on to state that although how MDMA works on the brain is not exactly understood, It is known to boost the production of oxytocin and serotonin, which play a critical role in mood regulation. Similar to psilocybin, it also reduces the activity of the amygdala, the fear-processing unit of the brain, which may strengthen feelings of social connection and safety. Patients can then revisit past traumatic experiences and unravel them without panicking.
One of the most encouraging studies by MAPS showed that 54 percent of the patients who took part in the trial had seen improvements to the point that they no longer could be classified as having PTSD. This was more than double the control group, which stood at 23 percent.
Surprisingly, the beneficial effects only seemed to increase over time, with 68 percent of patients no longer having PTSD after a year. The results were astonishing due to the fact that patients rarely go into remission from PTSD even with some of the best traditional drug regimens.
We are definitely in an interesting time where medicinal uses of psychedlics, marijuana and CBD are gaining mainstream acceptance.
The potential of psychedelic therapy is finally being explored and studied after a 50-year hiatus. Although the research shows incredible promise and results, it is not without limitations. Psychedelic treatment is not for everyone and must be avoided for those who already struggle with addiction to these drugs.
The main challenges are with regard to laws and policies of countries that continue to classify these compounds as harmful, without taking into account its medical abilities. Additionally, the process of getting drugs approved by governmental bodies is notoriously expensive, slow, and bureaucratic.
Despite these challenges, the future of psychotherapy is proving to be extremely exciting and promising. Only time will tell if the potential and hype for psychedelic therapy will come to fruition.